A dissertation submitted in partial compliance with the requirements for the Masters Diploma in Technology: Chiropractic at Technikon Natal, 1996. / Lower back pain due to mechanical dysfunction is a common cause of pain and disability in mankind. Lumbar spine facet syndrome is a major aetiology in mechanical lower back pain / M

This study examined the relationship between chronic low back pain (CLBP) patients' perceived (stated) levels of function and their measured (observed) performance in squatting and stair climbing activities as compared to healthy volunteers. Twenty patients with CLBP and 20 healthy subjects were asked through an interview to self-assess their ability to comfortably perform stair climbing and squatting as well as other tolerances. The subjects were then asked to perform the activities and their performance levels were recorded. Results of the t-tests and Analysis of Variance (ANOVA) procedures revealed that patients' estimate of squatting and stair climbing abilities as well as their demonstrated levels were significantly lower (p < 0.001) than those of the healthy subjects. There was a significant difference between groups in terms of the time required to perform squatting but not stair climbing. Both healthy subjects and patients with CLBP underestimated their physical capabilities. Findings indicate that the use of actual performance measurement combined with self-report of functional abilities is needed when assessing performance levels of both healthy as well as patients with CLBP.

Thesis (M.Tech.: Chiropractic)--Durban University of Technology, 2008 / Core strengthening has become a major trend in the rehabilitation of patients suffering with acute low back pain. Clinical trials have shown that core strengthening is beneficial for patients with low back pain. According to the literature, core strengthening consists of activating the trunk musculature in order to stabilize hypermobile symptomatic joints and thus, lessen mechanical stress to the spine. Literature suggests that vibration/acceleration training may be a more effective and sufficient method of core stability exercises, with regards to core muscle endurance and activation in treatment of acute low back pain. This may have more advantages than using traditional core stability exercises in the treatment of acute low back pain. However, vibration/acceleration training as core stability exercises has yet to be investigated. In order to choose the most appropriate treatment protocol for managing this condition, it is essential for research to be carried out to identify the most effective treatment, which would allow for better overall management of low back pain during the acute period. Therefore, this study was designed to establish the effectiveness of vibration/acceleration training as a core stability exercise in the treatment of acute low back pain and to establish whether this protocol should be utilized routinely in the management of this condition.

Submitted to the Faculty of Health at the Durban University of Technology in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Department of Chiropractic, Durban University of Technology, Durban, South Africa, 2015. / Background: Cryotherapy is often the first option in treating acute conditions and can be applied in various forms including ice packs and cooling gels. Cooling gels are easy to use and readily available making them popular with consumers. They can also contain additional ingredients which can assist with inflammation, making them ideal for musculoskeletal disorders. A cooling gel containing menthol and anti-inflammatory herbs is available in pharmacies nationwide in South Africa, but has not been clinically investigated. This gel is often used in the treatment of acute injuries such as low back pain but its effectiveness in treating this condition has not yet been verified. Objectives: To determine the effectiveness of a menthol cooling gel combined with anti-inflammatory herbs compared to a menthol gel and a placebo gel in the treatment of acute non-specific low back pain. Method: A double-blinded placebo controlled clinical trial (n = 60) was conducted. Each participant was randomly allocated into one of three treatment groups consisting of a minimum of 20 participants between the ages of 18 and 40 who met the study criteria. Informed consent was obtained from the participants prior to their participation in the study. At the initial consultation baseline measurements (pain rating, disability and pressure pain threshold) were taken and the respective treatments (menthol with anti-inflammatory herb, menthol or placebo gel) were administered. Participants were instructed on how to apply the gel at home and were requested to apply it three times a day for one week. Statistical analysis was performed using repeated measures ANOVA for inter- and intra-group analysis with one way ANOVA and chi square tests being used to compare baseline values. A p-value < 0.05 was considered to be statistically significant. The study received ethical clearance from the Durban University of Technology Institutional Research Ethics Committee (REC 81/13). Results: No significant differences were observed between the groups at baseline assessment, indicating that the groups were comparable. Participants were instructed on how to apply the gel at home and were requested to apply it three times a day for one week. Follow up appointments for data collection was scheduled at days three or four and six. No statistically significant differences were observed between the three groups over time for pain (p = 0.95), disability (p = 0.903) or pressure-pain threshold (p = 0.824), with all groups showing improvement. All three groups showed clinically significant changes in pain from moderate to mild over the duration of the study but no clinically significant changes were noted in terms of pressure-pain threshold and disability. Conclusion: The results indicate that irrespective of whether or not the gel contains active ingredients there was an improvement in acute low back pain. Further research needs to be conducted to determine if tissue depth and the concentration of the active ingredients such as menthol are factors affecting the efficacy of this gel.

