To compare the effectiveness of two osteopathic techniques, muscle energy (met) and inhibition, directed at the iliopsoas muscle (IP), on hip extension. Design




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НазваниеTo compare the effectiveness of two osteopathic techniques, muscle energy (met) and inhibition, directed at the iliopsoas muscle (IP), on hip extension. Design
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Participant Information Sheet


Study Title

A comparison between two osteopathic techniques, MET and inhibition, carried out on the iliopsoas muscle and their effect on hip flexor length.


Invitation

You are being invited to take part in an experimental research study. Before you decide to take part it is important for you to understand why the research is being done and what it will involve. Please read the following information and ask any questions on points that need clarifying. Take time to decide if you would like to take part. The study is comparing two techniques on their effectiveness on increasing hip flexor length.


Purpose of the study

The purpose of the study is to identify if one technique is more successful than the other in increasing hip flexor length. There appears to be a link between iliopsoas muscle tightness and low back pain and therefore by researching the most effective ways in which to treat this muscle, it may aid osteopaths in their treatment choice.


If you agree to take part in this study, it should take approximately 15 minutes of your time.


Why have I been chosen?

As a student studying as an undergraduate at the BSO, you have been invited to be a participant for this study.


Do I have to take part?

No. Your decision to take part or not will have no bearing whatsoever on your standing as a student at the BSO or member of the community. If applicable please check, with your medical insurers, that participation in the study will not affect your medical insurance.


What does it involve?

Taking part in this study is entirely voluntary. If you do decide to take part you will be given this information sheet to keep and be asked to sign a consent form. If you decide to take part you are free to withdraw at any point, without reason. Your decision to take part or not will have no bearing on your treatment/standing as a student at the BSO.


The study will involve two researchers, 4th year BSO students, one taking measurements of your hip range of motion and the other carrying out an osteopathic technique to the front of your hip region whilst you are in a side lying position; this may be a direct or indirect technique. You will be randomly assigned to one of 3 groups by choosing from a hat. A chaperone will be offered to participants since the study involves intervention to the groin area.


You may or may not experience some mild soreness for 48hrs after the techniques; this is often a normal response to soft tissue work. Should you experience any distress or physical discomfort from taking part in this study advice and help will be provided by the project supervisor. This experimental study, carried out on the BSO premises, is covered by the BSO insurance.


What do I have to do?

Read through this information sheet and if you do decide to take part you will be offered various dates to attend the experiment. You will then be asked to fill in the medical screening questionnaire and consent form, on fulfilling the inclusion criteria and consenting to taking part you will be required for approximately 10 more minutes. The procedure will be as follows: researcher 1 will take your first hip measurement, and then researcher 2 will perform one of the techniques, followed by researcher 1 who will take the final hip measurement. You are advised to wear a pair of stretchable shorts, both for your comfort and privacy and to enable the researchers to carry out the measurements and technique without restriction.


Will my taking part in the study remain confidential?

All information collected about the participants will remain strictly confidential and anonymous. Access to the data will be restricted to the 2 researchers and the supervisors for this study, at the BSO only. Data will be securely stored at the BSO and destroyed 6 years post completion of the study.


What will happen to the results of the study?

A copy of the results and information about the final study will be made available on request, via your first class private email address. If you would like a copy of the results and/or any other information regarding the study please email l.opie@bso.ac.uk.


Who is organising the research?

I am a final year BSO student completing this study as my final project. My supervisor is Alison Durant a BSO technique tutor. I would like to thank you for taking time to read this information sheet. Should you have any further questions our contact details are given below.


Researcher/Student Supervisor

Lisa Opie Alison Durant

BSO BSO

275 Borough High Street 275 Borough High Street

London SE1 1JE London SE1 1JE

Email: l.opie@bso.ac.uk Email: a.durant@bso.ac.uk

Mob:07956 954093


Medical Screening Questionnaire

Participant NO: AGE: Gender:


Please tick the relevant box for each question.


