M.Tech. (Chiropractic) / The aim of this study was to compare the effects of chiropractic manipulative therapy with and without stripping massage of the sternocleidomastoid, with regards to pain, disability, cervical range of motion and head repositioning accuracy in the treatment of chronic mechanical neck pain. The aim was determined by using the Vernon-Mior Neck Pain and Disability Index, Numerical Pain Rating Scale and the Cervical Range of Motion measuring instrument (CROM).The study consisted of thirty participants that had an equal male to female distribution. An age range was set and individuals had to be between eighteen and fourty. Participants were chosen according to inclusion and exclusion criteria that were set before the study commenced. Treatment received by the participants was dependent on which group they were allocated to. Group One received just chiropractic manipulative therapy to three restricted segments of the cervical spine. Group Two also received chiropractic manipulative therapy to three restricted cervical segments and had stripping massage of both sternocleidomastoid muscles.Treatment consisted of six treatments sessions and with the seventh visit only readings were taken. Treatments were carried out twice weekly so that the treatment time period fell over a three week study period. Participants were asked to complete the subjective data before the first, fourth and seventh visit. Subjective data was gathered by using the following: Numerical Pain Rating Scale and a Vernon-Mior Neck and Pain Disability Index Questionnaire. The objective data that was recorded by the researcher consisted of the cervical range of motion that was gathered by using the Cervical Range of Motion (CROM) machine and the head repositioning accuracy. Participants then received either chiropractic manipulative therapy to the restricted cervical spinal segments or a combination of stripping massage to the sternocleidomastoid muscles as well as chiropractic manipulative therapy, depending on their groupallocation. All data gathered by the researcher and then analysed by a statistician at the University of Johannesburg...

M.Tech. (Chiropractic) / Mechanical neck pain is the general term that refers to any type of pain within the cervical spine caused by placing abnormal stress and strain on muscles of the vertebral column. This is a very common musculo-skeletal disorder within the population, with 45% to 54% reporting neck pain at any given time of their lives (Martinez-Segura, Fernandez-de-las-Penas, Ruiz-Saez, Lopez-Jimenez and Rodriguez-Blanco, 2006). A vast majority of individuals do not experience a complete resolution of symptoms and as such often becomes a chronic pain (Cote, Cassidy, Carol and Kristman, 2004). Chronic pain by definition is one which is present for a period longer than six weeks (Segen, 2002). Accompanying the neck pain is often a limited or reduced range of motion within the cervical spine. Some studies suggest that hyper-tonicity and strain of the supporting muscles within this region due to an altered biomechanics also contributes to the pain and dysfunction (Armstrong, McNair and Williams, 2005 and Dall’Alba et al. 2001). One of the major muscle groups involved in this is the posterior cervical musculature. This is a general term used to describe the muscles located on the posterior aspect of the neck and includes longissimus capitis, semispinalis capitis, semispinalis cervicis, rotatores and multifidus (Dalley and Moore, 2006). Chiropractic adjustment therapy has been shown to have many effects of the body and especially the cervical spine including a decrease in pain perception and muscle hypertonicity (Kirkaldy-Willis and Cassidy, 1985), an increase in cervical range of motion (Bergmann, Peterson and Lawrence, 1993) as well as an increased skin pain tolerance level (Terrett and Vernon, 1984). Dry needling therapy has also been proven to have similar effects, including, a reduction in pain perception, an increase in range in motion of the specific linked biomechanical section, and most importantly a reduction of muscle tension (Travell and Simons, 1993). The purpose of this study was to see if a synergistic effect of the two above mentioned treatments would occur when combined under one treatment protocol. The aim of this study was to determine how effectively cervical adjustment therapy, dry needling of the posterior cervical muscles and a combination of the two treatments was in treating chronic mechanical neck pain with regards to pain, disability and cervical spine range of motion over a three week period. Participants were recruited from the University of Johannesburg Chiropractic Day Clinic. They were eligible to participate in the study once they met the inclusion and exclusion criteria. Participants were recruited by means of word of mouth as well as with the use of advertisements that were placed around the respective campuses of the University of Johannesburg. Thirty participants who presented with chronic mechanical neck pain, volunteered for this comparative study. This trial is a randomised controlled clinical trial which used convenience sampling. Group A received a combination treatment of dry needling and cervical manipulation. Group B received cervical adjustment only while group C received dry needling of the posterior cervical musculature alone. participants were treated for a total of 6 visits. Subjective and objective measurements were done at visits 1, 4 and a final visit 7 during which only measurements were taken. These effects are based on Vernon-Mior Pain and Disability Index, Numerical Pain Scale Rating, Pressure Algometer as well as Cervical Spine Range of Motion measuring instrument (CROM). The results of this trial indicated that all three treatments were effective in treating chronic mechanic neck pain. While one treatment was not statistically more effective than the other the dry needling and cervical manipulation alone produced a superior result. While combining these treatments was effective the synergistic effect one would expect was not as evident.

