Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Department of Chiropractic, Durban University of Technology, Durban, South Africa, 2016. / BACKGROUND: Low back pain (LBP) is a major health problem and a leading cause of disability worldwide, accounting for numerous medical and chiropractic consultations. Risk factors for developing as well as perpetuating LBP have been recognised, including psychosocial factors and to a lesser extent organic diseases. There is good evidence for the role of biological, psychological, and social factors in the aetiology and prognosis of back pain. The biopsychosocial model developed by Waddell (1987) has become a dominant consideration in determining the aetiology and prognosis of back pain, and has led to the development and testing of many back pain care interventions. This includes a focus on identifying and treating ‘yellow flags’ which are psychosocial factors that may result in LBP becoming chronic, and incorporating the treatment of these ‘yellow flags’ as a component of LBP care. AIM: The aim of this study was to determine a psychometric profile of patients attending the Durban University of Technology (DUT) Chiropractic Day Clinic (CDC) with non-specific LBP using the Keele STarT Back Screening Tool (SBST) and Bournemouth Questionnaire (BQ). METHODOLOGY: Once ethical clearance was obtained to conduct the research study at the DUT CDC, all patients over the age of eighteen presenting to the DUT CDC with non-specific LBP as new patients, or as former or current patients presenting with non-specific LBP as a new complaint, were directly approached by the researcher. The prospective participants were asked a series of screening questions in order to ensure that they qualified for the study. A total of 132 participants completed an informed consent, a pre-validated questionnaire, the SBST and the BQ. The questionnaires took approximately ten to fifteen minutes to complete; participants were given the choice to complete them either before or after their appointment so as not to interrupt the treatment time. All informed consents and completed questionnaires were collected by the researcher and stored in separate sealed ballot boxes. All questionnaires were kept confidential and only seen by the researcher and supervisor. A code was allocated to each questionnaire before data was captured on a spreadsheet for data analysis. The IBM SPSS version 22 was used for data analysis by a biostatistician. RESULTS: A total of 132 questionnaires were utilised for statistical analysis. Based on the SBST, 47.7% (n = 63) of the total population (N = 132), had a low risk of developing chronic LBP, 28.8% (n = 38) had a medium risk of developing chronic LBP, and 23.5 % (n = 31) had a high risk of developing chronic LBP. The BQ indicated that 63.6% (n = 84) of the total population (N = 132) scored 35 or less and thus had a low risk of developing chronic LBP, while 36.4% (n = 48) scored above 35 and thus had a medium to high risk of developing chronic LBP. A very strong association was found between the SBST and BQ risk groups (p = <0.001). A total of 87.1% (n = 27) of the participants who had a high risk of chronicity according to the SBST (N = 31) also had a high risk of chronicity according to the BQ. The female gender, being a current smoker and partaking in little or no physical activity were found to be statistically significant risk factors for chronic LBP. CONCLUSION: The results in this study suggest that patients presenting to the DUT CDC supports the notion that chronic LBP is a multifactorial condition with significant psychosocial implications and should be approached as such. / M

