A dissertation submitted in partial fulfillment of the requirements for the Masters Diploma in Technology: Chiropractic at Natal Technikon, 1994. / The effectiveness of chiropractic management of tension-type headache was evaluated in a single blind, randomised, placebo controlled tr ial us ing a pat ient populat ion of thirty (30) individuals who were suffering from tension-type headache / M

Dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic at Technikon Natal, 1998. / The cause of postnatal low back pain is not clearly understood. There have been few studies performed to determine the cause, and several theories have attempted to explain the occurrence of postnatal low back pain. It is suggested that an exaggerated lumbar lordosis, laxity of the ligaments due to relaxin, biomechanical strain on the muscles and ligaments of the lumbar spine and pelvis and temporary compensatory posture are possible aetiologies of postnatal low back pain. (Calguneri et al. 1982; Bullock et al. 1987 ; Berg et al. 1988; Wisneski et al.1992: 711 ; Mantle 1994:799.) / M

Cervicogenic headache is a disorder that is gaining more recognition in the medical field annually. Although a lot of controversy surrounds cervicogenic headache due to its wide array of symptoms and overlap with pre-existing primary headaches, there are many etiologies and treatment procedures that currently exist. The aim of this study was to determine the most effective treatment protocol for cervicogenic headache by comparing three different research trials from the University of Johannesburg Chiropractic day clinic (former Technikon Witwatersrand Chiropractic day clinic) within a two-year period. The treatment protocols that were compared were cervical spinal manipulative therapy, a combination of cervical spinal manipulative therapy and cervical strengthening exercises, temporomandibular joint manipulative therapy and postural correction of the lumbar spine to decrease anterior head carriage. Seventy-eight participants from a possible 96 candidates were contacted telephonically and asked verbal consent to participate in the research trial. The participants were required to complete a telephonic questionnaire that was drawn up by the researcher involved with the aid of a statistical consultant. The questionnaire took 5 minutes to complete. The aim of the questionnaire was to assess the percentage of participants who were currently suffering from headache and the severity, duration and frequency of their headaches. Participants also needed to compare their current and previous headaches. The data was statistically analysed using cross tabulations and CHI squared tests. Statistical significance was calculated using Fischer’s exact test and Phi test for the two-by-two tables, while the Pearson test and Cramer’s V test was performed on tables larger than two-by-two. Statistical analysis revealed that the manipulation groups provided relief for up to three months, after which, symptoms recurred. The group that received the Easy Back Postural Correction Device showed the greatest improvement of symptoms in terms of headache free duration and decrease in current headache severity, duration and frequency. It can thus be concluded that postural correction of the lumbar spine, which in turn corrects anterior head translation, is the treatment of choice for cervicogenic headache. / Dr. M. Moodley Dr. R. van Zyl

Purpose: The purpose of this pilot study was to assess the effects of Diversified Manipulation versus Sacro-Occipital Technique in the management and treatment of Sacroiliac Syndrome. Method: This study consisted of two groups, a Diversified group consisting of 15 subjects with Sacroiliac Syndrome and a Sacro-Occipital Technique group consisting of 15 subjects with Sacroiliac Syndrome. The subjects were between the ages of 18 and 55 years. Potential candidates were examined and accepted based on the inclusion and exclusion criteria. The Diversified group received Diversified Manipulative therapy to the sacroiliac joint, while the Sacro-Occipital group received SOT Category 2 blocking, from which the subjective and objective findings were based. Procedure: Each successful candidate was treated six times over a two-week period. Before the commencement of the treatment one, three and six, the candidate completed the Oswestry Back Pain and Disability Index questionnaire and the Numerical Pain Rating Scale. Digital Inclinometer readings were taken of the thoracolumbar and lumbosacral regions of the spine. Sacroiliac Manipulation was then administered to the Diversified group based on the restrictions obtained during motion palpation. Category 2 blocking was administered to the Sacro-Occipital Technique group based on the SOT Category 2 categorization test findings. The same treatment was administered at each of the six treatment sessions. Results: Objective statistically significant differences were noted on lateral flexion range of motion, in favour of the Sacro-Occipital Technique group. Subjective readings also showed statistically significant differences with regards to Oswestry Back Pain and Disability Index and Numerical Pain Rating Scale in favour of both the Diversified group and the Sacro-Occipital Technique group. Conclusion: The results of the study indicate that both Sacro-Occipital Technique and Diversified have a positive effect on patients suffering from Sacroiliac Syndrome. However, Sacro-Occipital Technique proved to have a greater overall benefit compared to Diversified manipulation in the treatment and management of Sacroiliac Syndrome. It should be emphasized that the present study was a pilot study to determine the effects of Diversified manipulation versus Sacro-Occipital Technique in the management of Sacroiliac Syndrome. Accurate conclusions could not be formulated due to the remainder non-significant statistical findings obtained from the study; therefore further research needs to be conducted on this comparative study. / Dr. B. Losco Dr. C. D. Losco

