Dissertation submitted to the Faculty of Health Sciences at The Durban University of Technology in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, 2008. / Objective: To determine the current knowledge and perceptions of biokineticists with respect to the chiropractic profession in South Africa. Design: A descriptive design was utilized in a qualitative questionnaire in order to evaluate, in a structured manner, the knowledge and perceptions of biokineticists with respect to Chiropractic. Subjects: The total population size used in the study was 657 (response rate n=78; 11.87%). Outcome Measures: These were based on a questionnaire which addressed biokineticists knowledge of Chiropractic, interaction with Chiropractic, Chiropractic terminology and scope of Chiropractic practice. Results: Of the 657 questionnaires that were mailed, only 78 questionnaires were returned and this gave a response rate of 11.87%. The most frequent view or attitude towards chiropractic was that it had a valuable role in the health care system (64%). About 50% of the respondents believed chiropractors to be greatly competent in examination and diagnosis whilst 40% felt that chiropractors were moderately competent in examination and diagnosis. Nevertheless, the rate of communication between biokineticists and chiropractors was found to be quite high, in this study. All together, 67% of biokineticists had communicated with chiropractors. Of those that had communicated, the communication was rated as positive (94.4%). Of those who had referred patients to chiropractors, 41.8% had received treatment feedback reports and of those who had received reports, 68.8% said they were concise and valuable. Conclusion: The results of this study show that the mean knowledge score was 60%. Thus the overall knowledge of chiropractic was high. The only factor that significantly affected respondents’ knowledge was their self reported knowledge of chiropractic. In congruence with this, the most common attitude towards chiropractic was that it had a valuable role to play in the health care system (64%).

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban University of Technology, 2008. / The aim of this study was to investigate the factors affecting the career choice of selected health-care students (physiotherapy, chiropractic, medicine and occupational therapy) in KwaZulu Natal. Multiple reasons exist for choosing careers. However, the set of factors involved when students commit to at least 4 to 7 years of their lives to these alternative and mainstream health care professions are of particular interest to this study. This was a demographic-epidemiological, cross-sectional survey-type quantitative study, based on a pre-validated questionnaire which was administered to the participants. The questionnaire was distributed to 29 first year chiropractic students of the Durban University of Technology, 32 first year physiotherapy and 22 occupational therapy students of the University of KwaZulu Natal, and 55 first year medical students of the Nelson Mandela School of Medicine. The results revealed that parents were a major factor influencing career choice (68.1%), as were significant other people (42%). However, siblings, peers and television did not have a major influence. Only television had a differential influence on the student groups (p<0.001). The medical students (20%) were influenced by television to a greater extent than the other professions. The majority of respondents obtained information from professionals visiting schools (56.5%), while family and guidance counsellors were also important sources of information (52.2% and 50.7% respectively). These results also revealed that chiropractic students were more likely to use the Internet to find out about careers than the other student groups. Previous past experience with a professional from their chosen career field did have a relatively strong influence (46.4%) whereas physiotherapists and chiropractors were more likely than the other two groups to be influenced by a professional from that career. V Working with people was the most important personal factor influencing career choice. The altruistic factor of helping others was the second most important factor. The least important personal factors were prestige, variety, lifestyle and enjoyment of working with their hands. Another result indicated that the ability to define personal goals was important for medical students but it was not very important for occupational therapy students. The joy of working with their hands was more important for chiropractic and physiotherapy students. The motivation to help others was more important to occupational therapy students. Finally, the results showed that prestige was most important for chiropractic students. A good work atmosphere was the most important work-related factor (75.4%), followed by the ability to run their own office (64.5%) and working conditions (55.1%). Of least importance was the presence of blood (7.2%). “The ability to run your own office” was significantly different between the student groups (p=0009) and chiropractic students were significantly influenced by this factor.

Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban University of Technology, 2006 116 leaves / The aim was to evaluate the prevalence of hand and wrist pain, as well as the relationships between occupational overuse syndromes in the hands and wrists of chiropractors in South Africa as a result of their daily use of manual therapy techniques while at work. There are very few statistics available that disclose the nature and incidence of work related injuries. However those statistics that do exist suggest that hands on patient activities place physical therapists at greater risk of injury in comparison to other health care workers (Lunne et al., 2000). A study conducted by Bork et al.(1996) determined the prevalence of work-related musculoskeletal injuries sustained by physical therapists. Hand pain (29.6%) and back pain (45%) where the leading cause of pain in physical therapists (Bork et al., 1996.) Chiropractic and physiotherapy are both health care professions that specialize in the treatment of disorders pertaining to the neuro-musculo-skeletal system (Hunter, 2004). Physical therapists use manual therapy techniques as part of their daily working activities, so it can be assumed that chiropractors too will have a high prevalence of hand and wrist pain as they utilize similar therapeutic techniques to physical therapists. Cromie et al.(2000) evaluated the prevalence, severity, risks, and responses of disorders in physical therapists. He identified 4 categories of major risk factors commonly associated with workers musculo-skeletal disorders in physical therapists 1. Risk factors related to specific activities. 2. Postural risk factors. 3. Risk factors with regard to work load issues 4. Risk factors in regard of work capacity and health of the participant (Cromie et al., 2000). Physical risk factors found to be associated with neck, shoulder, or hand and wrist disorders in cross sectional studies are heavy lifting, monotonous work, static work postures, vibrations and repetitive jobs, and a high work pace (Alfredsson et al., 1999). Other factors that have been associated with musculoskeletal pain are higher age and female gender (de Zwart et al., 2001; Wahlstedt et al., 2001; Feveile et al., 2002).

