A dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2002. / The aim of this point prevalence study was to compare the prevalence of temporomandibular joint dysfunction in recreational scuba divers and snorkiers, as opposed to non-divers, in terms of subjective findings. The Durban Metropolitan area diving population consisted of approximately 2500 divers and therefore the population size decided on was 200 divers and 200 non-divers. A total of 400 questionnaires were filled in with the participant's subjective data about their pain, limited mouth opening, and jaw joint noises. The divers were asked about their dive certification, and the number of dives done in order to establish whether they had dived within three months prior to participating in the study. The results were statistically analysed using chi-squared tests with the pvalue of a = 0.05. Tables and bar charts were constructed to visually represent the data and allow for descriptive analysis. The overall prevalence of TMJD in divers was 46.5% and in non-divers 54%. The chi-squared analysis shows no significant difference between the two groups. Among other findings, the relationship between the use of diving mouthpieces and TMJD was considered and it was established that 20% of divers, in this / M

A dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 2001. / The purpose of this study was to investigate the effectiveness of spinal manipulation compared to passive oscillatory mobilization in order to evaluate the more effective treatment in the management of chronic mechanical thoracic spine pain. It was hypothesized that spinal manipulation and passive oscillatory mobilization would both be effective in the treatment of chronic mechanical thoracic spine pain. It was further postulated that spinal manipulation would be comparatively more effective than passive oscillatory mobilization in terms of objective and subjective clinical findings. This randomised controlled clinical trial consisted of a study population of 60, obtained by convenience sampling. Those patients diagnosed as suffering from chronic mechanical thoracic spine pain were randomly allocated to two groups of 30 each. One group received spinal manipulation and the other group passive oscillatory mobilization on the affected segments. Both groups of patients received 5 treatments over a two-week period. The subjective data was obtained by the use of the short-form McGill Pain Questionnaire and the Numerical Pain Rating Scale-101 Questionnaire. These were filled in by the patient before the first, third and fifth treatments. The objective data was acquired through the use of the algometer. Readings were taken before and after the first, third and fifth treatments. Intra-group analysis of the short-form McGill Pain Questionnaire was done using the Wilcoxon Signed Ranks Test. The paired t-test was used for the Numerical Pain Rating Scale -101 Questionnaire and the Algometer Readings (intra-group analysis). Inter-group analysis of the short-form McGill Pain Questionnaire was done using the Mann Whitney unpaired Utest. The unpaired t-test was used for the Numerical Pain Rating Scale-l 0 I Questionnaire and the Algometer Readings (inter-group analysis). a was set at a 0.05 level of significance. The results were illustrated by means of tables and / M

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2005. / 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. The only treatment they received was a single mortise separation adjustment and all participants received the same treatment. Clinical outcomes were measured before and after the adjustment on both ankles using a Dualer Electronic Inclinometer and algometer. Only the affected ankle received an adjustment, but both ankles were measured. The participants were evaluated by the examiner at an initial consultation during which diagnosis of chronic ankle instability syndrome was made based on case history, physical examination and foot and ankle regional examination. Participants presented with at least four of the following (Kessler and Hertling 1983) / M

A dissertation in partial compliance with the requirements for a Master's Degree in Technology in the Department of Chiropractic at Technikon Natal / Cavitation sounds heard during chiropractic adjustments and manipulations to th extension spine are a common phenomena yet their significance is disputed, the mechanism of their production is a matter of speculation, and their origin has never been localized. (Lewit 1978: 4, Grieve 1989; 525) The purpose of this study was to locate the joints which cavitate during the performance of a L5 spinous hook adjustment and a lower sacroiliac adjustment. It was hypothesised that the cavitation sounds would arise from the L4-L5 and L5-S1facets on the side of contact during the L5 hook adjustment., and from the the sacroiliac joint on the side being adjusted during the lower sacroiliac adjustment. It was also hypothesised that the two adjustments would differ significantly in terms of the cavitation sounds produced. Volunteers were screened for agreement with the inclusion criteria. Of these 30 asymptomatic between the ages of 18 and 30 were selected. This was sample was then randomly divided into two groups of, one of which recieved the L5 hook adjustment and the other the lower sacroiliac adjustment. All of the subjects had eight microphones taped to the skin, over the relevant facets and the sacroiliac joints. Radiographic confirmation was used in order to ensure proper positioning of the microphones. The microphones were then connected to filters, amplifiers and a computer which recorded any sound signals registered during the adjustments. / M

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2016. / Background: Musculoskeletal disorders (MSDs) are a significant and common occupational health concern, consequently impacting work attendance and performance. High prevalence rates of MSDs have been reported amongst school teachers. Studies have linked these higher prevalence rates to typical daily teaching activities including prolonged standing, awkward postures, heavy lifting, bending and repetitive movements. Objectives: To determine the prevalence of neck, shoulder and low back pain among primary school teachers in the Central Durban area; to identify any risk factors associated with neck, shoulder and low back pain; and to establish the relationship, if any, between the prevalence and risk factors of neck, shoulder and low back pain among primary school teachers. Methods: This was a quantitative, descriptive and cross-sectional study, conducted in 12 selected public primary schools within the Central Durban area. Volunteers who met the inclusion criteria (n = 97) were invited to complete self-administered questionnaires. Results: Of the 97 completed questionnaires 83.1 percent (%) reported neck and shoulder pain and 71.0% low back pain. Neck and shoulder pain were significantly associated with a forward-bent head posture (p = 0.001), ethnicity (p = 0.001), and history of a severe trauma/injury (p = 0.006). Similarly, significant associations were noted with regards to medical conditions (p = 0.006), a backward-bent head posture (p = 0.016), lifting of heavy loads (p = 0.045) and treatment for severe injury (p = 0.047). Associations were also noted between low back pain and prolonged standing (p = 0.000), ethnicity (p = 0.008), transportation methods (p = 0.023), medical conditions (p = 0.031) and a history of a severe trauma/injury (p = 0.049). Conclusion: This is a first South African study, to our knowledge that highlights increased prevalence rates for both neck and shoulder pain and low back pain amongst teachers, with a variety of associated risk factors. This draws attention to the urgent need for intervention programs to be implemented to prevent/reduce the development of musculoskeletal pain amongst teachers. / M