Objectives: To determine the efficacy of chiropractic spinal manipulative therapy (CSMT) in the resolution of the persistent or chronic middle ear effusion that is associated with otitis media. This treatment was compared to the insertion of tympanostomy tubes with regards to parent perception and satisfaction. Methods: Thirty patients under the age of seven that were diagnosed as having persistent or chronic middle ear effusion were assigned to receive either tympanostomy tubes or chiropractic treatment according to parental choice. Results: After chiropractic treatment, an objective improvement in the middle ear status was noted by serial tympanography, demonstrating resolution of middle ear effusion. This was noted in 64.3% in the right ear, where a type B tympanogram improved to a type A or type C tympanogram, and in 58.3% in the left ear, where a type B improved to a type A or C tympanogram, or a type C improved to a type A tympanogram. After chiropractic treatment, subjective improvements were noted in the patient’s health, hearing, speech and language, behaviour and social skills, balance, gross and fine motor skills, otalgia and the amount of disturbed nights. Additional benefits from chiropractic treatment were noted in 93.3% of cases. Conclusions: The manner in which the middle ear effusion was resolved by chiropractic manipulation is by normalising the function of the eustachian tube. Eustachian tube dysfunction is a commonly reported aetiological factor in the development of otitis media with effusion, yet previously there was no treatment type to address this problem. Improvement of middle ear effusion occurred in 58.3-64.3% of cases, indicating that chiropractic spinal manipulative therapy could be a viable treatment option to correct the eustachian tube dysfunction. / Dr. Harold Humphries Dr. Chris Yelverton

M.Tech. / The purpose of this study was to determine the role of treating the gastrocnemius-soleus complex (GSC) through dry needling and passive stretching, in the management of chronic low back pain. This research aims to compare the effects of treating the GSC alone, lumbar spine manipulation alone or the combination of the two modalities in people suffering from chronic low back pain. Thirty candidates suffering from chronic low back pain between the ages of eighteen to forty years participated in this study. These candidates were recruited from the local surrounding area, through information pamphlets distributed throughout the Technikon Witwatersrand Doornfontein and advertisements placed in the local newspapers. Only those candidates that conformed to the selection criteria were allowed to participate in the study. Each candidate was randomly assigned to one of three groups as they enrolled for participation. Each group consisted of ten candidates. Group 1 candidates received treatment to the GSC by means of dry needling and passive stretching only. Group 2 candidates received lumbar spine manipulation only. Group 3 candidates received a combination of lumbar spine manipulation and dry needling and passive stretching of the GSC. Each candidate received treatment three times a week, every second day over three weeks thus receiving a total of nine treatments each. Subjective data was collected using the Numerical Pain Rating Scale 101 and the Oswestry Low Back Pain and Disability Questionnaire. Objective data was collected using the electronic inclinometer to measure the lumbar spine range of motion in flexion, extension, right and left lateral flexion and right and left anterior rotation. Pressure algometry of the most active trigger point in the GSC was also recorded. Both the subjective and objective data were recorded on the first, third, fifth and ninth treatment consultations before any treatment was administered.

M.Tech. / PURPOSE: To compare the effectiveness of Traumeel®S in combination with specific knee joint mobilisation with Traumeel®S tablets and ointment, or specific knee joint mobilisation alone, in the chiropractic treatment of knee osteoarthritis. By comparing the objective and subjective results obtained from this comparison, the most effective treatment protocol for knee osteoarthritis may be determined. STUDY DESIGN: A random sample of thirty patients, radiographically diagnosed with Grade 2 or Grade 3 knee osteoarthritis, were selected to participate in this study. These patients were randomly assigned to three equal groups of ten patients each. Monitoring examinations were conducted on the initial, third, sixth and final (ninth) consultations.

M.Tech.

M. Tech.

Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 126 leaves, Annexures A-N / Emergency medical personnel have a number of occupational risk factors that are listed in the reviewed literature (Davis and Heaney 2000, Volinn 1997 and Andersson 1999) as risk factors for low back pain. Physical lifting and carrying of patients and equipment increases stress on the lower back, while occupational stress and a high level of patient responsibility are mental risk factors (Davis and Heaney, 2000). Emergency medical personnel that spend long hours in response vehicles, ambulances or helicopters are exposed to vibrational stressors and may therefore have an increased risk of low back pain due to this whole body vibration (Palmer et al, 2000). In addition it has been noted that the number of motor vehicle accidents will also increase the risk of low back pain due to mechanical injury (Cassidy et al, 2003). Low back pain could therefore interfere with their ability to carry out their duties, affect their attitude towards patients and colleagues, impact on the level of patient care required of them, and result in increased absenteeism. Persistence of chronic low back with the inability to perform their duties may result in the need to find alternative employment or result in premature dismissal. The objectives of this study were: to determine if emergency medical personnel have a higher risk factor for the development of low back pain due to their occupation than the general population; as well as determine if an increase in the number of years working in the field (i.e. years of exposure) leads to an increased incidence and / or prevalence of low back pain.