Partial Dissertation in compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban University of Technology, 2007. / Aims and Objectives: The aim of this study was to determine whether spinal manipulation affects the perceived performance of runners with low back pain. More specifically, the objective was to determine whether any relationships existed between spinal manipulation, a runner’s perceived performance and their low back pain. Method: Twenty subjects who ran thirty kilometers a week and had LBP were selected for a pre- post- cohort study according to criteria set out beforehand. The subjects received spinal manipulation applied to their lower back twice a week for a period of two weeks. At each consultation, they were requested to fill out a “Perception of Running Performance” questionnaire prior to each treatment, and one week following the final consultation. / M

Dissertation submitted to the Faculty of Health at the Durban University of Technology in partial compliance with the requirements for the Master‟s Degree in Technology: Chiropractic, 2009. / The prevalence of neck pain in musculoskeletal practice is second only to that of low back pain (Vernon et al., 2007). There is a growing interest in neck pain research due to the escalating disability burden and compensation costs associated with neck pain (Côte et al., 2003). Manual therapies are commonly used in the treatment of neck pain (Côte et al., 2003). After an extensive literature review by Haldeman et al. (2008) they found that manual therapy techniques have some benefit but no one technique was clearly superior to the next. Therefore, the purpose of this study is to compare three commonly used manual therapy techniques in the treatment of chronic mechanical neck pain. OBJECTIVES The purpose of this study was to compare three different manual therapy techniques (SMT, MET and PNF) which are commonly used in the treatment of chronic MNP in terms of range of motion, pain and disability. METHOD Forty-five patients with chronic mechanical neck pain were obtained through non-probability convenience sampling and assigned into one of three treatment groups (15 per group) using a computer generated randomized table. The three different treatment groups were: Spinal Manipulative Therapy (SMT), Muscle Energy Technique (MET) and Proprioceptive Neuromuscular Facilitation (PNF). Each group received six treatments over a period of three weeks with a follow-up consultation. Measurements were taken at the first, third and sixth treatment and at the follow-up consultation. SPSS version 15.0 was used to analyse the data. A p value of <0.05 was considered as statistically significant. An intra-group analysis was done using repeated measures ANOVA testing to assess the time effect for each outcome separately. For inter-group analyses the time x group interaction effect was assessed using repeated measures ANOVA testing, and profile plots were used to assess the trend and direction of the effects. RESULTS Intra-group analysis of the results revealed that all three groups improved significantly between the first and the final consultation, for all measures. Inter-group analysis of the data did not show any difference between the three groups by the end of the final consultation. However, extension range of motion appeared to improve slightly faster in the PNF group iv but it was not significant when compared to the other two groups. Therefore, there was no statistical significance between the three groups. CONCLUSION It was concluded that all three treatment groups responded equally to the treatment, thus, suggesting that MET or PNF techniques can be used if SMT is contra-indicated. / M

A dissertation presented in partial fulfilment of the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2005. / Low -Dye taping is a method commonly used in sport participation and normal daily activity (Harradine, Herrington and Wright, 2001). It has been indicated in support of injured structures, decreasing edema and protection against re-injury (Reid, 1992:232). Contrary to these beliefs, studies have shown that low -dye anti-pronatory control is lost after relatively short episodes of exercise (Ator et al., 1991 and Vicenzino et aL, 1997). The variations in dynamic foot function with low -dye taping is not well understood, although tapin.g of the foot in low-dye type method has been advocated by many authors (Brantingham et aL, 1992, Ryan, 1995 and Chandler and Kibler, 1993). It was the purpose of this study to investigate the maximum ground reaction force and percentage contact time within 10 demarcated regions of the foot in asymptomatic patient with pes planus, cavus and normal medial longitudinal arches at four time intervals over 24 hours. Having established its baseline function it may serve as point of reference for clinical trials that wish to determine the role of taping as part of the management of symptomatic feet. This trial consisted of 60 participants with asymptomatic feet that were divided into three groups of 20. Participants were divided into three groups depending on their respective foot structures. To qualify for one of the three groups subjects had to either have flexible low, high or normal medial longitudinal arches. Maximum ground reaction forces (GRF) and Percent contact time was obtained for each of the three groups and for each of four visits. GRF were obtained with the aid of a registered orthotist who has agreed to work with the researcher on this project using the RSscan International 1m footscan plate system (Appendix L). The data was interpreted and analyzed using the RSscan Clinical Version 7.08 software package. / M

