Abstract

Background: Low back pain (LBP) affects a significant amount of Americans and results in significant healthcare costs, annually. Currently, evidence supports that manual therapy can have a positive effect on patients suffering from LBP; however, a majority of the outcome measures are subjective and few are objective. Presently, potential changes in gait mechanics in response to manual therapy in patients with LBP have not been investigated. Gait analysis may provide more objective outcome measures when studying the effects of manual therapy in patients with LBP. Purpose: For part I, the aim is to investigate the effects of manual therapy on the pain, function, motion/mobility, and muscle activation in individuals with non-specific LBP. For part II, the aim is to investigate any potential link between changes in gait with LBP, including spinal and pelvic motions during normal gait, muscle activation in gait, and connections with non-specific LBP and gait. Methods: An extensive and comprehensive evidence based literature search was conducted using four different databases which included PubMed®, CINAHL Plus, Cochrane, and ISI Web of KnowledgeSM. For part I, a thorough literature search for studies related to the effects of manual therapy on individuals suffering from LBP was conducted. For part II, a detailed evidence based search for studies related to the low back, or LBP and potential changes or connections to gait was conducted. Following the database searches, the pool of articles were reviewed for topic relevance, power, validity, study design, and accessibility and placed in subgroupings according to topic. Thirteen articles for part I, and twelve articles for part II were ultimately best suited to answer the clinical question, and were then thoroughly reviewed, analyzed and discussed. Results: Inpart I, evidence findings report both significant and non-significant results regarding decreased pain following manual therapy treatment. Also, findings report significant ll:nprovements in function and/or mobility, significant improvement in disability, and significant changes in EMG activity after manual therapy. Inpart II, evidence findings report various significant changes in lumbar spine and pelvic motions with modification of walking speed in "normal" subjects without LBP. Further findings report significantly higher values of erector spinae activity in LBP subjects in double support and swing phases of gait, and that LBP subjects have higher pelvic asymmetry compared to controls in standing. Discussion/Conclusion: Inpart I, evidence findings report both significant and non-significant results regarding decreased pain following manual therapy treatment. Findings also report significant improvements in function and/or mobility, significant improvement in disability, and significant changes in EMG activity after manual therapy. Inpart II, evidence findings report various significant changes in lumbar spine and pelvic motions with modification of walking speed in "normal" subjects without low back pain. Further findings report significantly higher values of erector spinae activity in LBP subjects in double support and swing phases of gait, and that LBP subjects have higher pelvic, asymmetry compared to controls in standing. Therefore, it is believed to be worthwhile to include gait analysis as an objective measure in conjunction with manual therapy in patients suffering from non-specific LBP.

Provenance

Submitted by Dyanna Monahan (dmonahan@salud.unm.edu) on 2014-04-21T21:54:00Z No. of bitstreams: 1 2012-1.pdf: 12897564 bytes, checksum: 6a95e78f85a6df38b474c691a6f4eff1 (MD5), Made available in DSpace on 2014-04-21T21:54:00Z (GMT). No. of bitstreams: 1 2012-1.pdf: 12897564 bytes, checksum: 6a95e78f85a6df38b474c691a6f4eff1 (MD5)

Document Type

Capstone

Keywords

lower baack pain, gait, manual therapy

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