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The difference on weight bearing asymmetry in the frontal plane by treating the upper cervical spine with HVLA- Thrust or Strain/Counterstrain

Journal: Unpublished MSc thesis Wiener Schule für Osteopathie, Date: 2009/11, Pages: 60, type of study: controlled clinical trial

Free full text   (https://www.osteopathicresearch.org/s/orw/item/2914)

Keywords:

upper cervical spine [3]
strain and counterstrain [24]
high velocity - low amplitude technique [8]
WSO [433]
pretest posttest design [108]

Abstract:

Study Design: A matched, pre- and post-test experimental design with three measurements. Outline/Problem Definition Visual, vestibular and sensorimotor afferences are needed for the regulation of balance. A functional disorder of the cervical spine can lead to an impaired vestibulo-spinal reaction ability. It is observed, that these subjects lose their ability to distribute weight evenly in the frontal plane in upright, still bipedal standing. This weight bearing asymmetry (WBA) is considered pathogenic if the weight bearing difference exceeds 4 kg under the feet. It was shown that the postural stability decreases in the quiet upright standing if the WBA increases. Research Question & Objective Osteopathic treatment for these functional cervical disorders aims at the increase of postural stability. The question is, how effective are the used techniques. Hypothesis The Strain/Counter-strain technique and the HVLA-thrust technique, applied to the upper cervical spine with a functional disorder, produce the same effect for the WBA. Relevance for the Patients Some patients had a bad experience with a HVLA- technique; they are often afraid and have a high muscle tone during treatment. Relevance for Osteopathy Is it necessary to take the risk of complications from an HVLA-thrust technique if there is an alternative. Methodology The subject group consisted of 60 patients, only female. The most important inclusion criterion was that the subject had a WBA of more than 4 kg in the two-scale test. The age of the subjects ranged from 21 to 42 years. The subjects were devided into a control group (n=20) and two intervention groups (HVLA-technique and Strain/Counterstrain). A two-scale test was used to measure the influence of upper cervical spine treatment on the WBA pre- and post-treatment and two weeks later. The two-scale test measures the ability of the subject to distribute the weight evenly on both feet. Results Parametrical tests (variance analysis) and non-parametrical tests (Kruskal-Wallis-Test) verified whether the treatment as the independent variable has a significant effect on the WBA as the dependent variable. In the control group there was no significant change in the two-scale test (p>0.05). After the treatment (2nd measurement) the intervention groups differed significantly from the control group (p=0.0001). This difference remains after 2 weeks (3rd measurement). We can conclude that the treatment with the Strain/Counterstrain technique and the HVLA-Thrust technique bring sustainable results. However the HVLA-Thrust technique even shows another significant improvement in the measurement repetition between the second and third measurement. It can be seen as the more effective treatment procedure. The Strain/Counterstrain technique and the HVLA-Thrust technique don’t have the same effect. Critical Reflection/Perspectives/Conclusions: This leads to the conclusion that the treatment of the upper cervical spine with strain/counterstrain and HVLA-thrust technique both bring good results. Even though the HVLA-thrust technique has the stronger effect, the strain/counterstrain technique can be an alternative if one wants to reduce the risk for the patient.


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