Journal of Traditional Medical Complementary Therapies

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Sağlıklı Kişilerde Lomber Vertebralar (L2-L3-L4) Üzerine Yüksek Hızlı Düşük Amplitüdlü Tekniği ile Yapılan Kayropraktik Manipülasyonun Hamstring ve Kuadriseps Kas Gücü Üzerine Olan Etkisinin Değerlendirilmesi: Deneysel Çalışma
Evaluation of the Effect of Chiropactic Manipulation with High Velocity Low Amplitude Technique on Lumbar Vertebras (L2-L3-L4) in Healthy Persons on Hamstring and Quadriceps Muscle Strength: Experimental Study
Zülal ATEŞOĞLUa , Ali Veysel ÖZDENb , Mehmet Kaan ALTUNOKc , Sefa Haktan HATIKd , Fırat DEMİRa , Celaleddin BİLDİKe , Mehmet ÜNALe
aSerbest Hekim, İstanbul, Türkiye
bBahçeşehir Üniversitesi Sağlık Bilimleri Fakültesi, Fizyoterapi ve Rehabilitasyon Bölümü, Ankara, Türkiye
cSelçuk Üniversitesi Sağlık Bilimleri Fakültesi, Fizyoterapi ve Rehabilitasyon Bölümü, Konya, Türkiye
dSinop Üniversitesi Türkeli Meslek Yüksekokulu, Sağlık Bakım Hizmetleri Bölümü, Sinop, Türkiye
eİstanbul Yeni Yüzyıl Üniversitesi Sağlık Bilimleri Fakültesi, Fizyoterapi ve Rehabilitasyon Bölümü, İstanbul, Türkiye
J Tradit Complem Med. 2023;6(3):237-45
doi: 10.5336/jtracom.2023-96474
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmada, sağlıklı kişilerde lomber vertebralar (L2-L3-L4) üzerine Yüksek Hızlı Düşük Amplitüdlü [High Velocity Low Amplitude (HVLA)] tekniği ile yapılan kayropraktik manipülasyonun (KM) hamstring ve kuadriseps kas gücü üzerine olan etkisi değerlendirildi. Gereç ve Yöntemler: Gönüllü ve sağlıklı 54 birey, KM ve sham gruplarına ayrıldı. Katılımcıların ölçüm ve testleri 24 saat arayla olmak üzere toplam 2 kez tekrarlandı. KM grubunun L2- L3-L4 vertebralarına kayropraktik HVLA teknikleri uygulanırken, sham grubunda pozisyonlama yapılıp herhangi bir itme manevrası uygulanmamıştır. Her iki grubun da uygulama öncesi ve sonrası; gonyometrik ölçümler ve Schober testi ile lomber bölge eklem hareket açıklığı, izokinetik dinamometre (CSMI HumacNorm) ile kuadriseps ve hamstring kas kuvveti ölçüldü. Katılımcıların cihazı denemeleri ve anlamaları için test seçeneği aktifleştirilerek iki tekrar ayarlanıp protokol kaydedildi. Bulgular: KM grubunda incelenen bütün değişkenlerde tedavi sonrası tedavi öncesine göre istatistiksel olarak anlamlı artışlar tespit edilirken (p<0,05); kontrol grubunda gövde fleksiyonu ve ekstansiyonu açı değeri, Schober testi, hamstring-sol 60°/sn ve hamstring-sol 240°/sn açısal hızda kas kuvveti hariç anlamlı farklılık görülmedi (p>0,05). KM grubunda düz bacak kaldırma [straight leg raise (SLR)]-sağ, SLR-sol, Schober, kuadriseps-sağ 60°/sn, kuadriseps-sol 60°/sn, kuadriseps-sağ 240°/sn, kuadriseps-sol 240°/sn, hamstring-sağ 60°/sn, hamstring-sağ 240°/sn parametrelerinde, kontrol grubuyla kıyaslandığında tedavi sonrası tedavi öncesine göre anlamlı artış olduğu tespit edildi (p<0,05). Sonuç: Kuadriseps ve hamstring kas kuvveti üzerindeki olumlu etkinin diz eklemini koruyarak olası yaralanmaları önleyebileceği, lomber eklem hareket açıklığındaki artışın ve sağlıklı vertebra diziliminin omurga dejenerasyonunu geciktirebileceği kanısına varılmıştır.

Anahtar Kelimeler: Kayropraktik; manipülasyon; lomber vertebra; kas gücü; eklem hareket açıklığ
ABSTRACT
 Objective: The effect of chiropractic manipulation with high velocity low amplitude (HVLA) technique on lumbar vertebrae (L2-L3-L4) on hamstring and quadriceps muscle strength in healthy subjects was evaluated. Material and Methods: Fifty four volunteers and healthy individuals were divided into chiropractic manipulation and sham groups. Measurements and tests of the participants were repeated twice, 24 hours apart. Chiropractic HVLA techniques were applied to the L2-L3-L4 vertebrae of the chiropractic manipulation group, while positioning and no pushing maneuvers were applied in the sham group. Before and after the application of both groups; lumbar range of motion was measured with goniometric measurements and Schober test, and quadriceps and hamstring muscle strength were measured with isokinetic dynamometer (CSMI Humac-Norm). Results: While statistically significant increases were detected after treatment compared to pre-treatment in all variables examined in the chiropractic manipulation group (p<0.05); there was no significant difference in the control group except for muscle strength in trunk flexion and extension angle value, Schober test, hamstring-left 60°/sec and hamstring-left 240°/sec angular velocity (p>0.05). In the chiropractic manipulation group, straight leg raise (SLR)- right, SLR-left, Schober, quadriceps-right 60°/sec, quadriceps-left 60°/sec, quadriceps-right 240°/sec, quadriceps-left 240°/sec, hamstring-right 60°/sec, hamstring- there was a significant increase in the right 240°/sec parameters after the treatment compared to the control group (p<0.05). Conclusion: It has been concluded that the positive effect on quadriceps and hamstring muscle strength can prevent possible injuries by protecting the knee joint, increase in lumbar joint range of motion and healthy vertebral alignment can delay spinal degeneration.

Keywords: Chiropractic; manipulation; lumbar vertebra; muscle strength; range of motion
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