Thesis (MScPhysio)--Stellenbosch University, 2015 / ENGLISH ABSTRACT: Background: The use of computers at school, university, work and for social media is growing and whilst neck pain is common in the general population, computer users have an even higher prevalence. Incorrect workstation ergonomics have been identified as a risk factor for the development of neck pain in computer workers. Aims: To assess the effect of adjusting chair and monitor height of a female office worker’s computer workstation on work related neck and upper back pain intensity, comfort of her sitting posture and disability. Methods: An N=1 study was conducted using the A-B-C design consisting of a computer workstation adjustment involving chair and monitor height of a female office worker. The effect of the intervention was evaluated using the Visual Analogue Scale (VAS) to measure neck and upper back pain intensity and comfort of sitting position, and the Neck Disability Index to measure disability. The effect of the intervention was assessed over the three phases, consisting of four weeks each. During these phases, the participant could continue with her usual computer work. The results were compiled and tabulated. Results: A reduction in neck and upper back pain intensity as well as an increase in sitting comfort position were found. However these improvements were not statistically or clinically significant. The effect size for pain intensity was 0.76 and for sitting comfort 0.21. The participant reported no disability as measured by the Neck Disability Index, at the start and at the end at the end of the study. Conclusion: The vertical adjustment of this female office worker’s chair and monitor height according to her anthropometrics improved neck and upper back pain intensity and comfort of sitting position. This ergonomic workstation intervention could form part of a practical management option for computer users with neck and upper back pain. Further research is recommended to establish whether these findings are generalizable to the wider community of computer users. / AFRIKAANSE OPSOMMING: Probleemstelling: Die gebruik van rekenaars by skole, universiteite, werksplekke en vir sosiale doeleindes neem toe. Nek pyn kom dikwels in die algemene bevolking voor, maar dit is meer prevalent in rekenaargebruikers. ‘n Werkstasie wat nie ergonomies korrek opgestel is nie, is geidentifiseer as ‘n risikofaktor vir die ontwikkeling van nekpyn in rekenaar werkers. Doelwitte: Om te bepaal of aanpassings in die stoel- en beeldskerm hoogte van ‘n vroulike kantoor werker se rekenaar werkstasie, ‘n effek het op werksverwante nek en boonste rug pyn, sitgemak en funksionele vermoë. Methode: Die N=1 studie met ‘n A-B-C ontwerp is onderneem en het bestaan uit n rekenaar werkstasie aanpassing waarby die hoogte van die stoel en beeldskerm van ‘n vroulike relenaargebruiker aangepas is. Die effek van die intervensie is ge-evalueer deur middle van die visueel analoogskaal (VAS) om pyn en sitgemak te bepaal; en die Nek Ongeskiktheids Indeks (NOI) om gestremtheid te bepaal. Die effek van die intervensie is oor drie fases, wat elk bestaan het uit vier weke, evalueer. Gedurende die fases, kon die deelnemer met haar gewone rekenaarwerk voortgaan. Die resultate is saamgestel en getabuleer. Resultate: Daar was ‘n vemindering in die intensiteit van nekpyn, boonste rug pyn en die sitgemak van die individu het ook verbeter. Hierdie verbeteringe was egter nie statisties of klinies betekenisvol nie. Die effek grootte vir pyn intensiteit was 0.76 en vir sitgemak was 0.21. Die deelnemer het geen gestremdheid gerapporteer, soos gemeet met die NOI met aanvangs van die studie of teen die einde van die studie nie. Gevolgtrekking: Die vertikale hoogte-aanpassing van die stoel en beeldskerm van hierdie vroulike rekenaar werker volgens haar antropometrie het bygedra tot ‘n verbetering in nek en boonste rug pyn, asook sitgemak. Hierdie ergonomiese werkstasie intervensie kan deel vorm van die praktiese hantering van nek en boonste rug pyn in rekenaargebruikers. Verdere navorsing wod aanbeveel om te bepaal of hierdie bevindinge veralgemeenbaar is na die wyer gemeenskap van rekenaarverbruikers.

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2016. / Background: Musculoskeletal disorders (MSDs) are a significant and common occupational health concern, consequently impacting work attendance and performance. High prevalence rates of MSDs have been reported amongst school teachers. Studies have linked these higher prevalence rates to typical daily teaching activities including prolonged standing, awkward postures, heavy lifting, bending and repetitive movements. Objectives: To determine the prevalence of neck, shoulder and low back pain among primary school teachers in the Central Durban area; to identify any risk factors associated with neck, shoulder and low back pain; and to establish the relationship, if any, between the prevalence and risk factors of neck, shoulder and low back pain among primary school teachers. Methods: This was a quantitative, descriptive and cross-sectional study, conducted in 12 selected public primary schools within the Central Durban area. Volunteers who met the inclusion criteria (n = 97) were invited to complete self-administered questionnaires. Results: Of the 97 completed questionnaires 83.1 percent (%) reported neck and shoulder pain and 71.0% low back pain. Neck and shoulder pain were significantly associated with a forward-bent head posture (p = 0.001), ethnicity (p = 0.001), and history of a severe trauma/injury (p = 0.006). Similarly, significant associations were noted with regards to medical conditions (p = 0.006), a backward-bent head posture (p = 0.016), lifting of heavy loads (p = 0.045) and treatment for severe injury (p = 0.047). Associations were also noted between low back pain and prolonged standing (p = 0.000), ethnicity (p = 0.008), transportation methods (p = 0.023), medical conditions (p = 0.031) and a history of a severe trauma/injury (p = 0.049). Conclusion: This is a first South African study, to our knowledge that highlights increased prevalence rates for both neck and shoulder pain and low back pain amongst teachers, with a variety of associated risk factors. This draws attention to the urgent need for intervention programs to be implemented to prevent/reduce the development of musculoskeletal pain amongst teachers. / M