□ Do you currently have any lower back pain?


□ Do you currently have any hip pain?

□ Do you currently have any lower limb pain/injury?

□ Have you been diagnosed with osteoarthritis of the hip?

□ Have you ever had a hernia? (ie. abdominal, inguinal)

□ Have you ever had abdominal surgery?

□ Do you currently have any abdominal pain? Including period pain?

□ Have you ever had any gynaecological operations?

□ Are you currently pregnant?

□ Have you recently been diagnosed with a fracture?

□ You have any skin condition in your pelvic region?

P

lease state if there is any other condition that may prevent you from being included in this study?


Thank you for accepting this invitation.


CONFIDENTIAL


Participant Identification Number:


CONSENT FORM


Title of Project: A comparison between two osteopathic techniques, MET and inhibition, on hip flexor extensibility.


Name of Researcher: Lisa Opie


Name of Supervisor: Alison Durrant


Please tick where appropriate


1. I confirm that I have read the information sheet for the 

above study and have had the opportunity to ask questions


2. I understand that my participation is voluntary and that I 

am free to withdraw at any time, without giving any reason


3. I agree to take part in the above study 


4. I would like to receive a summary of the results 


5. Please send a summary of the result to ……………………………………..


Name of the Participant Date Signature


Researcher Date Signature


1 copy for the researcher: 1 copy for the participant


Appendix 2


Modified Thomas test and measurement procedure: Once surface landmarkings were drawn on their greater trochanter and down the femur, researcher 1 who was blinded to group allocations, instructed the participant to sit as close to the edge of the table as possible, so that the whole of their thigh was clear of the end of the table and with researcher 1 providing assistance by placing one hand behind their back, they were instructed to flex the non-dominant thigh towards their chest and slowly roll back on the table a pillow was positioned under the head only. The participant then held the flexed thigh towards the chest, enough to maintain the low back and sacrum in their neutral position. The dominant thigh was then allowed to hang off the edge of the table whilst the researcher checked that pelvic neutral was maintained. Hip extension ROM was measured in degrees, using the goniometer, in relation to the horizontal of the table. Kendall et al (1993) classified that tight hip flexor muscles were if their thigh was above 0 degrees in relation to the table (See figure 1 in main text).


Muscle energy technique Group 1: Participants were instructed to lie on their side and to a flex and hold the hip and knee of their lower, non –dominant leg. This was to prevent any unwanted hyper-extension of the lumbar spine throughout the technique. Standing behind the participant, researcher 2 passively extended the thigh of the upper limb (dominant limb) until a tension barrier was felt and the participant reported a moderate stretching sensation, a technique advocated by Smith & Fryer (2008). This was followed by the participant carrying-out a moderate, concentric, isometric contraction into hip flexion against the researcher’s resistance (approx 20% of maximum contraction) for 10s; following the release of effort the thigh was stretched to a new barrier and held for 20s (Chaitow 2005). This procedure was immediately repeated one more time (see figure 2 in main text).


Inhibition technique group 2: Participant lay supine with knees flexed, while researcher 2 stood on the side to be investigated and located the anterior superior iliac spine (ASIS) of the dominant limb then moved approximately 5cm medial and 5cm inferior to locate the iliacus part of the iliopsoas muscle (Cash 1996). The participant was at this point asked to flex the hip briefly by lifting the foot off the table, to confirm that the muscle had been correctly located. The researcher’s palpating index and middle finger remained in contact with the skin overlying the located muscle and the pressure was gradually increased until the participant reported a moderate pain value (7/10) and this was maintained for 30s. The participant was instructed to report on any decrease in pain value, which was subsequently increased back to a moderate level. After a 30s interval, during which the researcher remained in contact with the skin overlying the original point, the technique was repeated for a further 30s. The participant was then instructed to remain in this position for 90s before the post-intervention measurement (see figure 3 in main text).

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