This unblinded, controlled pilot study was undertaken to determine if cervical spine adjustments had an effect on improving the low back pain in the workforce of the corporate environment. Subjects were treated at the Technikon Witwatersrand chiropractic day clinic in Johannesburg, South Africa. Thirty corporate employees suffering from low back pain were selected for this study. Subjects were recruited using posters put up at the Technikon Witwatersrand campus and at companies in and around Johannesburg. The patients were divided into three groups of ten. One group received chiropractic adjustments of the cervical spine. The second group received chiropractic adjustments of the lumbar spine and sacroiliac joints. The third group received a combination of chiropractic adjustments of the cervical spine, lumbar spine and sacroiliac joints. Patients were treated nine times over a four-week period. Objective data was recorded using a Digital Inclinometer to measure lumbar spine range of motion. Subjective data was obtained by participants recording their progress on the Oswestry Back Disability Index and Visual Analogue Pain Scale. The results showed that there was a statistically significant improvement in the pain and disability experienced by the patients in all three groups for the subjective measurements. There was however no statistically significant increase in range of motion in the lumbar spine for all three groups according to the objective measurements. This study concluded that cervical spine adjustments had a positive effect on improving the low back pain and disability experienced by the workforce in the corporate environment. / Dr. Barrett Losco Dr. Pauline Moolman

OBJECTIVE: To determine the most effective chiropractic treatment protocol in the management of chronic non-complicated low back pain. This was determined by comparing subjective and objective results gained from two treatment protocols, one of which included corrective spinal manipulative therapy directed towards the lumbar spine and pelvis with the implementation of an independent home prescribed rehabilitation program. The second treatment protocol consisted of a combination of corrective spinal manipulative therapy directed towards the lumbar spine and pelvis with the implementation of a spinal rehabilitation program under the close supervision and guidance of the researcher. DESIGN: The study was a clinical trial, which consisted of two groups of 15 patients each. These patients were procured using information pamphlets and advertising posters and were selected on the basis of particular inclusion and exclusion criteria. In addition, the selected candidates were also required to have a static isometric back extensor endurance test of 55 seconds and less as well as a decreased lumbar range of motion in the sagittal plane. INTERVENTION AND DURATION: Once the patients were randomized into two groups, the respective treatment protocols were implemented over a six week period. The control group was prescribed with a home exercise spinal rehabilitation program and the experimental group received a supervised spinal rehabilitation program. Both groups received chiropractic manipulation to the lumbar spine and pelvis to restore mobility and correct the mechanical dysfunction in the hypomobile joint. The frequency of follow-ups for this study was three times weekly for the first and second weeks, twice weekly for the third and fourth weeks, and then once weekly for the fifth and six weeks. MEASUREMENTS: Objective measurements included lumbar spine flexion and extension range of motion and Sorenson’s test. Subjective measurements were the Oswestry Low Back Pain and Disability Index and Numerical Pain Rating Scale 101 questionnaires. Measurements were taken at the first, sixth and twelfth consultations. CONCLUSION: The aim of this study was to determine whether chiropractic care in conjunction with a supervised “in-office” spinal rehabilitation program would prove to be a more effective method in decreasing low back pain measurements and indices when compared to a home prescribed exercise program in the management of chronic low back pain. Although the supervised group did show improvements on the areas indicated, none of the two groups showed statistically significant differences. Therefore it can be concluded from the results of this study that the home exercise group demonstrated as good a response as the supervised exercise group thus highlighting the positive effects of the adjustment alone. / Dr. E. Garlick Dr. B. Losco

M.Tech.