Doctor of Philosophy
University of Wollongong. Dept. of Biomedical Science
Pollard, Henry P., The effect of chiropractic manual therapy on the spine, hip and knee, Doctor of Philosophy thesis, University of Wollongong. Dept. of Biomedical Science, University of Wollongong, 2000. http://ro.uow.edu.au/theses/1097
This thesis examined the effect of commonly used manual therapy protocols on the range of motion (ROM) of the hip joint. The first study compared two hip manual therapy treatments for increasing ROM at the hip and lumbar spine. 57 chronic back pain sufferers between 18 and 40 years voluntarily entered a randomised clinical trial with three groups of hip treatment (manipulation, stretching and control). Only the manipulation group increased the hip ROM significantly when compared to control. Also, manipulation of the hip was associated with significantly less back pain than the other group when compared to the control. Neither experimental group was significantly different to the control for changing lumbar ROM. The second study investigated the effect of manual therapy treatment on chronic knee pain and hip ROM in 57 subjects (between 47 and 70 years) with knee osteoarthritis. The results showed that manual therapy significantly decreased the short term pain reported by subjects, but the treatment did not change the hip ROM. The third study compared the effectiveness of an upper cervical manipulation or a manipulation of the sacroiliac joint for increasing hip ROM in 52 healthy university students. The results demonstrated that the two manipulation treatments resulted in increased ROM at the hip, but only the cervical procedure significantly increased hip ROM. The fourth study used similar methodology to the third to compare the effect of a sub occipital stretching technique to a hamstring stretching technique in 60 healthy university students. I have demonstrated that the two stretching treatments both increased hip ROM but only the spinal group was significant. The fifth study found that a group of healthy students receiving manipulation to the L3/4 motion segment statistically increased short term quadriceps femoris muscle strength. Taken together, these results help to document for the first time the effect of several clinical protocols used by manual therapists to increase the ROM at the hip joint. I conclude that: manipulation of the hip should be considered in protocols trying to achieve increased hip ROM, and that treatment of the spine demonstrated an improvement in peripheral joint function of the hip.