Thesis (Ph. D.)--University of Texas at Austin, 2005. / Vita. Includes bibliographical references.

Thesis (M.S.)--University of Toledo, 2005. / Includes bibliographical references (leaves 44-46). Also available online (PDF file) by a subscription to the set or by purchasing the individual file.

Thesis (M.S.)--University of Toledo, 2005. / Includes bibliographical references (leaves 44-46).

Thesis (M.Tech.:Chiropractic)- Dept. of 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”.

Thesis (M.Tech.: Chiropractic)- Dept. of Chiropractic, Durban Institute of Technology, 2004. xvi, 155 leaves / The aim of this investigation was to investigate whether an immediate objective increase in hip strength was observed after an ipsilateral sacroiliac manipulation in patients suffering from chronic sacroiliac syndrome. The actions of hip flexion, extension, abduction and adduction were assessed. The study also investigated the patients’ subjective perception of pain due to the chronic sacroiliac syndrome before and after the manipulation. The proposed increases in strength would have been as a result of a reduction in arthrogenic muscle inhibition. Stimulation of nociceptors caused by the chronic sacroiliac syndrome would have lead to the presence of the arthrogenic muscle inhibition within the joint. Arthrogenic muscle inhibition has been described as an inability of a muscle group to utilise all its muscle fibres when performing a maximum voluntary contraction of that muscle group. Arthrogenic muscle inhibition is a joints natural response to pain, damage or distension within the joint. The response is an ongoing reflex inhibition of the muscles surrounding the joint in order to protect the joint. The inhibition of the surrounding musculature clinically manifests itself as a decrease in strength of the affected muscles. The decreased strength levels hampers rehabilitation of the affected joints as active exercise forms a vital role in the rehabilitation process. Current treatment options used to reduce arthrogenic muscle inhibition include lidocaine injection into the joint, cryotherapy and transcutaneous nerve stimulation. These treatments are aimed rather at the reduction of pain, joint effusions and atrophy of the related musculature than at the reduction of arthrogenic muscle inhibition. Recent studies have proposed that manipulation reduced arthrogenic muscle inhibition by causing excitation of the joint receptors, called the Wyke receptors. Stimulation of these joint receptors is thought to cause an alteration in the afferent input to the motorneuron pool resulting in a reduction of arthrogenic muscle inhibition. This study aimed to investigate whether sacroiliac manipulation could reduce arthrogenic muscle inhibition at the hip by assessing the immediate gains in hip muscle strength. The problem statement was to evaluate if an immediate subjective or objective change in hip strength was observed after an ipsilateral sacroiliac manipulation in patients suffering from chronic sacroiliac syndrome.

Dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic at Technikon Natal, 1997. / There have been few studies performed to determine the combined effects of spinal manipulative therapy with other modalities known to have beneficial physiological effects, especially in terms of mechanical low back pain (Ottenbacher and Difabio 1985). / M

Dissertation submitted in compliance with the requirement for a Master's Degree in Technology: Chiropractic, Technikon Natal, 1996. / The purpose of this study was to compare the effects of McMannis traction and Intermittent traction, both m conjunction with chiropractic manipulation in the treatment of chronic i.e. longer than four weeks, mechanical lower back pain. It was hypothesised by the author that McMannis traction would be the traction treatment of choice, as it enables the joints of the lumbar vertebrae to be moved through their normal anatomical range of motion while being traeticned axially. In addition this type of traction is more specific and allows the therapist to determine the amount of traction that is being applied to the patient because it is being applied manually. Intermittent traction on the other hand is a motorised non-specific traction and affects several joints at one time (Saunders 1979). / M