Patient satisfaction is one of the indicators of the quality of care being given to the users of a service. It can also be used as benchmarks for ensuring the delivery of quality physiotherapy services in health facilities. Physiotherapists have been involved in treatment of persons suffering from low back pain for decades. Treatment approaches are varied, but all have the common goals of pain relief, rehabilitation, and prevention of recurrence of low back pain. The purpose of this study was to investigate the satisfaction of low back pain sufferers with the physiotherapy services they receive. The study was carried out in selected public hospitals in Nairobi and the Central Province in Kenya.

Clinical research has shown that patients experience difficulty in adjusting to their pre-morbid worker roles after they have been through a back rehabilitation programme. The pressure and competitiveness of modern day society to achieve competence and to survive has proven to be stressful, both for the injured and uninjured, the unemployed and employed. Back rehabilitation and the successful return of the injured worker to the workplace have been of great interest to industry for the last decade, due to the ever-increasing support of legislature for the injured. There is a range of medical interventions available but few of these achieve successful outcomes due in part to the fact that many intervention strategies do not take the patients perspectives into consideration. Therefore, the purpose of the study was to explore back rehabilitated clients perceptions and experiences of the challenges they face in adapting to their worker roles.

The prevalence of low back pain has assumed an upsurge trend in the last five decades despite the many interventional strategies. One interventional strategy that has been unsuccessful has been patient education. Lack of positive results from many of the existing patient education programmes is probably due to the type of health information that has been presented and the method that has been used. Many of the health education programmes have been planned according to what the medical professionals assumed the individuals needed to know, assumptions that could have ignored some crucial aspects. This study explored the perceived health education needs of individuals with low back pain at the Nairobi Hospital Rehabilitation Unit in Kenya, the method used to educate the individuals, the appropriateness of the method according to the individuals in addition to identifying the source of the health education that the individuals had.

Thesis (M.Tech.: Chiropractic)--Durban University of Technology, 2008 / Core strengthening has become a major trend in the rehabilitation of patients suffering with acute low back pain. Clinical trials have shown that core strengthening is beneficial for patients with low back pain. According to the literature, core strengthening consists of activating the trunk musculature in order to stabilize hypermobile symptomatic joints and thus, lessen mechanical stress to the spine. Literature suggests that vibration/acceleration training may be a more effective and sufficient method of core stability exercises, with regards to core muscle endurance and activation in treatment of acute low back pain. This may have more advantages than using traditional core stability exercises in the treatment of acute low back pain. However, vibration/acceleration training as core stability exercises has yet to be investigated. In order to choose the most appropriate treatment protocol for managing this condition, it is essential for research to be carried out to identify the most effective treatment, which would allow for better overall management of low back pain during the acute period. Therefore, this study was designed to establish the effectiveness of vibration/acceleration training as a core stability exercise in the treatment of acute low back pain and to establish whether this protocol should be utilized routinely in the management of this condition.

Patient satisfaction is one of the indicators of the quality of care being given to the users of a service. It can also be used as benchmarks for ensuring the delivery of quality physiotherapy services in health facilities. Physiotherapists have been involved in treatment of persons suffering from low back pain for decades. Treatment approaches are varied, but all have the common goals of pain relief, rehabilitation, and prevention of recurrence of low back pain. The purpose of this study was to investigate the satisfaction of low back pain sufferers with the physiotherapy services they receive. The study was carried out in selected public hospitals in Nairobi and the Central Province in Kenya.

Clinical research has shown that patients experience difficulty in adjusting to their pre-morbid worker roles after they have been through a back rehabilitation programme. The pressure and competitiveness of modern day society to achieve competence and to survive has proven to be stressful, both for the injured and uninjured, the unemployed and employed. Back rehabilitation and the successful return of the injured worker to the workplace have been of great interest to industry for the last decade, due to the ever-increasing support of legislature for the injured. There is a range of medical interventions available but few of these achieve successful outcomes due in part to the fact that many intervention strategies do not take the patients perspectives into consideration. Therefore, the purpose of the study was to explore back rehabilitated clients perceptions and experiences of the challenges they face in adapting to their worker roles.