A dissertation submitted in partial compliance with the requirements for the Master's Diploma in Technikon: Chiropractic, Technikon Natal, 1998. / Mechanical low back pain is a common clinical entity which needs professional treatment (Margo 1994). Due to the nature of mechanical low back pain, recurrence of pain is a common entity that can cripple a patient and the ~tate financially. It is for'this reason that the professionals need to establish a cost effective method of treatment that helps maintain the pain free state and prevent recurrences / M

Dissertation submitted in partial compliance with the requirements for the Master's Diploma in Technology: Chiropractic at Technikon Natal, 1995. / The efficacy of chiropractic spinal manipulation on its own versus chiropractic spinal manipulation combined with other treatment modalities used in a chiropractic practice was evaluated in a single blind, randomised, controlled trial using a patient population of thirty nurses who were experiencing mechanical low back pain / M

"A dissertation submitted in partial compliance with the requirements for the Master's Diploma in Technology: Chiropractic, Technikon Natal, 1995. / Mechanical lower back pain is a common clinical entity which encompasses a spectrum of disorders. studies show that spinal manipulative therapy is of value in the treatment of mechanical lower back pain, while some chiropractors are of the opinion that McManis traction offers an effective adjunct to spinal manipulative therapy in the treatment of such conditions / M

A dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Technikon Natal, 1997. / Iliotibial Band Friction Syndrome is a common problem for patients as well as physicians. Many treatments have been devised for Iliotibial Band Friction Syndrome, but there is very little research to substantiate which of these treatments is most effective. Myofascial trigger points are a frequently overlooked and misunderstood phenomenon in the medical curriculae, yet with correct diagnosis and appropriate treatment the prognosis of these trogger points is usually excellent. The aim of this placebo-controlled study was to justify the hypotheses which stated that myofascial trigger point therapy would be effective in the treatment of Iliotibial Band Friction Syndrome (IBFS), as compared to detuned ultrasound as a form of treatment. / M