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban University of Technology, 2007 / The purpose of this study was to determine the relationship between Myofascial Pain Syndrome (MPS) of the pericranial musculature and the clinical presentation of episodic tension-type headache (ETTH). It set out to determine the extent to which MPS is related to the nature of the ETTH. ETTH is a very prevalent disorder, common to individuals in their third decade, and particularly females. Current literature suggests a multi-factorial aetiology, combining psychological and neuromusculoskeletal mechanisms, to name a few. Due to the many facets of this disorder, it has, for a long time, provided a challenge to the practitioner with regard to patient treatment and management. MPS is a condition that may affect any number of muscles, resulting in motor, sensory and autonomic symptoms. MPS of the pericranial muscles, namely the upper Trapezius, Sternocleidomastoid, Temporalis and Suboccipital muscles, produces a referred pain pattern similar to the pain pattern experienced during an ETTH. The literature states that the pain produced by MPS has been somewhat overlooked and it was thus necessary to further investigate the myofascial component of ETTH. This study was a quantitative, pilot, non-intervention, clinical assessment study, which required forty participants residing in the province of Kwa-Zulu Natal suffering from ETTH. The clinical assessment included a case history and physical and cervical examinations. The participants were requested to complete a headache diary over a period of 14 days. Following this, they returned to the Chiropractic Day Clinic for a second consultation. Data was collected at both consultations and the participant was offered one free treatment. The headache diary and Numerical Pain Rating Scale provided the subjective measurements, while the algometer and Myofascial Diagnostic Scale were used to gather the objective measurements. / M

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, Durban, 2001. / For neck pain, the first-line treatment of allopathic physicians is usually the prescription on non-steroidal ant-inflammatory drugs (NSAIDs), whereas the firstline treatment of chiropractic physicians is usually cervical manipulation. The literature shows that both chiropractic manipulation alone and NSAIDs alone are effective for the treatment of cervical facet syndrome, with chiropractic manipulation being much safer than the use of NSAIDs. Furthermore, patients that receive chiropractic care have been shown to generally be much more satisfied than those that receive conventional medical care. The aim of this study was to determine the short-term effectiveness of cervical spine manipulation as compared to Piroxicam administration in the treatment of chronic cervical facet syndrome. The study design that was chosen was that of a comparative clinical trial. Forty consecutive patients diagnosed with chronic facet syndrome of the cervical spine were randomly assigned to either the manipulation group or the NSAID group (twenty patients in each group). Each patient in group A received manipulative therapy of the cervical spine on three consecutive days. Each patient in group B received 40 mg of Adco Piroxicam on the first two days of treatment, and 20 mg daily for the remainder of the seven day treatment period. The patients were assessed by means of objective and subjective data obtained before each consultation on days 1, 3 and 7. The objective data was gathered from algometric pressure-pain threshold readings over the involved facet joint. The subjective information was obtained from the Short-Form McGill Pain Questionnaire, the Numerical Pain Rating Scale - 101 and the CMCC Neck Disability Index, as well as the patients perceived improvement which was recorded as a percentage on days 3 and 7. / M

A dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Technikon Natal, 1999. / The purpose of this study is to determine the relative effectiveness of (Contract-Relax- Agonist-Contract) CRAC stretching, a component of Proprioceptive Neuromuscular facilitated (PNF) stretching, as opposed to static stretching in the treatment of active myofascial trigger points of the shoulder girdle and neck muscles. This was a randomised clinical trial consisting of two groups. Group A received static stretching as their treatment protocol and Group B received PNF (CRAC) as their treatment protocol. Each group consisted of fifteen people between the ages of 18 and 55 who were randomly allocated to their respective groups. It is hypothesised that PNF (CRAC) stretching would be relatively more effective than Static stretching in the treatment of active myofascial trigger points of the shoulder girdle and neck muscles. Subjects diagnosed with active myofascial trigger points in the Trapezius, Infraspinatus and Rhomboid muscles were included in the study. The treatment regime consisted of a course of five treatments spread over a period of two weeks and then a one - month follow up consultation. Subjective and objective measurements were taken at the first, fifth and follow up consultations. Subjective data consisted of the Short Form McGill Pain Questionnaire, the CMCC Neck Disability Index and the Numerical Pain Rating Scale -101. The objective data was collected by means of algometer and goniometer measurements. This data was used to perform statistical analysis using the non-parametric Wilcoxin signed-rank test and the Mann Whitney unpaired test to compare intra-group and intergroup data respectively, at a 95% confidence level. This study suggests that both static and PNF (CRAC) stretching are effective in the treatment of active myofascial trigger points. However there is no clinical statistical difference between these two treatments. Further studies with a larger sample size are needed to clearly evaluate the use of stretching in the treatment of active myofascial trigger points. / M

Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 xiii, 81 leaves ; 30 cm / Damage to the proprioceptive organs, as well as lack of proprioceptive retraining, after an inversion ankle sprain, has been shown to contribute to the problem of recurring ankle joint injuries, which has the highest incidence of sports related injuries. The proprioceptive organs are important as afferent pathways in reflexes and for the adjustment of posture and muscle tone (Miller and Narson, 1995 and Jerosch and Bischof, 1996). Manipulation is thought to cause a change in the afferent pathways of the manipulated joints and it is proposed that this change may restore normal proprioceptive input, in a previously injured joint (Wyke, 1981 and Slosberg 1988). This however is unproven as indicated in a study by Lephart and Fu, (1995), where techniques to improve proprioception remain untested and according to Brynin and Farrar (1995), screening for proprioceptive and neuromuscular co-ordination should be carried out as part of a chiropractor’s physical examination and injury evaluation. This was a qualitative pre-post clinical study. Forty (40) subjects between the ages of 25 and 45, who had been diagnosed with chronic ankle instability syndrome, were recruited.

Thesis (M.Tech.: Chiropractic) - Dept. of Chiropractic, Durban Institute of Technology, 2005 221 leaves ; 30 cm / Previously the focus has been on the improvement of strength prior to proprioception (Calliet, 1997; Flemister et al. 1998 and Buhler et al. 2002). However according to Oloff (1994); Vegso (1995); Calliet (1997); Kawaguchi (1999); Buhler et al. (2002) and McGrew et al. (2003), focus should lie in obtaining a functional range of motion (increased flexibility) and proprioceptive ability and strength will follow with normalization of the relationship of the anatomical structures. All research in this regard has never assessed the assumption that the strength of the relevant musculature would return (Blokker et al.1992 and Klaue et al.1998). The objectives of this study were: to determine the relative effectiveness of Proprioceptive Neuromuscular Facilitation as compared to the Active Rocker-Board Exercises in the rehabilitation of chronic ankle sprains; as well as to determine the best sequence of applying these techniques to chronic ankle sprains in terms of objective clinical findings.

Thesis (M.Tech.: Chiropractic) -Dept. of Chiropractic, Durban Institute of Technology, 2005 xiii, 117 leaves of pages : ill. / The purpose of this pre-post crossover clinical trial was to investigate the relative effectiveness of the combination of stretching followed by strengthening, versus the combination of strengthening followed by stretching, of the gluteus medius and iliotibial band (ITB), in the rehabilitation of chronic Iliotibial Band Syndrome (ITBS) in long distance runners. The results were based upon subjective and objective clinical findings, as well as effect on running performance.

Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2003 1 v. (various pagings) / Mechanical low back pain is one of the most common clinical disorders that most people seek help for (Painting et al. 1998:110). Epidemiological studies indicate a lifetime prevalence of low back pain ranging from 60 to 80% with an annual incidence of approximately 30% (Mosheni-Bandepi et al., 1998). The Sacroiliac (S.I.) joint is a significant source of pain in patients with chronic low back pain and it therefore warrants further study (Schwarzer et al. 1995:31). S.I. syndrome is defined as pain over the S.I. joint in the region of the posterior superior iliac spine, which may be accompanied by referred pain over the buttock, greater trochanter, groin, posterior thigh, knee, and occasionally to the postero-lateral calf, ankle and foot (Kirkaldy-Willis, 1992:123). Research indicates that there seems to be a correlation between low back pain, more specifically S.I. pain and hip rotation (Ellison et al. 1990, Cibulka et al. 1999, Fairbank et al. 1984). Cibulka et al. (1998) found that patients with lower back pain who were classified as having signs suggestive of S.I. regional pain had significantly more external rotation than internal rotation on the posterior innominate side i.e. side of S.I. dysfunction (approximately a 20 difference). Manipulation is recognised as an effective means of treating mechanical low back pain, with respect to both Lumbar Facet Joint Syndrome and S.I. Joint Syndrome (Assendelft et al. 1992 and Koes et al. 1996). Kirkaldy- Willis (1992:123) states that manipulation is the most certain way of relieving the symptoms of S.I. syndrome. This investigation aimed to determine the effect of a sacroiliac joint manipulation on hip rotation ranges of motion (active and passive motion) in patients with chronic sacroiliac syndrome in terms of objective measures.