Thesis (M.Tech.: Chiropractic), Durban Institute of Technology, 2003. / Low back pain is one of the largest known causes of disability in western society. The purpose of this study was to evaluate the relative effectiveness of combined spinal manipulation and interferential current therapy versus combined oral meloxicam and interferential current therapy in the treatment of acute mechanical low back pain. / M

A dissertation submitted in partial compliance with the requirements for the Master's Degree of Technology: Chiropractic, Durban University of Technology, 2007. / The Transversus Abdominis (TrA) muscle is recognised in the literature as playing a vital and protective role in maintaining a healthy core and aiding lumbar biomechanics in the dampening of external forces applied to the lumbar spine. Pilates purports to employ the principles of core training yet there remains a deficit in the literature despite its popularity in rehabilitation and fitness industries. This study aimed to evaluate the efficacy of Pilates method in training the TrA in comparison to a moderately active population that regularly exercises in a gym environment, as well as a sedentary control. / M

Low back pain has long been estimated to be the most prevalent and debilitating source of chronic pain. The present study first reviews the literature addressing the various theories of pain, the physiological and psychological variables important in pain research, and the psychotherapeutic approaches that have been used to date to reduce pain. Thirty-seven hospitalized chronic back pain patients were administered the cold-pressor test and a medical pain stimulus procedure which was medically relevant to their back pathology. A card-sort method was utilized in order to assess the coping strategies employed by the patients during these two pain stimulus tasks. These procedures were repeated following treatment. Coping strategies used by patients during the two pain tasks were compared. Results demonstrated that there was a significant difference in the manner in which patients coped with the two types of pain. Cold-pressor measures of pain threshold and tolerance were not significantly different between pretreatment and post-treatment. These measures were also not positively correlated with treatment outcome. A multiple regression approach demonstrated that particular coping strategies were significantly predictive of treatment outcome. The medical pain stimulus procedure was found to provide more significant pedictor variables than the cold-pressor test. At pre-treatment assessment, patients who relied on dramatized coping strategies were less likely to be successful in treatment. Breathing activity and pain acknowledgement were positive coping techniques highly predictive of successful outcome in this study. The use of computers for assessment and other recommendations for future research were discussed.

A dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Durban University of Technology, 2007. / To determine the prevalence and demographics of lumbo-sacral cases recorded at the D.U.T Chiropractic Day Clinic from 13th January 1995 to 30th November 2005. To identify the aetiology, common lumbo-sacral diagnoses, associated signs and symptoms, management and contra-indications to chiropractic treatment recorded on the initial consultation of patients with lumbo-sacral complaints. / M

M.Tech. / Purpose: To determine what effects flexion distraction will have on males with chronic lumbar facet syndrome, in reference to intersegmental range of motion and pain. Method: Thirty male participants with chronic lumbar facet syndrome received flexion distraction technique. The trail consisted of seven visits over two to three weeks. Treatment was performed on the first to sixth visit, readings and questionnaires were completed on the first, fourth and seventh visits. Data collection was concluded before treatment on the mentioned visits. Subjective data consisted of the Oswestry Disability Index (ODI) and the Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2). Objective data included global lumbar range of motion measurements using the Baseline Digital Inclinometer, and segmental lumbar range of motion by means of the Radiographical Midplane Angle method. Results: Objectively, clinical significance of the intersegmental lumbar range of motion increased from the L1/L2 to the L4/L5 level (2.2% - 17.7%), but showed no statistical significance. In relation to the maximal motion possible at these levels, the increase in motion escalated from 0.8% at the L1/L2 segment to 9.2% at the L4/L5 segment. The global lumbar range of motion showed clinical significant increase in all of the ranges except for extension, however statistical significance was found in right lateral flexion only (p = 0.045). The greatest increase in motion was observed in left lateral flexion (15.72%) and a decrease in extension (3.72%) was illustrated. Subjectively, the group showed statistical significant improvement in both the SF-MPQ-2 (p = 0.000) and ODI (p = 0.000). Clinical meaningful change was noted throughout the subjective data, which resultantly showed a 66% and a 67% change in pain respectively. Conclusion: Flexion distraction has shown to have clinical significant effects on segmental and thus global range of motion, and great clinical meaningful change in pain levels and pain perception. Thus specific segmental mobilisation does affect the segmental motion.