Submitted in compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2017. / Background Performance of the golf swing is mainly influenced by the strength and power of the torso i.e. the low back and abdominal muscles (Gluck, Bendo and Spivak 2008). As rotary velocities increase, muscle force is absorbed by deforming connective tissue, allowing for increased rotation (Gluck et al. 2008). Therefore any decrease in range of motion of the spine in the golfer, could affect performance (Nordin and Frankel 2001). The cause of poor range of motion is often a result of a physical restriction or mechanical dysfunction within the joints (Blanchard 2004). Spinal manipulative therapy (SMT) has been found to bring about biomechanical effects such as an increase in range of motion (ROM) (Millan et al. 2012) by releasing trapped meniscoids and connective tissue adhesions (Pickar 2002). A lack of core muscle strength is also thought to result in an inefficient technique, which predisposes individuals to poor performance (Asplund and Ross 2010). According to Kibler (2006) core muscle strengthening (CMS) is essential for efficient biomechanical function, to maximise force generation and minimise joint loads in all types of activities. The effects of SMT on golfing performance are well documented (Jermyn 2004; Delgado 2006) however, the effects of CMS on golfing performance are unknown. By improving physiological and biomechanical function through CMS, performance indicators maybe maximised (Pickar 2002; Kibler 2006). Aim Therefore, the purpose of this study was to determine the effectiveness ofSMT compared to CMS on performance indicators club head velocity (CHV) and ball carry (BC) in asymptomatic amateur male golfers. Methods Fifty-two asymptomatic amateur male golfers were recruited for this study, but seven withdrew leaving a final sample size of forty-five. Participants were randomly allocated to either the Core Muscle Strengthening (CMS, n=20) or the spinal manipulative group (SMT, n=25). The SMT (n=25) group received a single session of SMT while CMS (n=20) underwent a four week CMS exercise program. Core muscle strength and indicators of performance were taken before and after the intervention using the Bio-pressure feedback unit (BPU) and GC2 Foresight (swing analyser) respectively. Statistical analysis included paired t-tests to assess change in duration of contraction in the CMS group, Pearsons correlation analysis was used to assess the correlation between changes in CHV and BC intra-group and profile plots were used to show direction and trend of the effect by means of the latest version of SPSS software. Results The main findings show that CMS will improve following a four week CMS program (p= <0,001).When compared over time both SMT and CMS have the same effect on CHV (p= 0.127), whereas CMS has a more profound effect over time compared to SMT on BC (p=<0.001). Conclusion Core muscle strengthening appears to have a positive influence on CHV and BC in asymptomatic amateur male golfers, however it is still uncertain which intervention is more effective. Therefore future studies of this nature should look to increasing the duration of the study or the sample size. / M

Submitted in partial compliance with the requirements fo the Master's Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2017. / Background Competitive swimming, as with most other sports that are participated in at more than a recreational level, involves a substantial amount of training. Training excessively results in the overuse of muscles. The overuse of muscles commonly causes the production of myofascial trigger points (MFTPs) within the overworked muscles. The presence of MFTPs is a condition known as myofascial pain syndrome (MPS). Myofascial trigger points may be active or latent. Either way, they produce a wide range of effects. This study focuses on the effect of reduced muscle strength. Muscle strength is essential to athletes as it determines performance. Swimmers with MFTPs will not perform at their full ability. Dry needling is an effective form of treatment for MFTPs as it produces immediate relief from the effects of MFTPs. There is not enough information on the immediate effects of dry needling on athlete performance. Since dry needling brings about the immediate relief of MFTPs, this study aims to restore a swimmer’s muscle power and hence improvement of their swimming performance post-intervention. Aim The aim of this study was to determine the immediate effect of dry needling common myofascial trigger points (MFTP) found in four muscles of the shoulder girdle on competitive swimmers’ 100m freestyle lap-times. Methods The design was a pre-test post-test quasi-experimental study. Thirty five competitive swimmers between the ages of 16 and 30 years old participated in this study. Each participant underwent one assessment. Participants’ lap-times were taken using a Sportline Econosport Stopwatch. The pre- and post-intervention lap-times were compared to each other using statistical analysis. The intervention for the purpose of the study was trigger point dry needling. Myofascial trigger points were assessed using manual palpation and the Myofascial Diagnostic Scale (MDS). Results The median lap time was slightly longer post intervention (0:01:16.10) than pre-intervention (0:01:16.03), and was highly statistically significant (p=0.001). The results of the study were inconclusive, however, as there were too many confounding variables (for example, fatigue due to repeatedly swimming laps, swimmers of a lower caliber and hence quicker fatigue rate being included in the study)which negated the effect of dry needling and so the poorer performance of the participants post-intervention could not be attributed entirely to the intervention. A small number of participant’s lap-times decreased post-intervention i.e. they performed better post-intervention. These individualswere predominantly sprint-swimmers. Conclusion Dry needling negatively affects immediate lap-time performance. Future studies should reduce the number of variables affecting the study, for example, having a sprinter versus long-distance swimmer group, testing the outcome of dry needling after the swimmer has had sufficient time (for example, a day) to rest post-intervention. / M

