A descriptive study of a manual therapy intervention within a randomised controlled trial for hamstring and lower limb injury prevention

Abstract

BackgroundThere is little literature describing the use of manual therapy performed on athletes. It was our purpose to document the usage of a sports chiropractic manual therapy intervention within a RCT by identifying the type, amount, frequency, location and reason for treatment provided. This information is useful for the uptake of the intervention into clinical settings and to allow clinicians to better understand a role that sports chiropractors offer.MethodsAll treatment rendered to 29 semi-elite Australian Rules footballers in the sports chiropractic intervention group of an 8 month RCT investigating hamstring and lower-limb injury prevention was recorded. Treatment was pragmatically and individually determined and could consist of high-velocity, low-amplitude (HVLA) manipulation, mobilization and/or supporting soft tissue therapies. Descriptive statistics recorded the treatment rendered for symptomatic or asymptomatic benefit, delivered to joint or soft tissue structures and categorized into body regions. For the joint therapy, it was recorded whether treatment consisted of HVLA manipulation, HVLA manipulation and mobilization, or mobilization only. Breakdown of the HVLA technique was performed.ResultsA total of 487 treatments were provided (mean 16.8 consultations/player) with 64% of treatment for asymptomatic benefit (73% joint therapies, 57% soft tissue therapies). Treatment was delivered to approximately 4 soft tissue and 4 joint regions each consultation. The most common asymptomatic regions treated with joint therapies were thoracic (22%), knee (20%), hip (19%), sacroiliac joint (13%) and lumbar (11%). For soft tissue therapies it was gluteal (22%), hip flexor (14%), knee (12%) and lumbar (11%). The most common symptomatic regions treated with joint therapies were lumbar (25%), thoracic (15%) and hip (14%). For soft tissue therapies it was gluteal (22%), lumbar (15%) and posterior thigh (8%). Of the joint therapy, 56% was HVLA manipulation only, 36% high-HVLA and mobilization and 9% mobilization only. Of the HVLA manipulation, 63% was manually performed and 37% mechanically assisted.ConclusionsThe intervention applied was multimodal and multi-regional. Most treatment was for asymptomatic benefit, particularly for joint based therapies, which consisted largely of HVLA manipulation techniques. Most treatment was applied to non-local hamstring structures, in particular the knee, hip, pelvis and spine.

High hamstring tendinopathy in 3 female long distance runners

“…1,11,14 Graston Instrument Assisted Soft Tissue Mobilization (GRASTON) is thought to create a local inflammatory response, augmenting the production of fibroblasts and therefore promoting healing of the injured tissue. 15,16 Once an inflammatory response has been initiated, controlled load to the musculotendinous structure, in the form of exercise, can help restore tensile strength. 14 Trigger point therapy may also be effective for treating active trigger points distal from the site of tendinopathy.…”

Sports chiropractic management at the World Ice Hockey Championships

“…This corresponded to an average of 1.54 procedures per treatment consultation, suggesting closer to a unimodal style of practice, not multimodal as was performed in this study. Based on this limited literature available from both professions, it would suggest the treatment techniques, modalities and style of practice differ between sports chiropractors and sports physiotherapists, with manual therapies and HVLA manipulation being more prominent in chiropractic [ 20 ]. However, comparative research is required to further assess this.…”

Retraction Note: a descriptive study of a manual therapy intervention within a randomised controlled trial for hamstring and lower limb injury prevention

“…The journal has been informed by its publisher BioMed Central that contrary to the statement in this article [ 1 ], they have been advised by the authors' institution Macquarie University, that its Human Research Ethics Committee did not approve this study. Because the study was conducted without institutional ethics committee approval it has been retracted.…”