M.Tech. / aim of this unblinded randomized control study was to compare Chiropractic Adjustive Therapy (CAT) to Interferential Current Therapy (IFC) as treatment for Painful Minor Intervertebral Dysfunction (PMID) in the lumbar spine. The effects of CAT and IFC on lumbar spine range of motion (ROM) and pain relief from PMID were also examined. The participants of the trials were treated at the Chiropractic Day Clinic at the University of Johannesburg. Thirty participants presenting with Low Back Pain (LBP) and PMID on segmental intervertebral examination were used for this study and divided into two groups of fifteen. Group A participants were treated with CAT applied to the painful intervertebral segment. Group B participants were treated with IFC over the painful intervertebral segment. The objective data for this research was recorded by the readings obtained from the application of transverse pressure by a Pressure Algometer to the lateral aspect of a painful spinous process. Further objective readings were taken using a Digital Inclinometer to measure the participants Range of Motion (ROM). Subjective data was obtained by an Oswestry Pain and Disability Index (ODI). The subjective and the objective data were both recorded at the first, fourth and seventh visit which took place over a three week period. The results of the study showed that Group A had a statistically significant decrease in Pressure Algometer Readings and ODI scores. Group A also showed a statistically significant improvement in ROM readings for Left Lateral Flexion, Left Rotation and Right Rotation. Group B did not show any statistical significance in either the subjective or objective data. Importantly, an Inter-group comparison for the Pressure Algometer Readings also revealed an increasing statistically significant difference between Group A and Group B from the first to the fourth and seventh visit. The pain elicited by transverse pressure to a spinous process is core to the diagnosis of PMID, which can result in many pain syndromes of vertebral origin (Maigne, 2006). This research provides evidence that CAT is more beneficial than IFC for the treatment of PMID in the lumbar spine over a short and longer period of time.

M.Tech. / OBJECTIVE: To determine the most effective treatment protocol in the treatment of Lower-Crossed Syndrome by comparing objective results gained from a Rehabilitation program (group one), Spinal Manipulative Therapy (group two) and a combination of these therapies (group three) directed at the sacroiliac joints and lumbar spine. DESIGN: The study was a clinical trial in which three experimental groups of sixteen participants each were compared to each other. These participants were recruited from the local general population and were selected on the basis of inclusion and exclusion criteria, presenting with Lower-Crossed Syndrome and demonstrating unremarkable clinical and radiological findings. INTERVENTION AND DURATION: After randomisation, group one received a Rehabilitation program which consisted of a stretching and strengthening program only, group two received Spinal Manipulative Therapy only whereas group three received a combination of Spinal Manipulative Therapy and a Rehabilitation program. The frequency of the follow up consultations for this study was two consultations over the first two weeks of the trial and once a week for the following four weeks of the trial. MEASUREMENTS: Objective measurements included lumbar spine flexion and extension ranges of motion, hip flexor flexibility (hip extension), active and passive hamstring flexibility, gluteus maximus and abdominal strength tests and Sorenson’s Test (static back extensor strength test). Subjective measurements were the Oswestry Low Back Pain and Disability Index and McGill’s Questionnaire. Measurements were taken before (pre-) and after (post-) the first (initial), third, fifth and eighth (last) consultations. CONCLUSIONS: The aim of the study was to determine the most effective treatment protocol in the management of Lower Back Pain in athletes presenting with Lower-Crossed Syndrome. Although the combined group (group three) showed the greatest improvement these findings were statistically no greater than the statistical findings in group one and group two. All groups showed a statistically significant improvement over the trial period. This illustrates that both Spinal Manipulative Therapy and a Rehabilitation program (including stretching and strengthening) was effective in the management of Lower-Crossed Syndrome. From this study it can therefore be concluded that one treatment protocol did not prove to be more effective than that of the others.