Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2003 163 leaves / Wessel et al. (1954) described the most accepted definition of infantile colic as, “Unexplainable and uncontrolled crying in babies from 0 to 3 months old”. The authors qualify their definition further by stating that the crying occurs for more than 3 hours a day, more than 3 days a week, for 3 weeks or more, usually in the afternoon and evening hours. Although this definition is old, it is the most widely recognized definition to date and is still used by authors (Canivet et al. 1996; Lindberg 1999; Wiberg et al. 1999; Lindberg 2000 and Sondergaard et al. 2000). Infantile colic is an idiopathic condition, with much debate about its aetiology and treatment (Pineyard 1992). It presents as excessive crying in an otherwise healthy infant who has a normal weight gain (Wiberg et al. 1999; Olafsdottir et al. 2001) and is one of the most frequent problems presented to paediatricians by new parents (Barr 1998). Furthermore, it is a self-limiting and benign condition with approximately 47% of cases resolving at 3 months, a further 41% resolving between 3 and 6 months, and the remaining 12% resolving between 6 and 12 months (Hide and Guyer 1982). Approximately 10 to 20% of infants under the age of three months suffer from infantile colic (Becker et al. 1998) and less than 5% of colicky infants suffer from organic diseases (Barr 1998). The diagnosis of infantile colic is arrived at by the method of exclusion, completing a thorough history and physical examination to rule out any possible serious illness or infection that may be present (Balon 1997). Lissauer and Clayden (1997: 126) noted that there is no firm evidence that the causative mechanism of infantile colic may be attributed to intestinal, biliary or renal causes. The authors further stipulated that cow’s milk intolerance and gasto-oesphageal reflux are seldom responsible. Effective treatment and management of infantile colic is necessary as the difficulties associated with inconsolable crying may persist and although infantile colic is not detrimental to an infant's health, it places tremendous stress on the family (Balon 1997). Moderate to severe cases of infantile colic, as stated by Lund et al. (1998), may involve uncontrollable crying for many hours during day and night, every day. The authors noted that it is destructive to infant and family, as there is a risk that the condition may negatively affect the mother-child bond after three months (Becker et al. 1998) and result in the infant sustaining non-accidental injury (Lissauer and Clayden 1997: 126). In view of the fact that infantile colic responded favourably to spinal manipulation, Wiberg et al. (1999) suggested that the discomfort and colicky symptoms of infantile colic might have a musculoskeletal origin rather than the assumed yet unproven gastrointestinal origin. This hypothesis is supported by the effective treatment response observed in spinal manipulative studies on infantile colic (Wiberg et al. 1999). It leads to the suggestion that either spinal manipulation may be useful in treating visceral disorders, as spinal manipulation has been postulated to cause somatovisceral spinal reflexes (Gatterman 1990: 204), or that infantile colic may be a musculoskeletal disorder, which may explain why spinal manipulation is effective in treating infantile colic. The motion palpation of infants’ spines remains controversial (Volkening 2000). Extensive literature searches have not revealed studies that have ascertained if spinal joint dysfunctions are responsible for the colicky symptoms. The observed clinical improvement (which was noted as a decrease in crying time of the infants) of the treatment groups has lead to the conclusion that removal of spinal joint dysfunctions may play a large part in the alleviation of symptoms of infantile colic (Klougart et al. 1989; Mercer 1999: 39; Wiberg et al. 1999). In studies by Klougart et al. (1989), Mercer (1999:15), Wiberg et al. (1999), only infants suffering from infantile colic were included, therefore it is yet to be determined whether symptoms seen in infants suffering from infantile colic, possibly as a result of spinal joint dysfunction, also occur in healthy infants with no symptoms of infantile colic. As mentioned by Gottlieb (1993), manual assessment of spinal joint dysfunctions in infants is well within the means of current practice in spinal manipulation and will be beneficial, as it may help to determine if there is a correlation between spinal joint dysfunctions and the prevalence of infantile colic. This study may result in more effective diagnosis and management of this benign, yet distressing condition. The purpose of the study is to determine if the prevalence of spinal joint dysfunctions is influenced by whether or not infants suffer from infantile colic.

Thesis (M.Tech.: Chiropractic) - Dept. of Chiropractic, Durban Institute of Technology, 2004 1 v. (various pagings) / Chiropractors are treating spinal joint dysfunction in infants that present with conditions such as infantile colic. Authors conducting research into spinal joint dysfunction in infants have used static and motion palpation to identify these spinal lesions in the infants. The reliability of static and motion palpation used in infants for the assessment of spinal joint dysfunction has not yet been established. The lack of a reliable assessment tool for spinal joint dysfunction in infants reduces the inferential validity of the research studies assessing the efficacy of chiropractic treatment in infants. It is therefore necessary to establish the interexaminer reliability of static and motion palpation in infants. The purpose of this study was to determine the interexaminer reliability of static and motion palpation for the assessment of spinal joint dysfunction in healthy infants aged two to ten weeks

Thesis (M.Tech.: Chiropractic) - Dept. of Chiropractic, Durban Institute of Technology, 2004 xvi, 100 leaves / There is a growing base of evidence demonstrating the important relationship between altered mechanics of the lower limb and low back pain. Sagittal plane blockage, specifically at the first metatarsophalangeal joints but also at the ankle joints, has been implicated as playing a role in the process of chronic mechanical low back pain. The purpose of this study was to determine whether a link could be found between chronic mechanical low back pain and sagittal plane blockage of the feet and ankles.