A lombalgia e a cervicalgia possui grande incidência em toda a população mundial. Segundo a Organização Mundial de Saúde (OMS), em média, cerca de 80% da população adulta apresenta, em algum momento da vida, pelo menos uma queixa de dor na coluna, onde a degeneração da articulação do processo articular é frequentemente apontada como a etiologia. Diversos estudos vêm sendo realizados, na tentativa de se compreender como ocorre o processo degenerativo patológico dessas articulações, onde, frequentemente são usados indivíduos sintomáticos. Deste modo, avaliou-se, com o uso de técnicas macroscópicas, de microscopia de luz e de microscopia eletrônica, a organização estrutural da cartilagem dos processos articulares (CPas) das vértebras cervicais (C) e lombares (L) de indivíduos jovens (GJ) e idosos (GI), presumivelmente assintomáticos. Foram utilizados blocos vertebrais obtidos de cadáveres necropsiados no Serviço de Verificação de Óbitos da Capital do Estado de São Paulo, onde familiares de todos os indivíduos forneceram informações que permitiram incluir ou excluí-los da pesquisa. Os resultados mostram que ocorrem alterações na superfície da CPa do segmento L no GJ. A degeneração da CPa ocorre de forma heterogênea entre os indivíduos do GI e as característica do grau 2 podem ser admitidas como decorrentes do processo de envelhecimento normal, não havendo diferenças entre os segmentos C e L. / Back pain and neck pain have a high occurrence in populations worldwide. According to the World Health Organization (WHO), approximately 80% of adults have at some instance in life pain in the spine with an etiology frequently indicated to be the degeneration of the articular process. Several studies have been undertaken to understand how the pathological degenerative process occurs and symptomatic subjects are frequently used for this end. Macroscopic and light and electron microscopy techniques have been employed to assess the structural organization of the cartilage of the articulation processes (CAP) of the cervical (C) and lumbar (L) vertebrae of presumably asymptomatic young (Y) and elderly (E) people. Samples, retrieved from routinely necropsied corpses by the Death Verification Service of the Capital City of the State of São Paulo (SVOC/SP) and the family of all individuals provided information that enabled include or exclude them from search. Results show that changes in the CAP surface of segment L of Y occur. CAP degradation occurs heterogeneously among elderly people, whereas second degree characteristics are caused by normal aging without any difference between the C and L segments.

Low back pain (LBP) is a common health problem that contributes to the high cost of health care. Improvement in trunk range of motion has been considered to be an important factor in ameliorating the symptoms of LBP. Kinesio® taping is a prominent therapeutic modality commonly used in the variety of populations for treating musculoskeletal conditions. However, previous research on the efficacy of Kinesio® taping for LBP is limited. The purpose of this study was to investigate the immediate and short-term effects of Kinesio® taping with the muscle inhibition technique on active trunk flexion range of motion. Twenty-five subjects with no history of LBP in the past 6 months or LBP lasting over six weeks at any point in past were recruited from a Division I athlete population. Each subject underwent two Kinesio® taping trials in a cross-over design with a 7-10 day washout period (placebo application and inhibition technique application), during which several trunk flexion range of motion measurements were made. Subjects wore the tape for 48 hours, and active trunk flexion range of motion was measured at baseline, immediate post-tape application, and 48 hours post-tape application. A significant trial by time interaction was found (F = 9.629; p = 0.002), and follow-up analysis of the inhibition technique trial revealed a significant increase in active trunk range of motion between baseline and 48-hours post-tape. No significant differences were noted in the placebo trial. The findings suggest that the inhibition Kinesio® taping technique may eventually prove to be a beneficial therapeutic modality for improving active trunk flexion range of motion in patients with LBP.

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

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published_or_final_version / Medical Sciences / Master / Master of Medical Sciences