A dissertation presented in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, 2001. / Hendler et al. (1995) describes low back pain as the most common, costly and disabling musculosketetal condition. Giles (1997: 28) supports this, stating that the annual incidence of low back pain in the adult population is between two and five percent, with a lifetime prevalence of well over 50%. For clinicians to choose the most appropriate therapy for managing this common condition it is essential for research to be carried out to define the most effective treatment. Shekelle (1994) explains that spinal manipulative therapy is an effective treatment for patients with low back pain, while Cherkin et al. (1995) states that there is strong evidence to support the use of nonsteroidal antiinflammatory drugs in the management of mechanical low back pain. It is therefore the purpose of this investigation to determine the relative effectiveness of spinal manipulative therapy compared to Diclofenac Sodium, in terms of subjective and objective measures, in the management of mechanical low back pain. This randomized controlled trial consisted of sixty patients between the ages of 18 and 65, complaining of mechanical low back pain. The sixty patients were randomly divided into two treatment groups of thirty each. One group received spinal manipulative therapy and the remaining thirty were administered Diclofenac Sodium. These patients were carefully screened to allow the researcher to diagnose the patient, with Lumbar Facet Syndrome, Sacroiliac Syndrome or Myofascial Pain Syndrome; or any combination of these syndromes. This is in accordance with Kirkaldy-Willis (1992: 105 - 119) classification system. The thorough examination ensured that each patient had no contra-indications to spinal manipulative therapy or Diclofenac Sodium. / M

Dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropratic, Technikon Natal, 2002. / McGregor et al ( 1998) stated that approximately 50 – 80 % of the population in Western society will experience low back pain at some point. According to Cibulka and Koldehoff (1999), the sacroiliac joint is a common cause of low back pain that is overlooked. This study aimed to provide insight into the relative effectiveness of three different approaches in the management of sacroiliac syndrome. Giles and Muller (1999) concluded that spinal manipulative therapy was an effective form of treatment for spinal pain syndromes whilst Burgos et al (2001) states that the use of transcutaneous non-steroidal anti-inflammatories in the management of musculoskeletal conditions is a common therapeutic strategy. This investigation aimed to determine the relative effectiveness of spinal manipulative therapy combined with transcutaneous flurbiprofen (TransAct® patches ) versus spinal manipulative therapy combined with either menthol or non-medicated placebo patches in the management of sacroiliac syndrome, in terms of objective and subjective measures. / M

A dissertation presented in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2005. / Following an inversion ankle joint sprain, damage to the proprioceptive organs can occur, which is made worse by lack of proprioceptive retraining and will increase the chances of re-injury (Hoffman and Payne 1995:144 and Anderson, 2002). Pellow and Brantingham (2001) indicated that patients who received multiple manipulations improved more rapidly than patients in the placebo group. Therefore it is proposed that manipulation provokes changes in afferent input that may restore normal proprioceptive input (Slosberg, 1988). However, Pellow and Brantingham (2001) were not able to establish what effect multiple manipulations had, as opposed to a single manipulation, on the proprioception on the foot and ankle complex and how this may influence the clinical outcome of the patient’s treatment. Therefore, it was hypothesized that multiple manipulations of the foot and ankle complex would have a greater effect on chronic ankle instability syndrome than a single treatment in terms of overall improvement subjectively and objectively. In addition to this the following was also hypothesized: • That multiple manipulations of the foot and ankle complex would increase the ROM to a greater extent than single manipulations. • That multiple manipulations would decrease point tenderness more effectively than a single manipulation. / M

Mini-dissertation in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic, Durban Institute of Technology, 2005. / According to the recent literature the application of non-steroidal anti-inflammatory drugs (NSAIDS) is the mainstay and first line of conventional treatment for many types of pain, including that of spinal origin (DiPalma and DiGregorio 1994; Dabbs and Lauretti 1995; Koes et al. 1997). NSAID therapy has inherent side effects (Goodman and Simon 1994), however, given the risks involved, they are still of value as an adjunct to spinal manipulation (Crawford 1988), which has been shown to have less side effects and be more effective than conventional NSAIDS (Dabbs and Lauretti 1995; Giles and Müller 1999). A homeopathic alternative to NSAIDS is Traumeel S, it fulfils all the criteria for a locally acting therapeutic medication, with promotion of the natural healing process, and minimum side effects (Zell et al. 1989). A study by Hepburn (2000) compared the relative efficacy of Traumeel S against NSAIDS in the treatment of cervical facet syndrome. Hepburn concluded that there was statistically no difference between the two therapies. It could therefore be inferred that Traumeel S may be a valid alternative to NSAID therapy in the treatment of cervical facet syndrome. This study tested this hypothesis by comparing the effectiveness of spinal manipulation with the concurrent administration of oral Traumeel S against spinal manipulation alone in order to assess the potential benefit of combining Traumeel S with manipulation. / M

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2003. / The purpose of the investigation was to evaluate the presence and extent of Quadriceps Femoris weakness in subjects with patellofemoral pain syndrome by the use of an isokinetic dynamometer. / M