Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 xii, [137] leaves / Musculoskeletal injuries in computer users are an increasing concern. The computer has become an essential working tool that is used throughout all levels of companies and organisations. Management and professional personnel are required to use computers, often without training in typing skills, this combined with higher stress and responsibility levels and lengthy work hours. Potentially this makes them a high-risk group for work related injury. Previous research has focused mainly on data entry and secretarial workers, who are often competent in typing and keyboard skills. There is an increasing body of literature that implicates a wide variety of factors responsible for computer and office related musculoskeletal injury, however there is still much conflict as to what factors play the most influential role in development of these disorders. Conflict largely remains over the role of individual and constitutional factors versus workplace factors such as ergonomic design and patterns of computer use. The aim of this study was therefore to determine the prevalence of and related risk factors associated with work related musculoskeletal injuries of the neck and shoulder in non-secretarial computer users within the South African context.

Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 / Optimal ventilation of the lungs is essential to the function of the human body. Our lungs can be expanded and contracted by the elevation and depression of the ribs. This causes an increase and decrease of the anteroposterior diameter of the chest cavity and the lungs are then expanded by raising the rib cage. There are several different dysfunctions which the ribs are subjected to. These dysfunctions consist of restrictions in either inhalation or exhalation and are associated with increased tone of the intercostals muscles between the ribs. Therefore, if the chest wall movement is restricted in any way, this will cause decrements in pulmonary function and exercise capacity. Furthermore, there is a significant increase in oxygen cost associated with external chest wall restriction, which is directly related to the level of chest wall restriction. Mobilization of the ribs aims to restore mobility and function but no investigations into the immediate effect of rib mobilization on chest wall expansion and lung function have been conducted. Therefore this study aimed to test whether chest wall expansion and therefore lung function can be influenced in ten minutes following a mechanical intervention.

Thesis (M.Tech.: Chiropractic)- Dept. of Chiropractic, Technikon Natal, 2002. 1 v. (various pagings) / 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.Tech.: Chiropractic, Durban Institute of Technology, 2006. / The purpose of this pragmatic controlled clinical trial was to investigate the efficacy of low-level laser therapy (LLL T) as a part of the palliative management of the hand symptoms of rheumatoid arthritis (RA). The results were based upon subjective and objective clinical findings. LLLT may offer a viable treatment option for the hand symptoms of RA as its application theoretically supports and suggests that the physiological effects of LLL Tare biostimulation, improved metabolism, increased cell metabolism, improved blood circulation, vasodilatation, analgesic effects, anti-inflammatory and anti-edematous effects; all of which are desired in the treatment of RA (Baxter, 1994; Kahn, 1994, Liggins, 2002). There is however controversy within the literature as to the efficacy of LLLT (Asada et al., 1991; Bliddal et al., 1987; Goats. et al., 1996; Hall et al., 1994; Heussier et al., 1993; Johannsen et al., 1994; Palmagren et al., 1989; Walker et aI., 1987). This is partially attributable to the lack of consensus regarding the methodology applied in these studies. Other inconsistencies regarding the efficacy of laser in the treatment of RA exist due to the wide range of differing wavelengths and doses that have been used in the published reports, thereby making it difficult to effectively compare studies (Asada et al., 1991; Goats et al., 1996; Hall et ai., 1994; Haslett et al., 2001, Heussier et ai., 1993; Johannsen et al., 1994; Palmagren et al., 1989; Walker et al., 1987). This study included a sample of 24 patients with rheumatoid arthritis. They were divided into two groups (Group A and Group B) based on their DASH score and their primary medication. Group A (treatment group) received LLLT of the metacarpophalangeal (Mep) joints and proximal interphalangeal (PIP) joints of their more severely affected hand. Patients in Group B (placebo / M

M.Tech. / This study aims to, using diagnostic musculoskeletal ultrasound, investigate the presence of intra-articular gas bubbles in the trapeziometacarpal (TMC) joint cavity in the absence of an axial distractive load, after a high velocity low amplitude (HVLA) Chiropractic adjustment and assess the state of the gas bubble after a 20 minute refractory period. Using plain film radiography, several authors, (Roston and Wheeler Haines, 1947, Semlak and Ferguson, 1970, Unsworth, Dowson and Wright, 1971 and Watson, Kernohan and Mollan, 1989) have consistently demonstrated the presence of an intra-articular radiolucent space in an MCP joint after cavitation. The MCP joint was always manipulated with an axial distractive load. The singular radiolucent cavity was shown to be visible only if an axial distractive force was acting across the joint at the time of the post-manipulation radiograph. Cramer, Tuck, Todd Knudsen, Fonda, Schliesser, Fournier and Patel, (2000), have used magnetic resonance imaging (MRI) to demonstrate a significant increase in the lumbar zygapophyseal joint spaces (0,7 mm) after an adjustment versus the control group (0,0 mm increase). The observed increase in joint space was the primary aim of their research and no reference is made to the presence of an intra-articular gas bubble or any apparent changes in joint space density on post-adjustment MRI scans. They attribute this increase in joint space to breaking of intra-articular adhesions. Using computed tomography (CT) and Radiography, Cascioli, Corr and Till, (2002), reported that no gas bubbles were visualised in the cervical facet joints after an adjustment, with and without traction. This study consisted of 18 participants between the ages of 21 and 26. A pertinent physical examination and a regional examination of the forearm hand and wrist were conducted to ensure no significant pathologies would exclude them from the study. The TMC articular cavity was scanned by an experienced musculoskeletal ultrasonographer at three intervals: pre-adjustment, directly post-adjustment, and at 20 minutes post- adjustment. The ultrasonograms were saved as digital copies for subsequent reports which were correlated with reports compiled during dynamic visualisation of the articular cavity at the time of scanning. The TMC joint was scanned in a physiological position i.e. there was no axial distractive load acting across the joint during any of the three scans.

