Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 xiii, 81 leaves ; 30 cm / Damage to the proprioceptive organs, as well as lack of proprioceptive retraining, after an inversion ankle sprain, has been shown to contribute to the problem of recurring ankle joint injuries, which has the highest incidence of sports related injuries. The proprioceptive organs are important as afferent pathways in reflexes and for the adjustment of posture and muscle tone (Miller and Narson, 1995 and Jerosch and Bischof, 1996). Manipulation is thought to cause a change in the afferent pathways of the manipulated joints and it is proposed that this change may restore normal proprioceptive input, in a previously injured joint (Wyke, 1981 and Slosberg 1988). This however is unproven as indicated in a study by Lephart and Fu, (1995), where techniques to improve proprioception remain untested and according to Brynin and Farrar (1995), screening for proprioceptive and neuromuscular co-ordination should be carried out as part of a chiropractor’s physical examination and injury evaluation. This was a qualitative pre-post clinical study. Forty (40) subjects between the ages of 25 and 45, who had been diagnosed with chronic ankle instability syndrome, were recruited.

Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 97 leaves ; 30 cm / In symptomatic sacroiliac syndrome, nociceptors located within the capsule and ligaments of the sacroiliac joint are said to be activated which in turn act on inhibitory interneurons that synapse with the motor neuron pool of the muscles of that joint (muscles responsible for hip flexion, extension, abduction and adduction fall within the sacroiliac motor neuron pool). These inhibitory interneurons relay information that decreases the recruitment ability of that motor neuron pool. This is termed Arthrogenic muscle inhibition (AMI) and it has been stated that the number of motor units innervating a muscle relates positively to the strength of that muscle and hence may have an effect on the functional ability of that muscle. However, it has been proposed that spinal manipulation activates mechanoreceptors (Wyke receptors) from structures in and around the manipulated joint causing changes in motor neuron excitability through the altered afferent input and thereby causing an increase in motor neuron recruitment and a decrease in AMI. Furthermore, it has been found that sacroiliac joint problems have often been related to reduced or asymmetric range of motion (ROM) of the hip and / or lack of proprioceptive ability in the ipsilateral limb. In light of the above, manipulation has been found to cause a re-establishment of normal muscle tone and joint kinematics, therefore relaxing the muscles in that area and restoring normal ROM of the involved joint. This study presents the results of sacroiliac manipulation on objective hip measures (including peak torques, ROM and proprioception).

Thesis (M.Tech.: Chiropractic) - Dept. of Chiropractic, Durban Institute of Technology, 2005 221 leaves ; 30 cm / Previously the focus has been on the improvement of strength prior to proprioception (Calliet, 1997; Flemister et al. 1998 and Buhler et al. 2002). However according to Oloff (1994); Vegso (1995); Calliet (1997); Kawaguchi (1999); Buhler et al. (2002) and McGrew et al. (2003), focus should lie in obtaining a functional range of motion (increased flexibility) and proprioceptive ability and strength will follow with normalization of the relationship of the anatomical structures. All research in this regard has never assessed the assumption that the strength of the relevant musculature would return (Blokker et al.1992 and Klaue et al.1998). The objectives of this study were: to determine the relative effectiveness of Proprioceptive Neuromuscular Facilitation as compared to the Active Rocker-Board Exercises in the rehabilitation of chronic ankle sprains; as well as to determine the best sequence of applying these techniques to chronic ankle sprains in terms of objective clinical findings.

Thesis (M.Tech.: - Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2006 xiii, 75 leaves, Annexures 1-2 / This research study was designed in the form of a quantitative, non-experimental, empirical clinical survey. Objectives: 1) To determine the period prevalence (1 January 1997 – 31 December 2004) of congenital cervical spine anomalies. 2) To determine if there is any association between the presenting clinical features and the congenital cervical spine anomalies in general. 3) To determine if there is any association between the presenting clinical features and individual congenital cervical spine anomalies. 4) To compare subjects presenting clinical features with reported clinical features from literature.

Thesis (M.Tech.: Chiropractic) -Dept. of Chiropractic, Durban Institute of Technology, 2005 xiii, 117 leaves of pages : ill. / The purpose of this pre-post crossover clinical trial was to investigate the relative effectiveness of the combination of stretching followed by strengthening, versus the combination of strengthening followed by stretching, of the gluteus medius and iliotibial band (ITB), in the rehabilitation of chronic Iliotibial Band Syndrome (ITBS) in long distance runners. The results were based upon subjective and objective clinical findings, as well as effect on running performance.

