A dissertation presented in partial compliance with the requirements of the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2003. / In recent years, sacroiliac syndrome has been widely accepted by many different health professions as one of the major contributors to low back pain. Manipulation to effect the relief of the condition has thus far proven to be one of the most effective methods. Comparatively little research has however been done on the different forms of physical therapy that can be used in conjunction with a manipulation so as to maximise its affect / M

A dissertation submitted in partial compliance with the requirements for a Masters Degree in Technology: Chiropractic, Durban Institute of Technology, 2003. / The purpose of this study was to determine the relative effectiveness of a home programme of ischaemie compression, sustained stretch and a combination of the two, in terms of subjective and objective clinical findings for the treatment of Myofascial Pain Syndrome. / M

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 1999. / Impingement syndrome of the shoulder is a very common problem, yet the diagnosis and management of it is still not completely understood. The purpose of this investigation was to investigate the effectiveness of the chiropractic adjustment in order to determine whether or not it is an effective approach in the treatment of impingement syndrome / M

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2017. / Background: Acute ankle sprains and chronic ankle instability syndrome (CAIS) may be managed effectively through conservative management approaches such as strapping. There are two main types of strapping viz. rigid tape which is used to stabilise the joint and limit joint motion and elastic tape which permits joint motion but provides dynamic support. Kinesio™ tape is becoming increasingly popular in the management of various conditions. It is reportedly beneficial in reducing pain, improving circulation, increasing proprioception and correcting muscle function. Due to claimed benefits of Kinesio™ tape, it should, in theory, be beneficial in the management of individuals with CAIS particularly in terms of reducing pain and improving proprioception. AIM: To investigate the effect of three types of strapping applied in the method described for the application of Kinesio™ tape in the management of CAIS. METHODS This study consisted of three groups of 15 participants (recruited through convenience sampling) with each group receiving a different tape (i.e. rigid, elastic or Kinesio™ tape), all three groups, however, received the same taping method which was the Kinesio™ tape functional correction application. After obtaining informed consent each participant underwent a case history, physical examination and a foot an ankle orthopaedic examination. Thereafter, baseline measurements of subjective pain rating (NRS-101), pain threshold (analogue algometer), ankle dorsiflexion, plantarflexion and inversion (analogue goniometer) and proprioception (Biodex Biosway portable balance system) were documented. Depending on the group, the particular tape was then applied and a follow up consultation was made for two to three days later where the tape was removed, measurements were reassessed and the tape was reapplied. At the final consultation three to four days later, the tape was removed and final measurements were assessed and documented. Statistical intra- (using Wilcoxon Signed Ranks Test) and inter-group (using the Mann-Whitney U-test) analyses of the data were performed due to a skewed distribution of the variables. Data was analysed using SPSS version 21.0 with the level of significance set at 0.05. RESULTS The mean (± SD) age of the participants was 24.8 (4.7) and there were 23 male participants in total. Intra-group analyses of subjective outcome measurements showed significant increases (p < 0.05) in subjective pain rating in all three groups across all consultations. Similarly, intra-group analyses of objective outcome measurements found significant increases (p < 0.05) in pain threshold and dorsiflexion range of motion in all three groups across all consultations. Plantarflexion and inversion range of motion also showed significant increases (p < 0.05) but these were not consistent across all consultations. Intra-group analyses of the sway index showed no significant improvements (p > 0.05) in Groups Two and Three across the three consultations. Only Group One showed significant increases during the eyes open foam surface (EOFoS) (p = 0.013) and eyes closed foam surface (ECFoS) (p = 0.047) test conditions between Consultations One and Two. Inter-group analyses of subjective outcome measurements showed no significant increases (p > 0.05) in subjective pain rating across each of the three consults in all three groups. Inter-group analyses of objective outcome measurements revealed a significant increase in pain threshold (p = 0.040) between Groups Two and Three at Consultation One. There was a significant increase in plantarflexion between Groups One and Three at Consultation Two (p = 0.021) and Consultation Three (p = 0.030). There were no other significant results amongst the three groups. CONCLUSION The results suggest that pain rating, pain threshold and ankle dorsiflexion would improve if taping is applied in the manner described for Kinesio™ tape irrespective of the type of taping used in the management of CAIS. The taping method did not result in a significant difference in proprioception. Further studies, with larger sample sizes are required to confirm the findings of this study and to determine the role of taping in the management of CAIS. / M

