Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 1997. / This study was done in order to compare the effectiveness of chiropractic treatment in association with a wellness approach, to chiropractic treatment without a wellness approach in the management of Mechanical Low Back Pain. Low back pain is an enormous problem in today's society. Vast amounts of money are spent annually on the investigation into and treatment of low back pain, and numerous work days are lost due to absenteeism. Chronic low back pain also affects the individual's life\xB7style, and can lead to psychological problems. Thousands of low back operations are done yearly, with a significantly high failure rate. (Frymoyer et al. 1980.) In this study factors such as cost, recovery tine and incidence of reoccurrence were used as criteria to determine the effectiveness of chiropractic treatment applied to the two groups of patients. The concept of holise was applied to one group, whereas the other group was treated without this approach. The study was conducted as a clinical trial, with two experimental groups. Thirty patients who had responded to an advertiselOent were selected and randomly divided into two groups. The patients were selected fro~ the general population on the grounds of their signs and sylllptoos. Group A received chiropractic treatment in association with the wellness approach. This comprised patient education in the form of guidance towards life-style changes and exercises. Patients were also given a detailed explanation of their problems, leading to an understanding of their conditions. Group B received chiropractic treatment only. Their condition was not explained, and they did not receive any of the holistic aspectts mentioned for group A. / M

A dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2004. / Arthrogenic muscle inhibition (AMI) is the reflex inhibition of the muscles that surround an injured joint in consequence to disturbed afferent feedback originating from the receptors of that joint. The resultant altered afferent innervation of the motor neuron pool leads to a decrease in recruitment ability within the motor neuron pool, a decrease in contraction force of the muscles that fall within the motor neuron pool, and hence the clinical manifestation of AMI as a decrease in muscle strength. Spinal manipulation has been proposed to activate mechanoreceptors and proprioceptors within and around the manipulated joint. The altered afferent input arising from their stimulation is thought to cause changes in motor neuron excitability. In this respect, sacroiliac manipulation has been shown to effectively reduce muscle inhibition and increase muscle strength of the quadriceps muscle group in patients with anterior knee pain. The focus of AMI has been aimed primarily at the quadriceps muscle group whereas little information is available on the functional properties of the muscles moving the hip joint. Thus, the purpose of the present cohort study was to determine the short - term effect of sacroiliac manipulation on ipsilateral hip muscle strength and subjective low back pain intensity in thirty male subjects presenting with low back pain, attributable to chronic sacroiliac syndrome. The first objective of the study was to evaluate the short - term effect of sacroiliac manipulation on the strength of the musculature of the ipsilateral hip joint for the actions of flexion, extension, adduction and abduction by means of the Cybex Orthotren II Isokinetic Rehabilitation System, with respect to objective clinical findings. / M

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic at the Durban Institute of Technology, Durban, 2006. / The purpose of this study was to evaluate the immediate and short term effects of spinal manipulative therapy on the club head velocity of amateur golfers suffering from mechanical low back pain. This purpose was identified as low back pain which has been noted as the most common musculoskeletal problem affecting amateur and professional golfers. In the right handed golfer the golf swing produces a distinctly asymmetric trunk motion, involving a combination of left axial rotation and right lateral bending. The significant lateral bending, shear, compression and torsional forces that the lower back contends with during the golf swing causes a peak compression load of more than eight times the body weight. In addition it is found that at the end of the follow through phase the golfer's lumbar spine is rotated and hyperextended. This is known as the reversed C position, in which the facet joints approximate and in addition torsional stress is placed on the annular fibers of the disc. With repetitive swings and incorrect form the lumbar facets bear the brunt of the abnormal forces on the lumbar spine. IV In addition to this, during the downswing phase of a golf swing the role of the multifidus is to limit flexion whilst the external oblique muscle induces rotation of the lumbar spine. Together both muscles produce rotation in the lower lumbar spine. Thus the golf swing, particularly during the downswing phase, places a tremendous burden on the multifidus muscle and may cause; o muscle injury which will contribute to the golfer's low back pain and I or o joint injury as a result of muscle fatigue. Furthermore the resultant uncontrolled contractions of the multifidus muscle produces torsion to the facet joints and disc. It is therefore likely that facet syndrome may be the main cause of low back pain in golfers, as modern golf publications urge golfers to use a maximum state of spinal rotation to generate a high club head velocity. / M