M.Tech.

M.Tech. (Chiropractic) / Introduction: Myofascial pain syndrome is often seen in clinical practice as a cause for pain. It is characterized as a dull ache to a burning pain that can cause referral of pain to other areas of the body (Travell and Simons, 1999). One method used to treat this, is by dry-needling therapy (DNT). DNT has proved to be effective in the treatment of myofascial pain, but it has shown to cause post needling soreness. This soreness discourages many patients from receiving further dry-needling or treatment (Kamanli et al. 2005). Ways to help alleviate post-soreness are heat, stretching, ultrasound and application of pressure (Fleckenstein et al. 2010). All these modalities are done after the needle has been removed. This then adds an extra modality to the treatment as well as increased treatment time; therefore these modalities are often skipped by practitioners (Hong, 1994). Another factor to look at is that many of these modalities have not been researched objectively for effectiveness on relieving the post-needling soreness (Kamanli et al. 2005). Using a moxi cigar, placed on top of the acupuncture needle whilst inserted into the active trigger point is a way in which heat as a modality to treat post-needling soreness can be combined into the needling time. Aim of study: The aim was to investigate if heat conduction using a moxi cigar is an effective modality in alleviating post-needling soreness when treating myofascial pain syndrome with DNT. Methodology: The trial comprised of 90 participants divided randomly into three equal groups. Group 1 received DNT of active trigger point 1 of the trapezius muscle only. Group 2 received DNT of active trigger point 1 of the trapezius muscle, with the addition of the burning moxi cigar to conduct heat through the acupuncture needle to the trigger point. Group 3 received DNT of active trigger point 1 of the trapezius muscle, followed by 5 minutes of ultrasound therapy over the acupoint. Each participant was treated once with readings being recorded pre-treatment, post-treatment and then final readings were taken 24 hours post-treatment. Subjective data was in the form of a numerical pain scale questionnaire and a pain diary. Objective data was CROM and algometer readings. Data analysis: data collected by the researcher was analyzed with the help of a statistician at STATKON at the University of Johannesburg. After consultation, it was concluded that results would be analyzed using Shapiro-Wilk test for normality and Levene’s test for equal variances. For all objective data collected, parametric testing would be used on objective data. The parametric tests used were: One way Anova and Post Hoc test. For subjective data, non-parametric testing was used on subjective data namely: Kruskal Wallis, Wilcoxon-signed rank and Mann-Whitney U test. Conclusion: Based on the results, clinically, the study showed that dry needling with the addition of ultrasound or moxibustion, as a treatment for post-needling soreness did appear to have better results. The use of these two added modalities did ease post-needling soreness which for many patients is the reason they don’t wish to receive further dry-needling treatment. When using moxibustion the post-needling soreness is eased. This added treatment can be used during the dry needling and does not require additional treatment time for the practitioner or for the patient. To conclude, the efficacy of using a moxibustion to alleviate post-needling soreness has been seen clinically. This treatment can be used with minimal addition treatment time and could be used in clinical practice.

M.Tech.

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 evaluate the relative effectiveness of manipulation versus meloxicam (a Non-Steroidal Anti-Inflammatory Drug) to determine which is more beneficial in treating osteoarthritis of the knee. This was a prospective, randomized clinical trial consisting of a population of sixty voluntary subjects, diagnosed as suffering from osteoarthritis of the knee. The patients were divided equally into two groups of thirty, with Group A receiving chiropractic manipulative therapy on eight consultations over three weeks, and Group B receiving meloxicam 7,5mg tablets once daily for three weeks. Capturing of the subjective and objective data for both groups took place on the first, fourth and eighth consultations. Subjective data was captured using the Numerical Pain Rating scale-l 01, the Visual Analogue scale, as well as the Patient -Specific functional scale. Objective data was gathered from goniometric and pressure algometer measurements. / M

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of technology, 2002. / Background: Low back pain is a common problem for which many conservative treatments are available. Spinal manipulation is considered one of the most effective of these treatments. Interferential therapy is widely used especially for pain control and often forms part of a treatment protocol. However, there is little clinical evidence to support this usage. Objective: The purpose of this investigation was to evaluate the effectiveness of interferential current therapy as an adjunct to manipulation in the treatment of acute mechanical low back pain in terms of subjective and objective measures. Methods: Sixty subjects suffering from acute mechanical low back pain were recruited through advertising and randomly divided into two groups with thirty patients each. Group A received manipulation and interferential therapy and group B received manipulation only. Both groups received 4 treatments and a follow-up consultation over a 2 week period. Subjective measurements were taken using the Numerical Rating Scale - 101and revised Oswestry low back pain questionnaire. Objective measurements were taken using an algometer and an orthopaedic rating scale. All measurements were taken before treatment on the first, third and fifth consultations. Statistical inter-group analysis was completed using the two sample unpaired t-test and the Mann-Whitney U-test. Friedman's T test was used to evaluate the intra-group information. The null hypothesis was rejected at a = 0.05 level of significance. Results: Both treatment groups A and B achieved a significant improvement in pain and disability over the treatment period. However, no significant differences in terms of pain and disability could be found between the two groups at any stage during, or at the end of the treatment period. / M