M.Tech. (Chiropractic) / Introduction The aim of this study is to determine whether standard leg rubs and reassurance combined with lumbosacral manipulations have an effect on growing pain symptoms by comparing it to standard leg rubs and reassurance only. The study can possibly serve as a platform for further research. Furthermore, this will be one of the first chiropractic studies done in this field and may provide the chiropractic profession with a proven treatment for growing pains. Methodology Thirty participants with growing pains between the ages of 4 and 12 years were recruited. The participants were placed into two groups of fifteen participants each on a first come first serve basis. The two groups received different treatment protocols according to their group allocation. Group One received chiropractic manipulative therapy to the lumbar spine and sacroiliac joint restrictions combined with legs rubs and reassurance administered by the parent(s)/guardian(s). Group Two received only legs rubs and reassurance administered by the parent(s)/guardian(s). The participants completed the study over a period of three weeks. Subjective and objective readings were taken. Subjective readings from each participant were taken using the Oucher self-rating pain scale (OSRPS) and a pain diary completed by the parent(s)/guardian(s). Objective readings were taken using a pressure algometer over the anterior tibial muscles bilaterally. A six-week post study follow up was done via email. Results The statistical data was analyzed using the Friedman test, Mann-Whitney test and the Wilcoxon Signed-Rank test. The results demonstrated that both groups responded favourably to their specific treatment over time. However, Group One proved to show a quicker response to treatment over time; and the post study follow up of Group One proved to be significantly more positive than Group Two. These results highlight the positive effects of the chiropractic manipulation. Discussion The fact that the participants of Group One have improved in subjective and objective measurements and the parent(s)/guardian(s) of the participants have responded very positively to the post study follow up, one has to consider that the anatomical theory proposed by Evans and Scutter (2007), the pain referral theory supported by Cookson (2003) and the activation of pain inhibitory systems supported by Wright (1995) and Sterling et al. (2001) might all be a likely aetiologies for growing pains. However, one has to consider that the participants from Group Two, who received no spinal manipulation, have also improved in subjective and objective readings. Therefore it is possible, and cannot be excluded, that the leg rubs administered to both groups could also have played a role in relieving the growing pains. Conclusion The results of the data collected from this study, the pressure algometer and OSRPS readings, showed that spinal manipulation did not have much of a benefit. However, the pain diaries and feedback from the parent(s)/guardian(s), which are probably more reliable for growing pains, indicates that spinal manipulation does show to be beneficial.

