The effect of cervical spine manipulation on elbow joint position sense in patients with acute cervical facet syndrome

M.Tech. (Chiropractic)Many studies have shown the effects of treatment of the cervical spine on body parts distal to the spine itself, which are linked, anatomically, biomechanically and neurologically. However, proprioception and its role on postural control mechanisms distant to the spine, is a field that has not been well researched. A method that has been developed to evaluate proprioception is joint position sense accuracy, which to date has been well researched on various pain conditions of the cervical spine. However the effect of cervical spine conditions distant to the spine has not been well researched. The purpose of this study was to determine the short to medium term effect of cervical spine manipulative therapy (SMT) compared to ultrasound therapy delivered to acute cervical facets on position sense of the upper limb by evaluating joint position sense accuracy of the elbow. It has been well researched that chiropractic manipulative therapy does not only improve cervical spine range of motion (Purvis, 1991), but also reduces neck pain (Herzog, Scheele and Conway, 1999). This study therefore illustrates that cervical spine manipulative therapy improves not only cervical spine pain and function but may further help us understand the vertebral subluxation complex and its effects on the nervous system in terms of improving upper limb proprioception.A random sample of thirty participants, between the ages of eighteen and fifty participants presenting with acute cervical facet syndrome volunteered for this study; the participants were examined and accepted according to the inclusion and exclusion criteria. The method of treatment administered to each participant was determined by group allocation. Group A received cervical spine manipulation delivered to the acute cervical facet joint and Group B received ultrasound therapy of the acute cervical facet joint. The acute cervical facet joints were located using Kemps test. Restrictions of the acute facet were assessed by motion palpation for hypomobile joint dysfunction