M.Tech. / This unblinded, randomised pilot study was performed to determine and compare the effect of innervation specific lumbar spine adjustments and stretching on the flexibility of the rectus femoris muscles in asymptomatic subjects. Twelve asymptomatic subjects between the ages of 20 and 30 years were recruited by the use of advertisements placed around the University of Johannesburg, Doornfontein Campus. The inclusion criteria required that the patient had decreased rectus femoris muscle flexibility (testing positive on the rectus femoris contracture test) and no history of, or any current osteoarthritis or pathology of the hips or knees. The patients were randomly placed into one of three groups by drawing a group number from a closed bag. Group 1 consisted of four subjects receiving a single lumbar spine adjustment per treatment relating to the most restricted segment in the L2-L4 area as well as bilateral proprioceptive neuromuscular facilitation (PNF) of the rectus femoris muscles; Group 2 consisted of four subjects receiving bilateral rectus femoris muscle stretches (PNF); and Group 3 consisted of four subjects who received a single lumbar spine adjustment at the L2-L4 area to the most restricted segment found. One adjustment per treatment was performed. With the subject in the rectus femoris contracture test position, a goniometer was used to measure the knee range of motion bilaterally before and after treatments. These measurements were used as objective data. Each subject was treated twelve times over a four to six week period. The objective results indicated that there was a statistically significant improvement in rectus femoris muscle flexibility in both Group 1 and Group 3. In conclusion, it was shown that specific adjustments at the spinal level of the nerve innervation for the rectus femoris muscle resulted in an improvement of the flexibility of the rectus femoris muscle and with a greater effect on the leg ipsilateral to the side of the spinal adjustment. This gives support for the effectiveness of innervation specific spinal adjustments.

M.Tech. (Chiropractic) / This unblinded, controlled pilot study was conducted in order to compare the effectiveness of chiropractic manipulative therapy with that of a combined therapy involving chiropractic manipulative therapy and myofascial trigger point therapy (dry needling technique and passive stretching), in the treatment of chronic mechanical posterior cervical spine pain. In executing the comparison, it was hypothesised that both treatment protocols would be effective, but that the combined therapy would be the most effective for the treatment of chronic mechanical posterior cervical spine pain, as this treatment protocol has equal emphasis on both the osseous and soft tissue structures. It was hoped that this combined therapy would be more effective in terms of a more speedy recovery and long term effect. This would not only benefit the patient from the point of view of health and quality of life, but financially as well, as less consultation fees would have to be paid. Patients wererecruited into the study by the use of advertisements in newspapers and posters, or from patients entering the Technikon Witwatersrand Chiropractic Day Clinic complaining of posterior cervical spine pain. Only those thirty patients who conformed to the specified delimitations and diagnostic criteria were accepted. These patients were randomly placed into two groups of fifteen patients each. One group received chiropractic manipulative therapy and the other group received the combined therapy. Each patient received twelve treatments over a one month period, ie. three treatments per week. After the treatment period there was a month break from treatment and a follow-up consultation at the end ofthis month. This follow-up period was used to determine the lasting effects of the treatment protocol. The subjective data was collected with the use of two questionnaires, the Neck Pain and Disability Index (Vemon Mior) and the McGill Pain Questionnaire. Further subjective data was collected, in the form of the number of fixations found in the cervical spine by the use of motion palpation and active myofascial trigger points found in the specified areas of the Trapezius and Levator Scapulae muscles. The objective data was obtained from the...