M.Tech. (Chiropractic) / PURPOSE: Shoulder pain has been identified to be one of the most common musculoskeletal problems found in a variety of different countries, showing characteristics of chronicity and recurrence. It is considered to be a main contributor towards nontraumatic upper limb pain. One of the identifiable causes of chronic or reoccuring shoulder pain may be attributed to myofascial pain syndrome which is caused by MTrP’s and produces symptoms that are similar to that of other shoulder pain syndromes. The infraspinatus muscle as an integral component of the rotator cuff complex is subject to high tension biomechanical strain as well as neuromuscular tension. While therapeutic interventions have been devised to treat varying degrees of biomechanical and neuomuscular tension, little evidence exists establishing which of these treatment regimes is most effective in treating myofascial trigger points. The purpose of this study was to compare different regional chiropractic adjustments relative to the attachment site and the innervation segment of the infraspinatus muscle and to identify the most effective treatment protocol with regard to chronic, active infraspinatus myofascial trigger point dysfunction. DESIGN: A selection of thirty participants were recruited for this study. The participants were divided into two groups of fifteen participants each. Group A received a chiropractic adjustment to the glenohumeral joint, the attachment site for infraspinatus muscle. Group B received a chiropractic adjustment to the cervical spine segments associated with the innervation to the infraspinatus muscle. Cervical spine restrictions specific to levels C4/C5 and/or C5/C6, and glenohumeral joint restrictions were determined using motion palpation techniques. All participants received a total of six treatments over a three-four week period. MEASUREMENTS: Subjective measurements were obtained by the Functional Rating Index Questionnaire and the Numerical Pain Rating Scale. Objective measurements were obtained using the hand-held pressure algometer and counting the number of active infrapsinatus myofascial trigger points. The data was collected on the first, fourth and seventh consultations. OUTCOME: With regards to the subjective readings, the results from the Functional Rating Index Questionnaire for the intragroup analysis indicated that the glenohumeral joint adjustment group showed the greatest improvement over time (15.5%). No statistically significant differences were noted for the intergroup analysis. The intragroup analysis of the Numerical Pain Rating Scale indicated that the glenohumeral joint adjustment group showed the greatest improvement over time (68.8%). The intergroup analysis indicated that there were no statistically significant differences. vii With regard to the objective measurements, the intragroup analysis of the pressure algometer readings indicated that the glenohumeral joint adjustment group showed the greatest improvement over time (21.7%). There were no statistically significant differences with the intergroup analysis. The intragroup and intergroup analysis of the number of active infraspinatus myofascial trigger point dysfunction showed no statistically significant differences between the groups or within each of the groups over time. CONCLUSION: The results showed that both treatment groups protocols were effective in reducing chronic, active infraspinatus myofascial trigger point dysfunction. Small differences were noted between the two treatment groups with regards to the subjective and objective findings. The glenohumeral joint adjustment group showed the greatest clinical and statistical improvements over the three-four week trial period.

M.Tech. / This research study was conducted as an unblinded controlled pilot study. The aim of this research was to investigate the effects of Chiropractic adjustive therapy on lower back pain in South African Police Service (SAPS) operational mounted policemen in Gauteng. The participants for this research where obtained from the Johannesburg, East Rand, Vaal Rand and Pretoria SAPS Mounted units. Only male participants were recruited and placed into one group where they received Chiropractic adjustive therapy to the restricted Lumbar and Sacroiliac joints. Thirty participants were treated 6 times over a 3-week period, which translated to 2 treatments per week. A two day follow-up visit (visit 7) was conducted to obtain only subjective and objective data, no treatment was administered. An important part of this study was that the duties of the participants continued as usual and were not stopped during this trial. Subjective data was collected using the Oswestry Pain and Disability Questionnaire. Objective data was collected using lumbar range of motion (with a Digital Inclinometer) in flexion, extension, lateral flexion and rotation. All data was collected during the 1st, 4th and 7th visits. Additional data was collected by enquiring about the saddle type and stirrup length that the participants used. The data collected was analysed using Maunchly and Greenhouse Tests for parametric tests and the Friedman and Wilcoxon Signed Rank Tests for the non-parametric tests. The results of this study concluded that Chiropractic adjustive therapy was effective in relieving or completely eliminating the lower back pain of the participants as well as increasing there lumbar spine range of motion.