A dissertation presented in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban institute of Technology, 2003. / Low back pain is a significant health problem that has had a major impact on quality of life and on health care costs (Weiner, et al. 2000:450). Schwarzer, et al. (1995) established the sacroiliac joint to be a significant source of pain in patients with chronic low back pain. Bernard and Kirkaldy-Willis (1987:2107-2130) established the sacroiliac joint to be the primary source of low back pain in 22.5% of 1293 patients presenting with back pain. According to a review article by Hendler, et al. (1995:169), “manipulation provides dramatic relief” in cases of sacroiliac syndrome. Little research, however, has been done regarding instrument manipulation and it’s effect on acute, chronic or acute on chronic sacroiliac syndrome. Osterbauer and De Boer, et al. (1993) found a significant decrease in Visual Analogue Scale and Oswestry scores following treatment using instrument manipulation for sacroiliac joint syndrome. They also noted a reduction in the number of pain provocation tests applied to the research subjects. “Unless reliability and validity of assessments and effectiveness of treatment procedures can be demonstrated, clinicians should temper their claims of measurement of, and direct effects on, the sacroiliac joint” (Walker 1992:914). The study design was a randomised, omparative clinical trial. Sixty voluntary subjects were accepted onto the trial; each diagnosed as having acute on chronic sacroiliac joint syndrome, and divided into two groups of thirty subjects. Each subject received five treatments within a three-week period. The subjects in group one received manipulation using the Diversified Technique of manipulation and those in group two received instrument manipulation using the “Activator Adjusting Instrument”. / M

Orientador: Renato Passini Junior / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-11-27T10:50:17Z (GMT). No. of bitstreams: 1 Quimelli_MuriloAyres_M.pdf: 276955 bytes, checksum: 9aa0551d435b36bbbc95e1a18e7da967 (MD5) Previous issue date: 2005 / Resumo: Objetivo: Avaliar a eficácia da acupuntura no tratamento da dor lombar no período gestacional. Método: Através de ensaio clínico prospectivo randomizado, foram selecionadas 42 gestantes, com idade de 18 ou mais anos e entre 28 a 35 semanas, com dores lombares, que realizaram acompanhamento pré-natal no Centro de Especialidades Médicas da Prefeitura Municipal de Campo Largo (PR), no período de fevereiro a agosto de 2004. As gestantes foram randomizadas para tratamento com acupuntura ou placebo. Foram realizadas três sessões de tratamento, com aplicação de questionário antes e depois das sessões, avaliando-se a intensidade da dor, capacidade para exercer atividades diárias, uso de medicação analgésica e incômodo causado pelo tratamento. Duas mulheres do grupo com acupuntura e três do grupo placebo não concluíram todas as sessões. A análise estatística incluiu os testes t-Student para distribuições normais, Mann-Whitney para distribuições assimétricas e Wilcoxon para amostras pareadas, com o nível de significância de 5%. Resultados: Para ambos os grupos houve redução da dor lombar, de forma estatisticamente significativa. No grupo com acupuntura, a redução, medida pela EAV, foi mais acentuada (5,8 x 0,5) do que no grupo controle (5,1 x 2,7). Houve melhora estatisticamente significativa na execução de várias atividades da vida diária (levantar peso, lavar roupa, limpar a casa, caminhar, fazer compras, ficar muito tempo sentada e dormir) no grupo com acupuntura, em relação ao grupo placebo. As mulheres que receberam acupuntura deixaram de utilizar medicação analgésica, o que não ocorreu no grupo controle, sendo esta diferença estatisticamente significativa (p<0,005). Não foi observada diferença em termos de incômodo causado pelo tratamento entre os dois grupos. Conclusões: para ambos os grupos a aplicação não incomodou e nem apresentou efeitos colaterais significativos. A acupuntura foi superior ao tratamento placebo na redução da dor em gestantes, melhora na realização de atividades diárias e redução do consumo de analgésicos / Abstract: Objectives: To evaluate the effectiveness of acupuncture in the treatment of back pain during the gestational period. Method: A randomized clinical trial was conducted, in which 42 pregnant patients were selected. The age of the patients ranged between 18 years and older and pregnancy ranged from 28 to 35 weeks. All had back pain and scheduled their prenatal follow-up visits at the Municipal Health Care Center of Medical Specialties in Campo Largo (PR), from February to August, 2004. Pregnant patients were randomized for treatment with acupuncture or placebo. Three sessions were performed and a questionnaire was applied before and after each session to assess pain intensity, capacity to perform daily activities, use of analgesic drugs and discomfort caused by the treatment. The acupuncture group had two losses and the placebo group had three losses, neither of which interfered with the results. Statistical analysis included Student¿s t-test for normal distributions, Mann-Whitney for asymmetric distributions and Wilcoxon¿s test for paired samples, with a 5% significance level. Results: In both groups, there was a statistically significant decrease in back pain. In the acupuncture group, the decrease was more important (5.8 x 0.5) than in the control group (5.1 x 2.7). The acupuncture group showed a statistically significant improvement in the performance of daily activities (lifting weight, washing clothes, house cleaning, walking, shopping, long time sitting and sleeping) when compared to the placebo group. Women receiving acupuncture did not use analgesic medication. The same did not occur in the control group and this difference was statistically significant (p<0.005). No difference was observed between both groups in terms of discomfort caused by the treatment. Conclusions: In both groups, application of the technique did not cause discomfort or significant side-effects. Acupuncture was superior to placebo treatment for pain reduction in pregnant patients, improving the performance of daily activities and decreasing the use of analgesics / Mestrado / Ciencias Biomedicas / Mestre em Tocoginecologia