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, South Africa, 2013. / Background: Lateral ankle sprains and the sequelae of Chronic Ankle Instability Syndrome (CAIS) are common, reaching a peak prevalence of 85%. Manual joint manipulation is an intervention utilised for CAIS. Manipulations are applied either manually or via a mechanical device. The Activator Adjustment Instrument (AAI) is commonly applied to extremities; however, a paucity of research exists, in respect of extremity conditions. Thus this study compared an AAI manipulation with a manual long-axis distraction manipulation (diversified technique) in the treatment of CAIS. Method: This ethics approved, quantitative, randomised controlled clinical trial, of 40 participants allocated between two groups. After receipt of informed consent participants were evaluated against the inclusion criteria and baseline measures were taken. One treatment of either manual or activator manipulation was followed by a measurements-only consultation within 48 hours. A p-value <0.05 was considered statistically significant. Intra- and inter-group analyses were done utilising repeated measures ANOVA tests. Results: Both groups showed a statistically significant improvement on all outcome measures over time, but neither group showed a significant improvement over the other. A trend in the inter-group comparisons reflected parallel improvements in the Algometer, Berg Balance Scale and the dorsiflexion range of motion (objective measures) and non-parallel improvements in the Numerical Pain Rating Scale and Foot and Ankle Disability Index. Conclusion: The results suggested a trend towards subjective improvement in the AAI group, which may have been influenced by the novelty of the AAI. Further research with larger sample sizes and more homogenous participant groups are needed to verify this outcome.

Dissertation submitted in partial compliance with the requirements for the Master’s degree in technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2013. / Background: Forward head posture (FHP) is a common postural abnormality that is commonly associated with weak deep cervical flexor muscles (DCF). The craniovertebral (CV) angle lies between a horizontal line running through C7 spinous process and a line connecting the C7 spinous process to the tragus of the ear. The smaller the angle, the greater the forward head posture. Weak DCF musculature and FHP has been linked to cervical dysfunction in the short and long term such as cervicogenic headache and premature development of cervical regional degenerative joint disease. Improving isometric endurance and neuromotor control of the DCF muscles using craniocervical flexion exercise (CCFE) has been shown to be efficient in patients experiencing cervical dysfunction such as headache, although the relevance of CCFE has not been established in the asymptomatic group. Deficiency in the activity of these muscles can be accurately measured using craniocervical flexion testing (CCFT). There is a paucity of information regarding the definitive relationship between weakness of the DCF and FHP in asymptomatic participants. This research will help establish an efficient and safe prophylactic treatment protocol preventing long term sequela associated with FHP. Objectives: To determine the effect of CCFE on cervical posture by assessment of the CV angle in asymptomatic participants as well as to determine the effect of CCFE on cervical range of motion by assessment of flexion, extension, bilateral rotation and lateral flexion movements in asymptomatic participants whilst measuring the effect of CCFE on isometric endurance and neuromotor control of the DCF muscles assessed by the CCFT in asymptomatic participants. Method: This is a quantitative pre/post intervention study comparing the results of one group of 45 asymptomatic participants before and after the CCFE protocol has been allocated to them over a period of 3-5 weeks. Participants FHP was assessed by measuring the CV angle. This was done by marking the C7 spinous process and extending a horizontal line toward the shoulder. Then marking the tragus of the ipsilateral ear and measuring the angle using the smart tool angle finder (MD products). iv CCFT measurements were taken and the CCFE protocol allocated to those who qualified to take part in the study. Lastly, cervical range of motion was measured. This group received a home exercise protocol of 3 sets of 10 supine chin tucks daily with each repetition being held for 10 seconds. The technique was first ensured by the researcher prior to leaving the consultation rooms and an exercise diary was given to the participant until the 5th and final consultation to record the progress and efficiency of the home programme as well as any complaints regarding this. Result: The asymptomatic group included in the study improved in both the seated and standing CV angle measurements in that the CV was greater at the conclusion of the pre/post intervention (p=0.00000002) and (p=0.000003) respectively . Cervical range of motion showed improvement in some but not all ranges. Flexion showed a reduction in range of motion (p=0.0086) which was significant. Extension showed an improvement in range of motion (p=0.0000002) which was significant. Rotation toward the left (p=0.00003) and right (p=0.00063) showed an improvement in range of motion which was significant. Lateral flexion showed improvement which was not significant in both, left (p=0.0145) and right (p= 0.24985) ranges of motion. Neuromotor control showed 100 percent improvement in that all 45 of the participants were able to perform CCFT correctly through all five stages at conclusion of the study. Conclusion: Therefore it can be concluded that asymptomatic participants will benefit from CCFEs In terms of CV angle improvement, cervical range of motion as well as neuromotor control of the DCF muscles.