M. Tech. / The main purpose of this study was: • To determine the different diagnostic techniques chiropractors use in Gauteng South Africa. Objectives included: • To determine chiropractics attitude and opinions regarding the different Diagnostic Techniques they use in their practices. • To determine any statistically significantly correlations between answers. • To develop a demographic profile of Chiropractors in Gauteng South Africa. In the world today there are 80 000 chiropractors who are the primary physicians performing manipulations in order to treat problems such as lower back pain. Incidentally 85% of the western world will suffer from at some stage of their lives (Hecker and Daniel, 2004). The identification of the common functional and structural components of the adjustable lesion is critical to the management of these conditions. Unfortunately it has also contributed to the misconception that all manipulative disorders have the same pathological basis (Bergman, 2002). A questionnaire-based study comprising a non-probabilistic, non-random, convenience sample was used to determine the diagnostic techniques used v by the chiropractors actively practicing in Gauteng South Africa. A total of 58 Chiropractors responded to the questionnaire, forming the sample population that was used to calculate results. According to this study, all the responding chiropractors practicing here in Gauteng South Africa (n=58/58 100%), examine the spine to identify areas or subluxations that require adjustments/manipulation. There are a variety of diagnostic techniques methods that they use in everyday practice. Most commonly motion palpation(96.5%), static palpation(93.1%), pain description of the patient(82.8%), leg length discrepancy(55%), neurological tests(77.6%), visual postural analysis(61.4%), orthopedic tests(75%), plain static and stress x-rays(44.5%) and kinesiology muscle testing(10.4%) are used. The perceived reliability of these diagnostic techniques are also considered to be good.

M.Tech. (Chiropractic) / Purpose: The pelvis, femur, tibia, fibula, ankle and foot form a closed kinematic chain during gait. According to biomechanical principles any restriction or tension in one part of the kinematic chain will create increased load on the other parts of the same chain (Comerford and Mottram, 2001; Sahrmann, 2000). This increased load can lead to dysfunction and compensation along the chain and also lead to gait anomalies. A chiropractic adjustment is utilised for the treatment of sacroiliac joint restrictions. There has not been research conducted to establish the effects that a chiropractic adjustment has on lower limb biomechanics and gait. The purpose of this study was to determine whether a sacroiliac adjustment had an effect on gait by looking at the gait parameters. Method: Sixty participants who were between the ages of 18 and 40 years were recruited. The participants were asked to sign a consent form and then a thorough history and physical examination was performed to ensure that participants did not have any disease or pathology that may have excluded them from the study. These included foot pathologies, knee pathologies, hip pathologies, structural leg length discrepancies, or any contraindications to chiropractic adjustment. A lumbar spine regional examination as well as motion palpation of the sacroiliac joints was performed to determine which joints were restricted. Each participant then underwent a gait assessment before and after they received a chiropractic adjustment to the restricted sacroiliac joint. Procedure: Participants only received one adjustment. Objective measurements were obtained using the Zebris FDM gait analysis system. This system uses high-quality capacitive force sensors that are arranged in matrix form. As a result, each sensor produces its own calibration curve. The measuring plates enable the static and dynamic force distribution to be analysed under the feet while standing and walking. The measuring plate is integrated in a level walking area. The measuring parameters are automatically calculated in the WinFDM program and a printable, easy to read report of the measuring results is then available (Zebris Medical GmbH, Germany). Each participant walked over the measuring plate for 4 times. This was done before and after the adjustment.Results: Statistically significant changes were seen between the pre and post treatment measurements of foot rotation on the treatment side, the step length on the treatment side, the stride length, the stance phase on both the treatment and non-treatment sides, the swing phase on the treatment and non-treatment side and the total double support. Conclusion: This study shows that a chiropractic adjustment to the sacroiliac joint does change certain gait parameters and it should therefore be part of any treatment regime for gait abnormalities. Podiatrists, biokineticists and chiropractors should work together when treating patients with gait abnormalities. As the study only recruited asymptomatic participants, further studies are necessary to determine the effect a chiropractic adjustment has on the gait of symptomatic patients.

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 1999. / To investigate the efficacy of adjusting the ankle in the treatment of subacute and chronic grade I and II ankle inversion sprains. The researcher hypothesised that adjusting a symptomatic ankle, in terms of the above, would result in a more significant improvement than that of a placebo treatment / M