The effect of chiropractic cervical spine adjustment on cervical range of motion, beyond the direct

129 Pages·2013·2.22 MB·English

by  Glen James Paton

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How to cite this thesis
Surname, Initial(s). (2012) Title of the thesis or dissertation. PhD. (Chemistry)/ M.Sc. (Physics)/
M.A. (Philosophy)/M.Com. (Finance) etc. [Unpublished]: University of Johannesburg. Retrieved
from: https://ujdigispace.uj.ac.za (Accessed: Date).
THE EFFECT OF CHIROPRACTIC CERVICAL SPINE ADJUSTMENT ON
CERVICAL RANGE OF MOTION, BEYOND THE DIRECT EFFECT OF
CAVITATION

A dissertation submitted to the Faculty of Health Sciences, University of Johannesburg, as
partial fulfilment for the Masters degree in Technology, Chiropractic by

Glen James Paton
Student number: 200711491

Supervisor:
Dr. C. Bester Date
DECLARATION
I, Glen James Paton, declare that this dissertation is my own work both in conception and
execution, except where otherwise indicated. It is being submitted in partial fulfilment for
the Masters Degree in Technology, in the course Chiropractic at the University of
Johannesburg. It has not been submitted before for any Degree or exam at any other
Technikon or University.

Signature of Candidate: ____________________________

Date: _________________

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AFFIDAVIT
TO WHOM IT MAY CONCERN

This serves to confirm that I _____________________________________________

ID number____________________________________________________________

Student number________________________________ enrolled student for the

Qualification________________________________________________________

Faculty____________________________________________________________

I herewith declare that my academic work is in line with the Plagiarism Policy of the
University of Johannesburg. I further declare that the work presented in: THE EFFECT OF
CHIROPRACTIC CERVICAL SPINE ADJUSTMENT ON CERVICAL RANGE OF
MOTION, BEYOND THE DIRECT EFFECT OF CAVITATION (minor dissertation) is
authentic and original, and that there is no copyright infringement in the work. I declare that
no unethical research practices were used or material gained through dishonesty. I
understand that plagiarism is a serious offence.
Signed at_____________________________on this _________________day of 2013.

_______________________________ ______________________________
Signature Print name

STAMP COMMISSIONER OF OATHS
Affidavit certified by a Commissioner of Oaths
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DEDICATION
I dedicate this work to my family and friends who have supported me through this
incredible journey.
To my parents, who have supported me through the years. This would not be possible
without all your efforts to help me realise my full potential. Thank you from the bottom of
my heart.
To my brother, Ian, thank you for support and practice needed to reach my goal.
To my Girlfriend, Nicole, thank you for all the support you have given me and words of
encouragement throughout this process. Words can‟t describe my appreciation.

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ACKNOWLEDGMENTS

To my supervisor, Dr. Charmaine Bester: Thank you for your guidance, effort and
willingness to help me on this journey. Your efforts and contribution to the profession are
greatly appreciated.
To Statkon: Dr. Becker and Julia Van Staden. Thank you for your assistance with the
statistical side, without you both I would have been lost.
To all the participants, without your help this work would not be possible, your participation
is highly appreciated.

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ABSTRACT
Purpose: This study aims to ascertain the extent Chiropractic manipulative therapy
increases ROM beyond the joint-separation induced ROM initially experienced via the
cavitation phenomenon in the absence of neck pain.
Method: Sixty participants between eighteen and thirty-five years of age, thirty male and
thirty female whom met the inclusion of no neck pain and perceived decreased ROM were
selected for participation. There was a single group with each participant‟s pre-adjustment
readings acting as a baseline.
Procedure: Participants were assessed for hypomobility and joint dysfunction. Those who
met the inclusion criteria underwent a detailed history, physical and cervical spine regional
examination on the initial consult. A pre-adjustment objective measurement was acquired
using a cervical spine range of motion (CROM) device.
Once the consent form was signed participants received Chiropractic cervical spine
manipulative therapy to the area/s of the cervical spine found to be restricted on motion
palpation by the researcher. Post-adjustment objective measurements were taken at one,
twenty, forty and sixty minutes using the CROM device. Participants were required to
remain in the researcher‟s examination room for 60 minutes post-adjustment with
continuation of regular day to day activity and no strenuous activity during the twenty-four
hour period of the study. The participant was required to return for a single follow up visit
within a time frame of twenty-four hours of the initial visit.
The follow-up visit required no treatment. At twenty-four hours, the participant was
objectively measured for cervical spine ROM using the CROM. The results were based on
objective data in the form of cervical spine ROM measurements.
Results: Clinical analysis of the percentage change in cervical spine ROM values revealed
that clinically and statistically significant improvement was seen in all ranges of motion
post-adjustment. General consensus showed that a peak value of improved ROM was
seen post-adjustment at the one minute interval for all ranges of motion except flexion.
Flexion demonstrated a peak ROM value at the twenty minute post-adjustment interval.
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With the exception of flexion all other ranges of motion demonstrated a decrease in ROM
at the twenty minute interval (interval 4). The general trend was that ROM fell for all ranges
of motion at the twenty-four hour post-adjustment interval as compared to the one minute
post-adjustment interval but importantly all ranges of motion maintained increased ROM as
compared to the baseline data.
Conclusion: The space occupying intra-articular gas phenomenon known as cavitation
contributed to increased ROM but is not the only or significant contributor. Up to 16.76% of
the initial ROM gained post-adjustment is hypothesized to be attributed to cavitation.
The results showed that the indirect/ extra-articular effects of the Chiropractic adjustment
are likely to be the main source of ROM gain. Chiropractic manipulative therapy increased
ROM for twenty-four hours after a single intervention as compared to the baseline data.

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TABLE OF CONTENTS
TITLE
PAGE.....................................................................................................................................i
DECLARATION....................................................................................................................ii
AFFIDAVIT...........................................................................................................................iii
DEDICATION.......................................................................................................................iv
ACKNOWLEDGEMENTS.....................................................................................................v
ABSTRACT..........................................................................................................................vi
TABLE OF
CONTENTS........................................................................................................................viii
LIST OF
FIGURES............................................................................................................................xiv
LIST OF
TABLES.............................................................................................................................xvi
LIST OF
APPENDICES..................................................................................................................xviii

1 INTRODUCTION
1.1 General
Introduction...............................................................................................1
1.2 Aim of the
Research....................................................................................................1
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1.3 Benefit of the
Research....................................................................................................1

2 LITERATURE REVIEW
2.1 Anatomy.....................................................................................................2
2.2 The Cervical
Spine..........................................................................................................2
2.2.1 Typical
vertebrae.......................................................................................2
2.2.2 Atypical
vertebrae.......................................................................................3
2.2.3 Facet joints of the cervical
vertebrae.......................................................................................5
2.2.4 Intervertebral
disc................................................................................................5
2.2.5 Uncovertebral
joint...............................................................................................6
2.3 Biomechanics of the Cervical
Spine..........................................................................................................6
2.3.1 Biomechanics of the upper cervical
spine..............................................................................................6
2.3.2 Biomechanics of the of the lower cervical
spine............................................................................................10
2.3.3 Coupled motion of the lower cervical
spine............................................................................................11
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