M.Sc PHYSICAL THERAPY THESIS (2010).doc (original) (raw)

Vertical Oscillatory pressure (VOP) is a technique of spinal manual therapy in physiotherapy, that has been documented to be the simplest and most versatile for the treatment of candidates indicated for manipulation (Nwuga, 1990). Several studies have shown that VOP has significant effect on pain intensity, mobility of the spine and cardiovascular system in patients with dysfunctions of the spine. However, its effect on the respiratory system during its application is less researched into. This study examined the effect of VOP on pain intensity and some respiratory variables in patients with cervical spondylosis. Thirty subjects with neck pain were in the experimental group while 30 individuals without neck pain were in the control group. Their ages ranged between 27 and 77 years. Vertical oscillatory pressure was applied on a pre-identified painful vertebra in prone position while taking the respiratory variables (vital capacity and respiratory rate). Severity of pain was assessed using a 10-point standard Borg scale before, during and after VOP. The researcher’s applied force on the spine was monitored by calculating the difference between the body weights during application of VOP and before VOP. The control group’s respiratory variables (vital capacity and respiratory rate) were also monitored before, during and after VOP. However the control groups were asymptomatic of pain hence standard Borg scale was not used for them. The result showed that vertical oscillatory pressure had no statistical significant effect (P>0.05) on respiratory rate of subjects with neck pain. VOP had statistical significant effect (p< 0.05) on respiratory rate of the control group. There was also statistical significant effect of VOP (P<0.05) on respiratory rate of the experimental when compared to the apparently healthy controls. The result further showed that vertical oscillatory pressure had statistical significant effect (p< 0.05) on vital capacity of subjects with neck pain. VOP had statistical significant effect on vital capacity of the control group. There was no statistical significant effect of VOP (P> 0.05) on vital capacity of the experimental when compared to the apparently healthy controls. Furthermore, the result showed that VOP had statistical significant effect (p< 0.05) on pain intensity of subjects in the experimental group. Furthermore, the result showed there was no statistical significant difference in the force applied (p> 0.05) between the experimental and the apparently healthy controls. Furthermore, the result showed that there were no significant correlation between force applied by the researcher and subjects’ age(r=0.08, p>0.05), body weight(r= 0.16, p>0.05), height(r=-0.10, p>0.05) and body mass index(r=0.19, p>0.05). Furthermore, result of the multiple regression analysis revealed that all the predictor variables (age, height, weight, body mass index) measured in this study accounted for 7.2% of the variability of the applied force. This implies that the remaining 92.8% not accounted for are due to the effects of other factors not included in the equation. The implication of this is that age and anthropometric parameters cannot accurately predict force required during application of VOP without significant errors. This study concluded that vertical oscillatory pressure relieved neck pain (decreased from moderate pain to very mild pain) with a significant increase in vital capacity and no significant increase in respiratory rate of patients with cervical spondylosis. This implies that vertical oscillatory pressure may be a safe treatment for neck pain in patients with cervical spondylosis. It may also be beneficial in the presence of mildly/moderately decreased vital capacity measurement resulted from phrenic nerve involvement (C3- C5 supplying diaphragm) in patients with cervical spondylosis.