Thesis (M.Tech-:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 xv, 121 leaves ; ill. ; 30 cm / According to research, continuing symptoms of pain, instability, crepitus, weakness, stiffness (Pellow and Brantingham, 2001) and swelling (Patel and Warren, 1999:332) commonly follow an acute ankle sprain. The cause of these symptoms is often attributed to the development of a tight sensitive scar (Reid, 1992:251) within the injured ligament. The treatment options available include scar tissue debridement (Bassewitz and Shapiro, 1997), manipulation (Edmond, 1993:164), mobilization, (Hockenbury and Sammarco, 2001) and ultrasound (Thomson, Skinner & Piercy, 1991:43-44). Transverse friction massage could also be used to reduce adhesions (Kessler, 1990:85) and improve mobility of the tissues (Kessler, 1990:140). The Graston Technique Instrument Assisted Soft Tissue Mobilization (GTIASTM) comprises a set of stainless steel instruments (Carey 2003:2) designed to detect and reduce scar tissue and adhesions (Carey 2003:7) by bringing about an area of controlled microtrauma (Hammer, 2003(b):1) and inflammation (Carey 2003:32) through a mechanism similar to that of friction massage.

Thesis (M.Tech.: Chiropractic)- Dept. of Chiropractic, Durban University of Technology, 2007 xv, 145, 22 leaves / It has been shown that patient satisfaction evaluation is an excellent tool that may be used to determine whether practitioner services are meeting the needs of the general public. Furthermore, it has been observed that patients who were satisfied with their treatment behave differently to those who were dissatisfied with their levels of care, as patient’s who were satisfied with their levels of treatment are more likely to be compliant with their treatment regime and more likely to seek out similar care for the same condition in the future. With satisfaction having such an affect on patient’s behaviour toward practitioners and the treatment experience outcomes, it is imperative to understand the underlying factors that may affect the levels of satisfaction.

Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2003 1 v. (various pagings) / Mechanical low back pain is one of the most common clinical disorders that most people seek help for (Painting et al. 1998:110). Epidemiological studies indicate a lifetime prevalence of low back pain ranging from 60 to 80% with an annual incidence of approximately 30% (Mosheni-Bandepi et al., 1998). The Sacroiliac (S.I.) joint is a significant source of pain in patients with chronic low back pain and it therefore warrants further study (Schwarzer et al. 1995:31). S.I. syndrome is defined as pain over the S.I. joint in the region of the posterior superior iliac spine, which may be accompanied by referred pain over the buttock, greater trochanter, groin, posterior thigh, knee, and occasionally to the postero-lateral calf, ankle and foot (Kirkaldy-Willis, 1992:123). Research indicates that there seems to be a correlation between low back pain, more specifically S.I. pain and hip rotation (Ellison et al. 1990, Cibulka et al. 1999, Fairbank et al. 1984). Cibulka et al. (1998) found that patients with lower back pain who were classified as having signs suggestive of S.I. regional pain had significantly more external rotation than internal rotation on the posterior innominate side i.e. side of S.I. dysfunction (approximately a 20 difference). Manipulation is recognised as an effective means of treating mechanical low back pain, with respect to both Lumbar Facet Joint Syndrome and S.I. Joint Syndrome (Assendelft et al. 1992 and Koes et al. 1996). Kirkaldy- Willis (1992:123) states that manipulation is the most certain way of relieving the symptoms of S.I. syndrome. This investigation aimed to determine the effect of a sacroiliac joint manipulation on hip rotation ranges of motion (active and passive motion) in patients with chronic sacroiliac syndrome in terms of objective measures.