Impact of selected manual therapy techniques on relative length and symmetry of lower limbs loading with body weight.

The study participants will be about 400 adults aged 19-30 years old, recruited from students of physical education, nursing and physiotherapy at the University of Applied Sciences in Tarnów. In the study group will be people in whom the difference in load of lower limbs with body weight will be equal to or greater 5% and the control groups will be consisted of two groups people. Each of the participants will be informed in detail about the course of research and asked to give their written consent to participate in the project. Additionally, before being assigned to one of the three study groups, the lower limbs relative length will be measured. All the maneuvers (manipulations / mobilizations) will be performed towards the shorter limb. Patients from the study group will be randomly assigned to one of three groups: • Group I 40 participants: people from group I will have a one-time manual procedure (manipulation) of low strength and low amplitude in the C2 region. Intervention (manipulation) will be applied once only. The approximate duration of the intervention is 20 minutes, with 10 minutes of manual therapy applied). Manipulation targeted to the C2 or global segment in the cervical segment will be carried out towards the functionally shortened limb. Mobilization of the sacroiliac joint in the direction of extension of the lower limb will be carried out on the functionally shortened limb side. Manual procedure targeted in the region of C2 - rotation manipulation This procedure will be performed after prior exclusion of contraindications to its use. Patient in a sitting position. The therapist stands on the relatively shortened side facing the participant. Manipulation for rotation will be performed towards the relatively shortened limb. The therapist's hands are arranged in such a way that one covers the occiput and the middle finger of the other hand the arch of the C2 vertebra, e.g. if the relative shortening of the lower limb is on the right side of the subject, the therapist stands on the other side facing the front and his left hand covers the occiput and the middle finger of the right arm of the C2 vertebra. Then the therapist makes the patient's head move to inflection, lateral contralateral contraction and ipsilateral rotation in such a way as to achieve the pre-stress - the barrier. When the barrier is obtained, the therapist performs the so-called "Manipulative push" at level C2. • Group II 40 participants: people from Group II will be performed once with a global manual procedure (manipulation) for the entire cervical spine with low strength and low amplitude. Intervention (manipulation) will be applied once only. The approximate duration of the intervention is 20 minutes, with 10 minutes of manual therapy applied. Global manual procedure for low force and low amplitude rotation within the cervical spine This procedure will be performed after prior exclusion of contraindications to its use. Manipulation for rotation will be performed towards the relatively shortened limb. The therapist sits behind the subject, resting his back on his chest. The thumb of one of the therapist's hands covers the patient's lower nape and the fingers from 2-5 are placed on the temporal and zygomatic bones. The fingers of the other hand are arranged so that the pointer lies on the branch of the jaw and the thumb on the outgrowth of the C7 vertebra. Arranged hands perform slight inflection, lateral contralateral flexion and opposite rotation to the flexion. After reaching the barrier, the therapist performs the so-called "Manipulative push" on all segments of the cervical spine towards the functionally shortened limb. • Group III 40 participants: for people from Group III a single mobilization for extension in sacroiliac joint will be performed - Kowtuna grip. Intervetion will be applied once only. The approximate duration of the intervention is 20 minutes, with 10 minutes of manual therapy applied. Intervention (mobilization) will be applied only once. Mobilization of the sacroiliac joint towards extension in the hip joint (Kowtuna technique) This procedure will be performed after the exclusion of contraindications for mobilization. Participant in the supine position, the therapist stands on the side of the shorter limb facing the participant. If the participant has a relative shortening of the right lower limb, then the therapist faces the participant on the right at hip height With the left hand, the therapist bends passively the participant's right lower limb in the knee joint, embracing his thigh above the knee from the inside, and the participant's lower leg rests on the therapist's forearm and shoulder. The therapist's right hand's fingers directed toward the caudal side and the edge of the 5 metacarpal bone and the pisifirm bone pressed on the posterior iliac spine, upper right. The therapist asks participant to breathe in while simultaneously using his left hand to extend the right hip joint to reach the barrier. When the participant exhales, the therapist's left hand deepens extension in the right hip joint, reaching a new barrier. At the same time, the therapist's right hand presses the edge of the fifth metacarpal bone and the pisiform bone on the posterior posterior iliac spine in the abdominal and caudal direction In the case of a relative shortening of the left lower limb, we proceed in the same way as in the case of a relative shortening of the right lower limb. All manual procedures and measurements will be made by the same therapist (with 35 years of experience), a manual therapy instructor training doctors and physiotherapists in this field.