Thesis (B.A.)--Haverford College, Dept. of Economics, 2008. / Includes bibliographical references.

A dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic at Technikon Natal, 1999. / The aim of this investigation was to compare the relative effectiveness and cost effectiveness of piroxicam and manipulation in the management of acute grades 1 and 2 inversion ankle sprains in terms of subjective and objective clinical findings. / M

M.Tech.

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Tecnology: Chiropractic, Technikon Natal, 1999. / Infantile colic is a common condition in paediatric practice (Larson & Ayllon 1990) with very little consensus in medical circles as to its aetiology, diagnosis, treatment and prognosis (Pinyerd & Zipf 1989). The purpose of this study is to ascertain the therapeutic efficacy of chiropractic spinal adjustments in relieving the symptomatology of infantile colic. / M

Dissertation submitted in partial compliance with the requirements for the Masters in Technology: Chiropractic, Durban University of Technology, 2010. / Aim: To determine a radiographic and clinical profile of adult subjects with scoliosis and to determine an association between selected radiographic and clinical parameters. Subjects: Sixty subjects between 18 and 45 years, with or without neck/back pain, previously diagnosed with scoliosis. Methodology: A case history and a physical examination of the subject which included an orthopedic assessment of the cervical, thoracic and lumbar spinal areas were conducted for all subjects. Selected clinical data viz. a case history, family history, level and location of pain if present, presence of leg length inequality, pelvic obliquity, shoulder height inequality and/or rib hump was recorded. A full spine A-P radiograph was taken for each subject in the weight-bearing position. Selected radiographic parameters viz. location of curve/s, side of convexity, degree of pedicle rotation, level of the apex vertebra and the Cobb angle of inclination were assessed and recorded. SPSS version 15.0 (SPSS Inc., Chicago, Illinois, USA) was used for data analysis. Results: The mean (± SD) age of the subjects was 26.8 (± 7.9) years. The majority of the subjects were females (63.3 %). A family history of scoliosis was reported by 14 subjects. Most of the subjects (73.3%) complained of pain of moderate severity at the time of presentation. The thoracic and lumbar regions were common areas of complaint in symptomatic subjects and they were most likely to experience pain at the level of the apex vertebra. Shoulder height inequality was observed in 96.7% of subjects, LLI in 91.7% of subjects, rib hump in 73.3% of subjects and pelvic obliquity in 86.7% of subjects. The majority of scoliotic curves were of idiopathic origin (96.7%). Thirty subjects presented with more than one curve. The mean (± SD) Cobb angle for the major curve was 21.3º (± 13.1º) while the mean (± SD) Cobb measurement for the minor curve was 16.7º (± 5.4º). The range for the major and minor curve was 11.5º - 97.0º and 10º- 37º respectively. Both the major and minor curve had the majority of curves located in the thoracic region. However, the apex vertebra was most likely to be found in the T7/T8 region for the major curve and L1/2 region for the minor curve. Pedicle rotation was Grade 1, Grade 0 or Grade 2 (in that order) for the major curves and Grade 0, Grade1 and Grade 2 for the minor iv curves. There was no significant association between the gender of the patient and the severity of pain (p = 0.725), severity of the major curve (p = 0.545) or grade of pedicle rotation (p = 0.639). There was also no significant association between the ethnicity of the subjects and severity of the major curve (p = 0.088) or degree of pedicle rotation (p = 0.882). No significant association was found between location of the major curve and presence of pain (p = 0.565) or between the side of the curve and pain (p = 0.812). There was no correlation between the degree of pain and the degree of curve (r = 0.102). No significant association was found between LLI and degree of curvature (p = 0.470). A significant association between LLI and reported pain was found (p = 0.034). A significant association was observed between the presence of a rib hump and the degree of curvature (p = 0.049). A positive correlation was found between rib hump elevation and degree of curvature (r = 0.814). A positive correlation between rib hump elevation and degree of pedicle rotation was found (rho = 0.308). Conclusion: Idiopathic scoliosis is the most common form of scoliosis in young adults. Pain is a common clinical feature in adult scoliosis. The size of the curve does not influence the magnitude of the LLI, pelvic obliquity or shoulder height inequality, however since these clinical features are common findings in the scoliotic individual, it is suggested that these parameters be routinely evaluated for their diagnostic significance. The presence of shoulder height inequality, LLI, rib hump and pelvic obliquity are deemed to be good clinical signs of scoliosis. Even though LLI was not associated with the magnitude of the curve, it may be a significant contributor to the back pain as LLI was found to be the only clinical parameter to have a significant association with pain. Therefore clinicians should explore the treatment of LLI to alleviate pain associated with scoliosis. The presence of a rib hump is a good clinical indication of the presence of a scoliosis.

A dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 1999. / There have been few studies conducted to determine the effects of stretching as a therapy on its own in the treatment of low back pain. In response to this, the objective of this study was to evaluate the relative effectiveness of stretching the hamstring muscles on low back pain experienced by cyclists. Thirty two cyclists with low back pain were screened for lumbar facet syndrome, sacroiliac syndrome and myofascial pain syndrome of the quadratus Iumborum, gluteus medius and gluteus maximus muscles and randomly divided into two groups of sixteen. Detuned ultrasound was applied to the hamstring muscles of the patients in the placebo group twice a week for three weeks. Patients in the experimental group were involved in a stretching program whereby the hamstring muscles were passively stretched for three sets of thirty seconds duration, two days a week for three weeks. Both groups were evaluated in terms of subjective clinical findings by utilising the Oswestry Low Back Pain Disability Questionnaire, the Numerical Pain Rating Scale-101, and theti / M

A dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 1996. / The purpose of this investigation was to determine the efficacy of chiropractic treatment in the management of primary dysmenorrhea. The sample consisted of 30 patients who were randomly assigned to 2 groups, the control and experimental. This single blind study consisted of 16 visits, twice a week for the first 4 weeks and thereafter once a week for the next 8 weeks. During a menstrual cycle, prior to commencement of treatment, the patients were required to complete a Short-Form McGill Pain Questionnaire on the last day of dysmenorrhea and a Numerical Pain Rating Scale 101 on each day of experienced menstrual pain. These questionnaires were completed at home. Treatment for the experimental group consisted of soft tissue massage of the lumbar and thoraco-lumbar paravertebral. musculature combined with spinal manipulative therapy of the areas of fixation in the' lumbar and sacra-iliac regions. The control group received purely soft tissue massage of the lumbar and thoraco-lumbar paravertebral musculature. The areas of fixation were determined by motion palpation, joint challenge and tenderness to spinal palpation. There was no follow-upvisit conducted in this study. An analysis of the data revealed a statistically signiflcant improvement in the experimental group in terms of the Short Form McGill Pain Questionnaire (p=< 0,001) as well as for the control group (p=< 0,01), whilst in terms of the Numerical Pain Rating Scale 101 the experimental group showed an improvement (p=< 0,05) but the control group failed to show a significant change (p= 0,068). / M

A dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2005. / It has generally been accepted that 60 to 80% of the general population will suffer from low back pain at some point in their life. (Kirkaldy - Willis, 1992). The use of manipulation for the treatment of low back pain is well documented but lumbar mobilization has undergone comparatively little investigation (Goodsell et al., 2000). Furthermore, there remains little evidence to advocate the use of Muscle Energy Technique (MET) in the form of a randomized clinical trial (Wilson, 2003). The purpose of this study was to determine whether patients with acute and sub-acute low back pain would demonstrate a reduction in disability after being treated with MET or specific passive mobilization. Both interventions are joint mobilization techniques the only difference being that one is passive and the other (MET), is an active technique / M

M.Tech. / The purpose of this unblinded controlled study was to determine the effective of dry needling of the Vastus Medialis Oblique muscle when utilised in conjunction with conservative chiropractic management for Patellofemoral Pain Syndrome (PFPS). The subjects of the trial were treated at the Chiropractic Day Clinic at the University of Johannesburg. Thirty patients suffering from chronic Patellofemoral Pain Syndrome were chosen for the study and they were divided into two groups of fifteen. The first group received conservative chiropractic care which consisted of manipulation of the sacroiliac joint, mobilisation of the knee and patella joints and stretching and strengthening exercises consisting of Quadriceps standing self stretch and Quadriceps setting as the strengthening exercise. The second group received the above treatment but also underwent dry needling of the Vastus Medialis Oblique muscle. The objective data for this research was recorded using a lower limb isometric dynamometer and the subjective data was recorded with a pain scale. Both sets of data were recorded on the first, third and fifth treatments. The results of the trial showed that there was a significant increase in strength with a reduction in pain levels for both groups but there was no statistically significant difference when comparing the two groups. The dry needling group did however improve at a faster rate than the other group but it did even out after the five treatments. What was noteworthy is that the males of the study improved their strength by a much greater extent than the females which is uncommon for PFPS. The end result of this study is that overall, dry needling of the Vastus Medialis Oblique muscle is not highly beneficial in the long term management of PFPS but does have its benefits in the early stages of the treatment in order to relieve the acute pain and increase the Quadriceps muscle strength rapidly.

A dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2005. / Several studies in Europe, Canada and the USA indicate that communication between GP’s and chiropractors is not ideal. Langworthy and Birkelid’s (2001) study concluded that with increasing emphasis on multidisciplinary health care, greater understanding and better communication is needed in order for the patient to obtain optimum benefits. The medical profession in the past has generally been opposed to the theories and practice of chiropractic, for a variety of reasons, including lack of scientific validity as well as unsubstantiated management utility (Silver, 1980). However, a Canadian study indicates that much progress has been made in diminishing the gap between GP’s and chiropractors (Verhoef and Page, 1996). Few studies have investigated GPs’ knowledge, awareness and attitudes toward complementary and alternative health care providers, especially in relation to the balance between market rivalry and interprofessional care (Langworthy and Smink, 2000). One such study performed in the Netherlands by Brussee et al. (2001) found that a statistically significant relationship existed between the level of knowledge of chiropractic and the frequency of referral of patients by GP’s. In the UK, it was found that many GP’s were more comfortable in referring to physiotherapists because they felt they had a better understanding of the treatment involved (Breen, et al., 2000). The chiropractic profession is attempting to improve co-operation with the medical profession via the scientific validation of its theories and practice through research (Rubens, 1996). The current perception in South Africa is that GP’s do not tend to refer patients to chiropractors. This has implications for chiropractic in the South African context in terms of integration. Therefore, as the current “gatekeepers” of primary healthcare, it is important to ascertain the perception and knowledge that this group has of the chiropractic profession in South Africa. The purpose of this investigation was therefore to determine the current knowledge and perception of GP’s in South Africa of chiropractors and chiropractic treatment in general. This should establish a knowledge base to facilitate greater understanding and co-operation between GP’s and chiropractors. / M