<p>The aim of the current study was to determine the relationship between low back pain and physical activity levels among nurses in Kanombe Military Hospital (KMH), as well as other confounding factors leading to low back pain. A quantitative, cross-sectional and descriptive design was used to conduct the study. The study population and sample included all clinical nurses in all the departments/wards at KMH (excluding three nurses doing administrative work only and the four who participated in the pilot study). A total of 133 nurses participated in the study and data was collected using three self administered questionnaires. The first one requested socio-demographic data, followed by the International Physical Activity Questionnaire (IPAQ) which examined the physical activity levels of nurses, and lastly the Nordic Musculoskeletal Disorder Questionnaire which examined low back pain prevalence. A response rate of 122 (92%) was obtained.</p>

published_or_final_version / Biochemistry / Doctoral / Doctor of Philosophy

Low back pain (LBP) is a common complaint and health problem in Hong Kong, particularly among middle-aged individuals. LBP is the main cause of chronic disability which significantly affects the daily life activities of patients. Pain might result in repeated hospital admissions and subsequently increase the burden on health care providers in Hong Kong. LBP has an enormous effect on quality of life and therefore deserves research attention. Growing evidence shows that yoga may help reduce the level of chronic LBP in adult patients. However, no systematic review has been conducted to support the translation of this theory into practice. Therefore, this thesis aims to evaluate the current evidence on the efficacy of yoga in reducing chronic LBP among adult patients to achieve the following objectives: formulate an evidence-based protocol on yoga practice, assess the implementation potential of the formulated protocol, and develop implementation strategies and evaluation plan for the use of this protocol in a local public hospital in Hong Kong. Five databases were used for the systemic review of relevant studies. These databases were those of Cochrane Library, CINAHL Plus, PudMed, British Nursing Index and Medline (Ovid). A total of eight papers (randomized controlled trials) fulfilled the inclusion criteria of this study. The Scottish Intercollegiate Guidelines Network (SIGN) was used to extract the data and evaluate the paper quality. The findings of the selected papers indicated that yoga practice has a significant effect on reducing pain among adult patients with chronic LBP. The innovation is proposed to be conducted in an adult orthopedic and traumatoloy (O&T) ward. Evidence-based yoga guideline is developed to guide nurses in the effective implementation of the protocol. The SIGN grading system is chosen to grade the recommendations in the guideline. Adult patients with persistent LBP longer than three months are the target population. All study participants practice specific yoga postures under the supervision of yoga instructors and trained nurses in the outpatient clinic. These patients continue home practice for 30 minutes daily or at least twice a week. Based on the findings of the reviewed literatures and the adaptation of these findings into the proposed innovation, the feasibility of implementing evidence-based yoga guideline in the local clinical setting in Hong Kong is demonstrated. An effective communication plan is developed to gain support from stakeholders and efficiently implement the innovation. A two-month pilot study is designed to test the feasibility of the guideline. Pain level, which is the primary outcome of the study, is measured by using Pain Numerical Pain Scale (NRS). Evaluation will be completed after the pilot test and at the end of the whole programme and refinement of the protocol will be accomplished according if necessary. Protocol effectiveness will be determined by a decrease in back pain level after practicing yoga. Other outcomes include the knowledge and satisfactory level of the staff with regards to the protocol, as well as and the costs and benefits of program implementation. / published_or_final_version / Nursing Studies / Master / Master of Nursing

<p>The aim of the current study was to determine the relationship between low back pain and physical activity levels among nurses in Kanombe Military Hospital (KMH), as well as other confounding factors leading to low back pain. A quantitative, cross-sectional and descriptive design was used to conduct the study. The study population and sample included all clinical nurses in all the departments/wards at KMH (excluding three nurses doing administrative work only and the four who participated in the pilot study). A total of 133 nurses participated in the study and data was collected using three self administered questionnaires. The first one requested socio-demographic data, followed by the International Physical Activity Questionnaire (IPAQ) which examined the physical activity levels of nurses, and lastly the Nordic Musculoskeletal Disorder Questionnaire which examined low back pain prevalence. A response rate of 122 (92%) was obtained.</p>

Thesis (M.Tech-: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 x, 57 leaves, Annexures 1-10 / To determine if serum cortisol levels are increased following Spinal Manipulation Therapy (SMT) to the low back region and to determine the effect of a short rest interval on the cortisol levels