Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban University of Technology, 2011. / Background: Wong and Deyo (2001) believe that 98% of the LBP cases are musculoskeletal (mechanical) in origin and 51,7% of these individuals are chronic sufferers (Andersson, 1999). Weak spinal stability muscles have shown to be an aetiological cause (Chok, Lee and Latimer, 1999). Wolff, Weinik and Maitin (2003) agree a combination of brace aided pelvic stabilization combined with a spinal stability programme may be the best treatment intervention for chronic low back pain (CLBP). Objective: The purpose of this research was to determine the relative effectiveness of three treatment protocols with (Group A-Groovi-SI-Belt®; Group B-standard SI belt) and without (Group C-control) brace aided pelvic stabilization in patients with CLBP. Method: Forty-six patients suffering from CLBP were randomly allocated to one of the three treatment groups. A spinal stability programme was progressively taught and enforced in all three groups. Weekly follow-up consultations were required to assess subjective and objective outcomes of the three treatment interventions. Outcomes were obtained by using the Numerical Pain Rating Scale (NRS); Quebec disability scale; Active straight leg raiser test; Biofeedback device and the static trunk extensor endurance test. Results: Data was analysed using the SPSS version 15.0 (SPSS Inc. Chicago, Ill, USA).Comparing pre and post outcome measurements using a p value <0.05 which was considered to be statistically significant. All three treatments improved most outcomes significantly over time. The Groovi-SI-Belt® showed non significant trends of quicker rates of improvement. . Conclusion: This study revealed that brace aided pelvic stabilization combined with a spinal stability programme was a beneficial treatment intervention with the Group A being superior to Group B.

Thesis (M.S.)--Virginia Polytechnic Institute and State University, 1994. / Vita. Abstract. Includes bibliographical references (leaf 37). Also available via the Internet.

Thesis--Kansaneläkelaitos, 1989. / Added t.p. with thesis statement inserted.

M. Tech. / It is well known internationally that the high prevalence of back pain costs the economies of the world many billions of dollars annually. This has prompted a great deal of research abroad into means of reducing the deleterious economic effects of back pain. One of the results of this research is the realisation that Chiropractic treatment of back pain offers an efficacious and cost effective alternative to the conventional medical treatments currently employed in most countries. To this end there has been a move, by health management organisations in the USA and Canada, toward the integration of Chiropractic into their health care systems in a gatekeeper role with notable success in terms of cost reduction. Similar research has not been conducted in the Republic of South Africa and, notwithstanding the evidence emerging from abroad, Chiropractic, although integrated into many health care systems, remains inaccessible to most back pain sufferers, particularly those employed in the lower ranks of industry. This is in large part due to the unavailability of Chiropractic services in the more remote areas of the country where many mines are situated, but also partly due to the lack of incentive for mining companies to make use of Chiropractic services. The data used in this study was obtained from the in-house medical aid of a reputable South African mining company. The data was used to summarise the cost of treatment of selected categories of back pain by the various service providers within the medical fraternity. The medical costs were then compared to the similarly summarised Chiropractic cost of treatment for the same categories of back pain. The results indicate that Chiropractic costs compare favourably with those of the General Practitioner (GP) and Physiotherapists on a stand alone basis. The data indicates however that the medical approach invariable leads to specialist referral that in turn often results in surgery with the associated imaging, theatre and hospitalisation costs. When these costs are considered it becomes obvious that Chiropractic involvement at an early stage has the potential to considerably reduce the cost of treatment of back pain.

Thesis (M.Tech.: Chiropractic) - Dept. of Chiropractic, Durban Institute of Technology, 2004 xvi, 100 leaves / There is a growing base of evidence demonstrating the important relationship between altered mechanics of the lower limb and low back pain. Sagittal plane blockage, specifically at the first metatarsophalangeal joints but also at the ankle joints, has been implicated as playing a role in the process of chronic mechanical low back pain. The purpose of this study was to determine whether a link could be found between chronic mechanical low back pain and sagittal plane blockage of the feet and ankles.

Thesis (M.Tech.: Chiropractic)-Durban Institute of Technology, 2004 xiii, 53 leaves : ill. ; 30 cm / Epidemiological studies, conducted in various countries around the world suggest that low back pain (LBP) represents a serious health risk, affecting populations all over the world. Evidence suggests that the prevalence of LBP is relatively high among people in their 20’s and 30’s. A few epidemiological studies on student populations in other countries suggest prevalence rates of 27 to 71% (Gemmel et al. 1990, Klaber-Moffet et al. 1993, Reis et al. 1996, Lebowski 1997), however LBP among students in South Africa had not yet been investigated. This study concentrated on the prevalence of LBP among the student population of a South African tertiary institution, i.e. Durban Institute of Technology (DIT). This study also proposed to investigate the level and nature of care seeking among those people suffering from LBP. A third aim of this study was to investigate the correlation between potential risk factors and the prevalence of LBP among the student population of South Africa. These were: age, gender, race, height, weight, smoking habits, parity, physical exercise and occupation.

