Thesis (M. Dip. Tech.)--Technikon Witwatersrand, 2002. / Supervisor: Dr. Harold Humphries. Also available via World Wide Web.

Chronic neck pain, including subclinical neck pain (SCNP), is a significant problem that places a burden on the healthcare system. Chiropractic manipulation has shown not only to be effective in treating symptoms of neck pain, but also in providing a neuromodulatory effect on the central nervous system. The motor cortex and cerebellum are thought to be important neural structures involved in motor learning and sensorimotor integration (SMI), and are therefore key structures to investigate how SMI is changed in a SCNP group following chiropractic care. Motor sequence learning (MSL) has also been shown to provide alterations in cerebellar projections to the motor cortex. Therefore, the studies in this thesis set out to determine if it was possible to induce both cortical and cerebellar learning, and if chiropractic care could alter motor output via transcranial magnetic stimulation measures to facilitate this learning. The study‟s results suggest that in a healthy group of subjects there is alteration in the intracortical inhibition of the motor cortex and no significant change in the cerebellum, following MSL. However, the results also suggest that in a SCNP group, there is a modulation of the cerebellar connections to the motor cortex but no effect specific to the motor cortex following both MSL and chiropractic manipulation. Therefore, these findings suggest that people with intermittent neck pain have concomitant changes in SMI and could manifest as clinical symptomology. / UOIT

M.Tech. / Purpose: This randomised, controlled, comparative pilot study was undertaken in order to investigate the effectiveness of the chiropractic manipulation alone, the chiropractic manipulation followed by heat therapy or the chiropractic manipulation followed by cryotherapy in the treatment of cervical facet syndrome. It was hypothesised that all three treatment protocols would be effective, but that applying chiropractic manipulation followed by heat therapy would be the most effective protocol in the treatment of cervical facet syndrome. Method: Forty-five participants were recruited by means of advertisements posted around the University of Johannesburg Doornfontein campus and surrounding businesses. Only those participants who conformed to the inclusion criteria were accepted to form a part of the study. The forty-five participants were randomly placed into three groups of fifteen each. Procedure: Group 1 received chiropractic manipulation only as their treatment protocol. Group 2 received chiropractic manipulation followed by heat therapy as their treatment protocol and group 3 received chiropractic manipulation followed by cryotherapy as their treatment protocol. Each participant received six treatments over a two week period and attended a follow-up consultation in the third week. The follow-up consultation was used to assess the lasting effects of the treatment protocol. Results: The objective data in the form of cervical range of motion was obtained by means of the Cervical Range of Motion instrument. The subjective data was collected by means of the Vernon-Mior Neck Pain and Disability Index and the Numerical Pain Rating Scale. At the end of the trial, statistical analysis was performed to determine whether one treatment protocol was more effective compared to the other treatment protocols. The results indicated that group 2 (Chiropractic manipulation followed by heat therapy) proved to be the most effective treatment protocol. Although the other treatment protocol as well as the control group showed good objective results. Subjective results showed that although all three groups showed statistically significant results, group 2 showed the best results. Thus it is noted that in order to achieve a potentially lasting increase in range of motion and a decrease in pain and disability, the treatment protocol used for group 2 should be the treatment of choice. Conclusion: Trends indicate the most effective treatment protocol in the treatment of cervical facet syndrome is when chiropractic manipulation is followed by heat therapy. The advantage of this combination is that each treatment modality is used to its full potential, thereby providing the patient with the best results in terms of lasting benefits.