Ultrasound guided joint space distance changes during manual traction of acromioclavicular joint in young and healthy adults

Abstract

Abstract Introduction: Manual traction is a commonly used technique in manual therapy. However, depicting changes in joint space distance via real time imaging during traction is seldomly applied. The aims of the study were to identify ACJ joint space distance changes during manual traction and creation of a classification of the techniques upon the largest change in the resultant parameter (l) representing joint space distance. Material and methods: Thirteen healthy volunteers were examined unilaterally. Acromioclavicular joint space distance changes were measured with dynamic ultrasound imaging during followingmanual traction techniques: International Academy of Orthopedic Medicine technique (IAOM AC), Karel Lewit’s Prague School of Manual Medicine & Rehabilitation technique (LAC) and author’s own proposition (B AC). The differences in joint space distance between resting position (RP) and the traction technique position, created three parameters of displacement - horizontal (x), vertical (y) and (l) - the resultant component. Results: Parameters were not coherent with normal distribution. Statistical differences showed significance in the (x) parameter for IAOM AC compared with L AC (p<0,0183) and B AC (p<0,02). All techniques presented a significant increase of the resultant distance (l), compared with RP as the reference value - IAOM AC p<0,0036, L AC and B AC p<0,0000. In few cases L AC decreased the distance in the (x) parameter, but not significantly. Conclusions: 1.Significant changes of (x) parameter did not correspond with the significance of the resultant parameter (l), which prevented authors from creating a classification of the techniques. 2.All traction techniques used in the study increased the joint space distance compared to RP, which confirms traction’s theoretical assumptions. 3.For clinical purpose the change of (x) parameter may prove crucial for therapy’s effectiveness, despite lack of change in the joint space distance in the resultant parameter (l) by itself.