Thesis (DPhil)--University of Stellenbosch, 2005. / ENGLISH ABSTRACT: Although a legitimate provider of manipulative therapy, chiropractic largely functions outside mainstream health care in South Africa. A narrow research focus, poor institutional representation and inadequate professional integration all contribute to its undetermined role in health care. This study exploratory, qualitative study sought to investigate the state of the art of chiropractic with respect to beliefs, philosophy, research methods and clinical practices. Semi-structured, interviews were used to extract responses from ten chiropractors, six patients and four researchers. The results were interpreted on three levels; thematically, in relation to chiropractic’s discipline and profession and as a function of the ‘3 worlds’ framework. The thematic analysis revealed that: 1. Beliefs and philosophical traditions play an active role in the practice and science of chiropractic. 2. The chiropractic investigative paradigm has started to mature. 3. The contextual role of research methods is being clarified. 4. Contemporary chiropractic practice is not as evidence-based as it should be. 5. The chiropractic model of practice is significantly different to the perceived standard medical model. 6. Chiropractic clinical practice has a fuzzy identity. 7. Chiropractic’s professional status is unclear. 8. The professional and disciplinary components of chiropractic are still institutionally immature. 9. Chiropractic’s legitimacy is questionable. Themes 1-3 indicated that beliefs and philosophical traditions affect the way in which chiropractors conduct themselves clinically, the way patients view the world of health care and the manner in which researchers study clinical phenomena. Themes 4-6 suggest that the state of the art of chiropractic clinical practice is different from medicine, however the exact nature of its model of practice seems quite fluid. Themes 7, 8 and 9 suggest that the degree of professional and institutional maturity provide chiropractic with only partial legitimization.With regards to the discipline it seems that science and education have an important buffering role to play between the patient and the practitioner, in order to curb metaphysically motivated practices. Furthermore, chiropractic’s investigative paradigm is progressing atypically and hence the view of it conforming to a standard view of science is questioned. With regards to professional matters, our study indicates that chiropractors function on a spectrum which runs between “technicians” and “physicians”. Whilst patients have holistic health care beliefs it seems they are pushed toward chiropractic, through negative allopathic health care experiences and are drawn to the profession by its integrated model of practice. However, the lack of mainstream healthcare integration counter balances this worth and reduces chiropractic’s professional legitimacy. Two cross over themes were revealed. Firstly, chiropractic’s investigative paradigm has started to narrow the gap between applied science and clinical practice and secondly chiropractic’s legitimacy cannot lie in the opinion of medicine. The ‘three worlds’ framework indicated that the first three themes are meta-scientific (W3) reflections on beliefs, philosophical traditions and research methodology. The fourth theme reflects the relationship of research and practice (W2 and W1), and the remaining five themes are reflections clinical practice (W1 activities). Our study contends that chiropractic has the potential to develop into a mainstream health care provider through the implementation of a multi-leveled development strategy. / AFRIKAANSE OPSOMMING: Alhoewel chiropraktyk ’n geoorloofde verskaffer van manipulasieterapie is, funksioneer dit grootliks buite hoofstroomgesondheidsorg in Suid-Afrika. ’n Eng navorsingsfokus, swak institusionele verteenwoordiging en ontoereikende professionele integrasie het tot die onbepaalde rol van chiropraktyk in gesondheidsorg bygedra. Hierdie verkennende kwalitatiewe studie het gepoog om chiropraktiese praktyk ten opsigte van oortuiginge, filosofie, navorsingsmetodes en kliniese praktyke te ondersoek. Semi-gestruktureerde onderhoude is gebruik om response van tien chiropraktisyns, ses pasiënte en vier navorsers te verkry. Die uitslae is op drie vlakke geïnterpreteer: (i) tematies; (ii) met betrekking tot die chiropraktiese dissipline en beroep; en (iii) as ’n funksie van die “drie wêrelde”-raamwerk. Die tematiese analise het die volgende blootgelê: 1. Oortuiginge en filosofiese tradisies speel ’n aktiewe rol in die praktyk en wetenskap van chiropraktyk. 2. Die chiropraktiese ondersoekende paradigma is besig om verder te ontwikkel. 3. Die kontekstuele rol van navorsingsmetodes word duideliker gemaak. 4. Hedendaagse chiropraktiese praktyk is nie soveel op bewyse gegrond as wat dit behoort te wees nie. 5. Die chiropraktiese model van praktyk verskil aansienlik van die aanvaarde standaard- mediese model. 6. Die identiteit van chiropraktiese kliniese praktyk is vaag. 7. Chiropraktyk se professionele status is onduidelik. 8. Die professionele en dissiplinêre komponente van chiropraktyk is steeds institusioneel onderontwikkel. 9. Die legitimiteit van chiropraktyk is betwisbaar. Temas 1 tot 3 het daarop gedui dat oortuiginge en filosofiese tradisies die wyses beïnvloed waarop chiropraktisyns klinies handel, waarop pasiënte die wêreld van gesondheidsorg sien, en waarop navorsers kliniese verskynsels bestudeer. Uit temas 4 tot 6 kan afgelei word dat chiropraktiese kliniese praktyk van geneeskunde verskil; die presiese aard van die praktykmodel kom egter heel onbestendig voor. Uit temas 7, 8 en 9 kan afgelei word dat die graad van professionele en institusionele ontwikkeling chiropraktyk slegs gedeeltelik legitimeer.