The disabling conditions of chronic low-back pain continue to cost patient, family, and society. The intricate mechanisms which perpetuate this medical condition often consist of both organic and functional factors. This study evaluated personality and psychosocial variables which may control individual responses to facet denervation, a treatment for chronic lumbar distress. The subjects were 47 chronic pain patients whose symptoms conformed to the facet syndrome. Patient responses to the Minnesota Multiphasic Personality Inventory (MMPI) and the Sixteen Personality Factor Questionnaire were reviewed in an effort to predict statistically symptomatic relief. Also, the patients' involvement in litigation and their accuracy in determining their pain level were studied as possible influencing variables. Results show the litigation factor and two scalesof the MMPI to be most useful in predicting patient response from facet denervation treatment.

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban University of Technology, 2007. / Background: Various congenital spinal anomalies are common findings in the general population. Their clinical significance is controversial with no definitive association been made between any specific congenital spinal anomaly to any clinical features. Project Design: This research study was designed in the form of a quantitative, non-experimental, empirical clinical survey. Method: Data was obtained from thoracic and lumbar spine radiographs contained in the Chiropractic Day Clinic at the Durban University of Technology from 1 January 1997 to 31 December 2005 and from the corresponding patient files. Through the research procedure, 519 thoracic and lumbar spine radiographs were located in the confines of the Chiropractic Day Clinic. Due to the exclusion criteria of a past or present history of trauma to the thoracic or lumbar spine areas, 147 radiographs were excluded. Objectives 1.To determine the period prevalence (1 January 1997 – 31 December 2005) of congenital thoracic and lumbar spine anomalies. 2.To determine if there is any association between the presenting clinical features and the congenital thoracic and lumbar spine anomalies in general. 3.To determine if there is any association between the presenting clinical features and individual congenital thoracic and lumbar spine anomalies. 4.To compare subjects presenting clinical features with reported clinical features from literature. / M

Title of master's thesis: The relation between backache and urinary incontinence Aims: The aim of the thesis is to find relations between various body structures. The main focus is on the analysis of the connections between backache and urinary incontinence depending on duration of backache, localization, backache promotion and sports activities. Methods: The survey was carried out by a four-page questionnaire. In total there was a group of 97 respondents, 79 women and 18 men, who had problems with backache, urinary incontinence or both. The age range of the respondents was from 18 up to 84 years. The questionnaires were distributed to specialized clinical centers in the fields of rehabilitation and physical medicine. The survey data was processed and analyzed by using the statistical program SPSS, Statistical Package for the Social Sciences. Results: The results indicate that there is a relation between backache and urinary incontinence. There is also a relation between promotion of pain in the lower extremities and urinary incontinence. Moreover, it has shown that more than half of the respondents had backache and urinary incontinence at the same time. However, the last two results have not been found statistically significant. According to the survey there is a proved influence of the...

Yau, Ching Ying. / Thesis (D.Nurs.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 180-194). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese; appendixes includes Chinese.

Thesis (M.CM)--Hong Kong Baptist University, 2006. / Dissertation submitted to the School of Chinese Medicine. Includes bibliographical references (leaves 45-46).

This investigation utilized a novel, self-help, multi-element psychological program to manage chronic low back pain. A literature review indicated that this disorder was costly and prevalent, yet a large percentage of chronic low back pain patients did not respond to traditional treatment. Recent research has demonstrated that numerous psychological difficulties have been associated with this disorder, including depression and anxiety. It was hypothesized that these psychological concomitants of chronic low back pain maintain and promote further pain, as part of a vicious cycle. Self-help treatment attempted to break this tension-pain-anxiety cycle using various stress reduction, and cognitive and behavioral management strategies.

Chronic pain sufferers are frequently misunderstood and stigmatised. The aim of this investigation was to provide a description of the lifewor1d of people with chronic low back pain, using the phenomenological method. Themes which emerged were that the persistent nature of chronic pain makes it particularly difficult to endure, arousing a profound fear of the future. It causes a disruption in the relationship between the person and the body, in which the person is forced to function within the constraints of pain. Sufferers are unable to fulfil social roles as expected and are forced to revise their goals and activities. The distress of their experience is mediated by the ability to make sense of their condition, finding meaning in the pain itself. The study highlights the value of the phenomenological method in health psychology. Recommendations are made which may be of benefit to people with chronic pain and their families. / Psychology / M. Sc. (Psychology)