Original Research

Comparison between high-velocity low-amplitude manipulation and muscle energy technique on pain and trunk neuromuscular postural control in male workers with chronic low back pain: A randomised crossover trial

Leandro A. Sturion, Alexandre H. Nowotny, Fabrice Barillec, Gilles Barette, Gabriela K. Santos, Fellipe A. Teixeira, Karen P. Fernandes, Rubens da Silva
South African Journal of Physiotherapy | Vol 76, No 1 | a1420 | DOI: https://doi.org/10.4102/sajp.v76i1.1420 | © 2020 Leandro A. Sturion, Alexandre H. Nowotny, Fabrice Barillec, Gilles Barette, Gabriela K. Santos, Fellipe A. Teixeira, Karen P. Fernandes, Rubens da Silva | This work is licensed under CC Attribution 4.0
Submitted: 13 December 2019 | Published: 26 October 2020

About the author(s)

Leandro A. Sturion, Programs in Rehabilitation Sciences UEL/UNOPAR, LAFUP-UNOPAR, Faculty of Physical therapy, Universidade Pitagoras, Londrina, Brazil
Alexandre H. Nowotny, Programs in Rehabilitation Sciences UEL/UNOPAR, LAFUP-UNOPAR, Faculty of Physical therapy, Universidade Pitagoras, Londrina, Brazil
Fabrice Barillec, Département des Thérapie Manuelle, Gilles Barette Formations, Saint Cyr du Ronceray, Valorbiquet, France
Gilles Barette, Département des Cadre de santé-kinésithérapeute, Thérapie Manuelle, Gilles Barette Formations, Valorbiquet, France
Gabriela K. Santos, Programs in Rehabilitation Sciences UEL/UNOPAR, LAFUP-UNOPAR, Faculty of Physical therapy, Universidade Pitagoras, Londrina, Brazil
Fellipe A. Teixeira, Escuela de Osteopatia de Madrid, Parque Taquaral, Campinas, Brazil
Karen P. Fernandes, Programs in Rehabilitation Sciences UEL/UNOPAR, LAFUP-UNOPAR, Faculty of Physical therapy, Universidade Pitagoras, Londrina, Brazil
Rubens da Silva, Programs in Rehabilitation Sciences UEL/UNOPAR, LAFUP-UNOPAR, Faculty of Physical therapy, Universidade Pitagoras, Londrina, Brazil; and, Département des sciences de la santé, Lab BioNR, CUpht, Université du Québec à Chicoutimi (UQAC), Saguenay, Québec, Canada


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Abstract

Background: A therapeutic recommendation for restoring function in individuals with chronic low back pain (CLBP) is manual therapy through manipulative spinal or muscle energy techniques.

Objectives: To compare the effectiveness of two osteopathic manipulative techniques on clinical low back symptoms and trunk neuromuscular postural control in male workers with CLBP.

Method: Ten male workers with CLBP were randomly allocated to two groups: high-velocity low-amplitude (HVLA) manipulation or muscle energy techniques (MET). Each group received one therapy per week for both techniques during 7 weeks of treatment. Pain and function were measured by using the Numeric Pain-Rating Scale, the McGill Pain Questionnaire and the Roland Morris Disability Questionnaire. The lumbar flexibility was assessed by Modified Schober Test. Electromyography (EMG) and force platform measurements were used for evaluation of trunk muscular activation and postural balance, respectively at three different times: baseline, post intervention, and 15 days later.

Results: Both techniques were effective (p < 0.01) in reducing pain with large clinical differences (-1.8 to -2.8) across immediate and after 15 days. However, no significant effect between groups and times was found for other variables, namely neuromuscular activation and postural balance measures.

Conclusion: Both techniques (HVLA thrust manipulation and MET) were effective in reducing back pain immediately and 15 days later. Neither technique changed the trunk neuromuscular activation patterns nor postural balance in male workers with LBP.

Clinical implications: These results may facilitate clinical decision-making for CLBP management in physiotherapy programs.


Keywords

low back pain; osteopathic manipulative treatment; high-velocity low-amplitude; muscle energy; electromyography; postural balance; physiotherapy; biomechanics

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