Methods Participants Twenty female participants were randomly selected from the Palo Alto Country Club girls golf program. Participants were included if they were a right-handed golfer, had a reported history of low back pain for 2 or more weeks, practice at least2 hours 4 times a week, and competed in at least 1 high school golf season. Participants were excluded if they had a history of serious trauma, had received any surgical interventions relating to the lumbar spine, had been diagnoses with another spine related injury in the past 6 months, have been treated for an injury using steroids, and had any skin irritations or diseases around or on the lumbar spine. Ages ranged from 13 years-18 years old with a mean of 16.5years of age.
The parents or legal guardians were required completed an informed consent form and attended a demonstration prior to the start of the experiment on behalf of the minor child. Upon meeting the inclusion requirement s and proper documentation participants were randomly divided into 2 groups based on the selection of previously coded envelopes the “treatment group” (cupping therapy) and the “control group” (foam rolling). Neither the examiner nor the participant knew what couplet her would be assigned too until the following appointment for treatment (Lee-Mei, 2015). Instruments: Several instruments were needed in the study in order to collect data on range of motion and also to apply the intervention to the participants. Range of motion measurements were taken for lumbar flexion, lumbar extension, and lumbar right rotation. Measurement were taken by a single examiner to avoid discrepancies in data collection. Lumbar flexion and extension measurement were taken using the iPhone app TiltMeter (advanced level and inclinometer). This app was chosen over other traditional inclinometers due to a lack of training with those instruments at the time of the experiment. Calibration was not needed when using this application. Data can be logged, recorded, and transferred post evaluation. Several studies have concluded that smart phones are built with the capabilities to sense joint movement and measure range of motion (Otter et al, 2015 as seen in Pourahmadi, 2016). Pourahamdi, Taghipour, Jannati, Mohseni-Bandpei, Takamjanim and Rajabzadeh(2016) found through a cross sectional study when comparing the tradition gravity based inclinometer and the TiltMeter app that when measuring lumbar flexion and extension excellent intra rater reliability (0.84-0.92), good inter-rater reliability(0.77-0.89), and excellent r values of validity (0.85-0.91) were found. These results indicate that there was no difference in data obtained from the 2 measuring instruments and justify the use of the TitlMeter app as a valid instrument. (Pourahamdi,2016). The TiltMeter advanced level and inclinometer application was obtained through the Apple App Store and used on an iPhone model 6 (iPhone is a trademark of Apple Inc., Cupertino, California, USA). The TiltMeter application allows the evaluator to log each measurement and a calibration lock feature for each participants. To evaluate right rotation, the examiner used a simple transparent plastic standard goniometer. The goniometer was 12.5 inches in length and read 0-90 degrees, 0-180 degrees, and 0-360 degrees in 1 degree increments. The control group used a high density foam roller 36 inches in length (Power System, Knoxville, Tennessee, USA) For the intervention of cupping treatment was provided using 4-6 double-walled glass cups with diameters ranging between 2.24’’-2.70” (K.S Choi Corp, Los Angeles, California, USA). Perceived pain was evaluated using a 10-point visual analogue scale (VAS). A report of a 0 score expressed “no pain at all”, and a score of 10 expressed …show more content…
Prior to the measurement the examiner using the Posterior superior iliac spice as a landmark to locate S2 spinous process. From there the skin was marked with black marker at T12/L1 and the S1/S2 levels. To evaluate lumbar flexion, the iPhone was placed bottom side on the T2/L2 marker. The participants were instructed to stand in neutral positon with feet shoulder width apart, and then to give their best effort to reach their max lumbar flexion. From the max lumbar position, participants were asked to maximally extend their lumbar spine. The same procedure was done with the iPhone placed on the S1/S2 marker. Calculations of total lumbar flexion and extension were obtained by subtracting the S1/S2 measurements from the T1/T2 measurements
The parents or legal guardians were required completed an informed consent form and attended a demonstration prior to the start of the experiment on behalf of the minor child. Upon meeting the inclusion requirement s and proper documentation participants were randomly divided into 2 groups based on the selection of previously coded envelopes the “treatment group” (cupping therapy) and the “control group” (foam rolling). Neither the examiner nor the participant knew what couplet her would be assigned too until the following appointment for treatment (Lee-Mei, 2015). Instruments: Several instruments were needed in the study in order to collect data on range of motion and also to apply the intervention to the participants. Range of motion measurements were taken for lumbar flexion, lumbar extension, and lumbar right rotation. Measurement were taken by a single examiner to avoid discrepancies in data collection. Lumbar flexion and extension measurement were taken using the iPhone app TiltMeter (advanced level and inclinometer). This app was chosen over other traditional inclinometers due to a lack of training with those instruments at the time of the experiment. Calibration was not needed when using this application. Data can be logged, recorded, and transferred post evaluation. Several studies have concluded that smart phones are built with the capabilities to sense joint movement and measure range of motion (Otter et al, 2015 as seen in Pourahmadi, 2016). Pourahamdi, Taghipour, Jannati, Mohseni-Bandpei, Takamjanim and Rajabzadeh(2016) found through a cross sectional study when comparing the tradition gravity based inclinometer and the TiltMeter app that when measuring lumbar flexion and extension excellent intra rater reliability (0.84-0.92), good inter-rater reliability(0.77-0.89), and excellent r values of validity (0.85-0.91) were found. These results indicate that there was no difference in data obtained from the 2 measuring instruments and justify the use of the TitlMeter app as a valid instrument. (Pourahamdi,2016). The TiltMeter advanced level and inclinometer application was obtained through the Apple App Store and used on an iPhone model 6 (iPhone is a trademark of Apple Inc., Cupertino, California, USA). The TiltMeter application allows the evaluator to log each measurement and a calibration lock feature for each participants. To evaluate right rotation, the examiner used a simple transparent plastic standard goniometer. The goniometer was 12.5 inches in length and read 0-90 degrees, 0-180 degrees, and 0-360 degrees in 1 degree increments. The control group used a high density foam roller 36 inches in length (Power System, Knoxville, Tennessee, USA) For the intervention of cupping treatment was provided using 4-6 double-walled glass cups with diameters ranging between 2.24’’-2.70” (K.S Choi Corp, Los Angeles, California, USA). Perceived pain was evaluated using a 10-point visual analogue scale (VAS). A report of a 0 score expressed “no pain at all”, and a score of 10 expressed …show more content…
Prior to the measurement the examiner using the Posterior superior iliac spice as a landmark to locate S2 spinous process. From there the skin was marked with black marker at T12/L1 and the S1/S2 levels. To evaluate lumbar flexion, the iPhone was placed bottom side on the T2/L2 marker. The participants were instructed to stand in neutral positon with feet shoulder width apart, and then to give their best effort to reach their max lumbar flexion. From the max lumbar position, participants were asked to maximally extend their lumbar spine. The same procedure was done with the iPhone placed on the S1/S2 marker. Calculations of total lumbar flexion and extension were obtained by subtracting the S1/S2 measurements from the T1/T2 measurements