M. Tech. / Background: No substantiated theory exists by which chiropractic adjustments are known to correct myofascial trigger points (MTrPs). Myofascial trigger points are theorized to be either a primary muscle dysfunction or a secondary manifestation to central/ peripheral neurological mechanisms. Chiropractic adjustments are theorized to exert their therapeutic influence either primarily through biomechanical effects and/ or via neurophysiological mechanisms. Objective: The objective of this study was to investigate the effects of chiropractic adjustments on chronic, active rhomboid MTrPs, by comparing the clinical effects attained with rhomboid attachment-segment (C7-T5) relative to rhomboid innervation-segment (C4 and/ or C5) chiropractic adjustments. Setting: University of Johannesburg Chiropractic Day Clinic in Johannesburg, Gauteng. Participants: Thirty female subjects selected from the general population (from 18 to 40 years) were randomly divided into two different treatment groups of 15 each. Methods: The subjective information required the completion of the Subjective Pain and Discomfort Questionnaire, including the Numerical Pain Rating Scale (NPRS). The objective measures collected were pressure-pain threshold (PPT) and range of motion measurements using the algometer and digital inclinometer, respectively. Additionally, the change in the number of active MTrPs over the treatment period was recorded. All measurements were recorded at the first, third and fifth consultations, over a 3 to 4 week period. The data gathered were then statistically analyzed with the use of a 95% confidence interval. The nonparametric Friedman and Wilcoxon Signed Rank tests were used for the intragroup comparisons, and the Mann Whitney- U test was used for the intergroup comparisons. Interventions: Treatment group 1 received upper-thoracic/ attachment- segment chiropractic adjustments, and treatment group 2 received mid-cervical/ innervation-segment chiropractic adjustments. The research project was carried out so that both groups received 5 treatment sessions over 3 to 4 weeks. Results: There were no statistically significant results obtained for intergroup comparisons. Attachment-segment chiropractic adjustments revealed statistically significant changes in NPRS values (p=0.000), PPT values (p=0.000), cervical spine right lateral flexion range (p=0.004), thoracic spine extension (p=0.005) and left rotation range (p=0.003) over time. Innervationsegment chiropractic adjustments revealed statistically significant changes in NPRS values v ii (p=0.001), cervical spine right rotation (p=0.003), thoracic spine flexion (p=0.001) right lateral flexion (p=0.001) and left rotation (p=0.005) over time. Conclusions: This study does not suggest that attachment-segment or innervation-segment chiropractic adjustments possess greater clinical efficacy relative to one another in terms of improving the clinical picture associated with chronic, active rhomboid MTrP activity. In a further study, a larger sample size will be necessary to identify subtle changes in measurement parameters.

M. Tech. / Abstract Purpose: The purpose of this study was to assess the effects of Diversified Chiropractic adjustments versus Flexion-Distraction Technique in the management and treatment of chronic Lumbar Facet Syndrome. Method: This study consisted of two groups, Group A and Group B, each consisting of 15 participants with chronic Lumbar Facet Syndrome. The participants were between the ages of 20 and 45 years. Potential candidates were examined and accepted based on the inclusion and exclusion criteria. Group A received Diversified Chiropractic Adjustments and Group B received Flexion-Distraction Technique to the lumbar facets. Procedure: Each participant was treated eight times over a period of four weeks. Before the commencement of treatment one, four and eight, the participants completed the Oswestry Low Back Pain and Disability Index questionnaire and the Visual Analogue Scale. A Digital Inclinometer was used to measure lumbar spine ranges of motion. Diversified Chiropractic adjustments were then administered to Group A based on the restrictions obtained during motion palpation. Flexion-Distraction Technique was administered to Group B based also on the restrictions that were obtained during motion palpation. Results: Objective statistically significant differences were noted on flexion and left lateral flexion ranges of motion before treatment, and clinically significant differences we noted on flexion and right lateral flexion after treatment, in favour of Group A. Subjective readings also showed statistically significant differences with regards to Oswestry Low Back Pain and Disability Index and Visual Analogue Scale in favour of both Group A and Group B. Conclusion: The results of the study indicate that both Diversified Chiropractic adjustments and Flexion-Distraction Technique have a positive effect on patients suffering from chronic Lumbar Facet Syndrome. However, Diversified Chiropractic adjustments proved to have a greater overall benefit compared to Flexion-Distraction Technique in the management and treatment of Lumbar Facet Syndrome.

M.Tech. / Purpose: This study aims to compare the effects of spinal manipulative therapy to the lumbar spine and/or pelvis, and spinal manipulative therapy to the lumbar spine and/or pelvis in conjunction with the application of transcutaneous flurbiprofen patches in the treatment of sub-acute/chronic mechanical low back pain with regards to pain, disability and lumbar spine and pelvic range of motion. These effects were based on a questionnaire consisting of a Numerical Pain Rating Scale, and an Oswestry Low Back Pain and Disability Questionnaire, and on lumbar spine range of motion (ROM) readings taken using a digital inclinometer. The questionnaire was completed and the ROM readings taken prior to treatment on the first, fourth and seventh consultations.