Effect of manual manipulation on mechanical gait parameters

Area of Science:

• Biomechanics
• Musculoskeletal Health
• Rehabilitation Science

Background:

• Manual manipulation is used to improve pain and musculoskeletal function.
• Gait analysis is increasingly used in clinical practice, aided by advanced motion capture technology.
• This study systematically reviews manual therapies' impact on objective gait mechanics.

Purpose of the Study:

• To systematically review the literature on manual medicine modalities and their effects on biomechanical gait parameters.
• To assess the objective impact of manual therapies on gait mechanics.

Main Methods:

• Systematic literature search across six databases using combined keywords and MeSH terms.
• Screening of titles and abstracts for relevance, followed by quality assessment using the Cochrane Risk of Bias Tool.
• Inclusion of clinical trials with manual manipulation and multiple mechanical gait parameters; exclusion of case reports and subjective mobility measures.

Main Results:

• Twenty studies were included, utilizing manual techniques from osteopathic, chiropractic, massage, and physiotherapy backgrounds.
• Primary conditions studied included back, knee, and ankle issues, alongside healthy and Parkinson's patients.
• Gait parameters were mostly measured using multicamera motion capture or force platforms, with variable or absent control groups.

Conclusions:

• Twelve of 20 studies showed significant effects of manipulation on gait variables like step length and range of motion.
• High heterogeneity in study design, populations, interventions, and outcome measures prevents robust conclusions.
• Current evidence quality is low, with insufficient data to confirm manual therapies' impact on biomechanical gait parameters; standardized methodology is needed.