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic at Durban Institute of Technology, 2007. / Objectives The objectives were to compare the relative effect of manipulation and core rehabilitation in the treatment of acute mechanical lower back pain in athletes. Project Design: The study design was a randomized controlled parallel group trial. A quantitative study was performed, by making use of a pre à à à ¢ and post experimental investigation (Nansel et al. 1993 and Naidoo, 2002). Setting: Participants presenting with acute low back pain with an onset of 7 days or less, to the Chiropractic Day Clinic at the Durban University of Technology. Subjects: Thirty athletic participants, either male or female, between the ages of 18 and 45 years presented at the initial consultation which included participant screening and establishment of their suitability for the study. These were then divided into either group A (which received a manipulation) or group B (which received core exercises). Outcome measure: A correct contraction of the core stability muscles was maintained, with a decrease in pressure (in mm Hg) on a Pressure Biofeedback Unit, and an increase in length of time (in seconds). Results: It was found that there was no significant difference between the manipulation and the core rehabilitation groups. Although both groups showed v improvement with regards to their acute mechanical low back pain, the core rehabilitation group improved at a significantly faster rate than the manipulation group with regards to endurance on the stabilizer. Conclusions: Both treatments were equally beneficial for most of the quantitative outcomes measured in this study. However, for the outcome of time on the stabilizer, the core rehabilitation group improved at a significantly faster rate than the manipulation group (p=0.006).

A dissertation presented in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2002. / Waddell (2000) describes low back pain as a 20th century medical disaster as, despite the efforts, skills and resources available today, the management of simple backache has not reduced the rate of chronic back pain and disability. Foster (1989: 9) indicates that as many as 60-80% of the general population experience LBP during adult life, with between 12-35% suffering from it at anyone time. Waddell (2000: 301) states that while 90% of acute or recurrent attacks settle within 6 weeks, 60% of people have at least one re-occurrence within the next year. Swenson (1998: 108) estimates that mechanical disorders of the spine represent at least 98% of LBP cause. Waddell (2000: 305) believes the aim of primary management is to provide symptomatic control of pain and prevention of disability. A large number of therapeutic options may be considered to provide symptomatic relief however, there is no good, scientific evidence that these options produce lasting benefits or that they change the natural history of back pain. He believes that symptomatic measures are only valuable if they facilitate active exercise and rehabilitation. Waddell (2000: 303) states that there is considerable evidence that manipulation can provide short-term symptomatic benefit in patients with acute back pain without nerve root pain of less than 1 month's duration. Manipulation may be equally effective in dealing with recurrent attacks, however there is limited evidence for the effectiveness of manipulation in patients with chronic LBP and nerve root pain. With the rising popularity of magnetic field diagnostic techniques such as MR! (magnetic resonance imaging), magnets and electrical devices are beginning to gain mainstream medical. / M

A dissertation presented in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, 2001. / Hendler et al. (1995) describes low back pain as the most common, costly and disabling musculosketetal condition. Giles (1997: 28) supports this, stating that the annual incidence of low back pain in the adult population is between two and five percent, with a lifetime prevalence of well over 50%. For clinicians to choose the most appropriate therapy for managing this common condition it is essential for research to be carried out to define the most effective treatment. Shekelle (1994) explains that spinal manipulative therapy is an effective treatment for patients with low back pain, while Cherkin et al. (1995) states that there is strong evidence to support the use of nonsteroidal antiinflammatory drugs in the management of mechanical low back pain. It is therefore the purpose of this investigation to determine the relative effectiveness of spinal manipulative therapy compared to Diclofenac Sodium, in terms of subjective and objective measures, in the management of mechanical low back pain. This randomized controlled trial consisted of sixty patients between the ages of 18 and 65, complaining of mechanical low back pain. The sixty patients were randomly divided into two treatment groups of thirty each. One group received spinal manipulative therapy and the remaining thirty were administered Diclofenac Sodium. These patients were carefully screened to allow the researcher to diagnose the patient, with Lumbar Facet Syndrome, Sacroiliac Syndrome or Myofascial Pain Syndrome; or any combination of these syndromes. This is in accordance with Kirkaldy-Willis (1992: 105 - 119) classification system. The thorough examination ensured that each patient had no contra-indications to spinal manipulative therapy or Diclofenac Sodium. / M

M.Tech.