The efficacy of a conservative chiropractic management approach in the treatment of symptomatic hallux abcuctovalqus (bunions)
The purpose of this study was to determine the efficacy of a conservative chiropractic management approach in the treatment of symptomatic hallux abductovalgus (bunions). The study was a prospective, randomised clinical trial involving sixty subjects, thirty in each group, which were selected from the general population. Group A received a conservative chiropractic management approach, encompassing progressive mobilization of the first metatarsophalangeal joint, used in conjunction with cryotherapy and adjustment of all other fixations found in the foot and ankle. Group B received a placebo treatment by means of de-tuned Action Potential Therapy administered to the involved foot. Each group received six treatments over a two-week period and attended a one-week follow up consultation for data collection. Objective assessment was performed by measuring the pressure pain threshold using a digital algometer. Subjective assessment was by means of the Numerical Rating Scale-101 (NRS-101) and the Foot Function Index (FFI). The Hallux-metatarsophalangeal-interphalangeal Scale (HAL) incorporated assessment of both objective and subjective measurements. Assessments were taken at the first, third, sixth and one week follow-up consultations, for all the subjective and objective data. Statistical analysis was completed under the supervision of Mr K. Thomas at . the Technikon Natal, at a 95% confidence interval. The parametric two-sampled paired t-test, the Friedman's test and the Dunn's post test were used to analyse the data within each group (intra-group analysis), whilst the parametric two-sampled unpaired t-test and the non-parametric Mann Whitney unpaired U-test were used to analyse the data between the two groups (inter-group analysis).