Thesis (M.Tech.: Chiropractic)- Dept. of Chiropractic, Durban Institute of Technology, 2004 128 leaves / Background: Lower back pain is a common problem, globally, as well as in South Africa. Zulu is the first language of a very large proportion of the South African population, and as such, addressing the needs of this population group with respect to lower back pain is a priority. Many reliable pain indexes exist in English to record the degree of disability with regard to Lower back pain. These are invaluable tools in aiding the health practitioner to assess the progress of treatment and the severity of the patient’s disability. One of the most creditable and frequently used indexes is the Roland – Morris Low Back Pain Disability Questionnaire. However, no such scale exists in Zulu Objective: The purpose of this investigation was, firstly, to interpret the data from the statistical tests for discordance in order to assess whether the face validated Zulu translation of the questionnaire (ZRM1.1) is sensitive and specific enough for use as a tool in data collection, when compared to the English version (ERM). Secondly, to make recommendations for further improvement in terms of the ZRM1.1.

Thesis (M.Tech.: Chiropractic)-Durban Institute of Technology, 2004 xiii, 53 leaves : ill. ; 30 cm / Epidemiological studies, conducted in various countries around the world suggest that low back pain (LBP) represents a serious health risk, affecting populations all over the world. Evidence suggests that the prevalence of LBP is relatively high among people in their 20’s and 30’s. A few epidemiological studies on student populations in other countries suggest prevalence rates of 27 to 71% (Gemmel et al. 1990, Klaber-Moffet et al. 1993, Reis et al. 1996, Lebowski 1997), however LBP among students in South Africa had not yet been investigated. This study concentrated on the prevalence of LBP among the student population of a South African tertiary institution, i.e. Durban Institute of Technology (DIT). This study also proposed to investigate the level and nature of care seeking among those people suffering from LBP. A third aim of this study was to investigate the correlation between potential risk factors and the prevalence of LBP among the student population of South Africa. These were: age, gender, race, height, weight, smoking habits, parity, physical exercise and occupation.

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic at Durban Institute of Technology, 2007. / Objectives The objectives were to compare the relative effect of manipulation and core rehabilitation in the treatment of acute mechanical lower back pain in athletes. Project Design: The study design was a randomized controlled parallel group trial. A quantitative study was performed, by making use of a pre à à à ¢ and post experimental investigation (Nansel et al. 1993 and Naidoo, 2002). Setting: Participants presenting with acute low back pain with an onset of 7 days or less, to the Chiropractic Day Clinic at the Durban University of Technology. Subjects: Thirty athletic participants, either male or female, between the ages of 18 and 45 years presented at the initial consultation which included participant screening and establishment of their suitability for the study. These were then divided into either group A (which received a manipulation) or group B (which received core exercises). Outcome measure: A correct contraction of the core stability muscles was maintained, with a decrease in pressure (in mm Hg) on a Pressure Biofeedback Unit, and an increase in length of time (in seconds). Results: It was found that there was no significant difference between the manipulation and the core rehabilitation groups. Although both groups showed v improvement with regards to their acute mechanical low back pain, the core rehabilitation group improved at a significantly faster rate than the manipulation group with regards to endurance on the stabilizer. Conclusions: Both treatments were equally beneficial for most of the quantitative outcomes measured in this study. However, for the outcome of time on the stabilizer, the core rehabilitation group improved at a significantly faster rate than the manipulation group (p=0.006).

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 2001. / Neck pain is a common condition that has become a serious health concern. Since there is controversy regarding the most effective management of this condition, further research needs to be executed. The purpose of this investigation was to compare manipulation combined with a cervical pillow to manipulation alone in the management of mechanical neck pain. The rationale behind this, was that manipulation is one of the most common treatments for spinal conditions and has shown significant results in alleviating mechanical neck pain. Cervical pillows have been investigated by various researchers. They have concluded that cervical pillows are effective in treating mechanical neck pain. Thus, using the pillow as an adjunct to manipulation should attain superior results to manipulation alone. This study consisted of 40 patients who were randomly divided into 2 equal groups. The average age of the patients was 34 years old and the average duration of neck pain was pain of greater than 6 months. The patients received 6 treatments over a 4 week period. Group1 were manipulated and given a cervical pillow to sleep on, while group 2 received manipulation alone. / M

Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2003 163 leaves / Wessel et al. (1954) described the most accepted definition of infantile colic as, “Unexplainable and uncontrolled crying in babies from 0 to 3 months old”. The authors qualify their definition further by stating that the crying occurs for more than 3 hours a day, more than 3 days a week, for 3 weeks or more, usually in the afternoon and evening hours. Although this definition is old, it is the most widely recognized definition to date and is still used by authors (Canivet et al. 1996; Lindberg 1999; Wiberg et al. 1999; Lindberg 2000 and Sondergaard et al. 2000). Infantile colic is an idiopathic condition, with much debate about its aetiology and treatment (Pineyard 1992). It presents as excessive crying in an otherwise healthy infant who has a normal weight gain (Wiberg et al. 1999; Olafsdottir et al. 2001) and is one of the most frequent problems presented to paediatricians by new parents (Barr 1998). Furthermore, it is a self-limiting and benign condition with approximately 47% of cases resolving at 3 months, a further 41% resolving between 3 and 6 months, and the remaining 12% resolving between 6 and 12 months (Hide and Guyer 1982). Approximately 10 to 20% of infants under the age of three months suffer from infantile colic (Becker et al. 1998) and less than 5% of colicky infants suffer from organic diseases (Barr 1998). The diagnosis of infantile colic is arrived at by the method of exclusion, completing a thorough history and physical examination to rule out any possible serious illness or infection that may be present (Balon 1997). Lissauer and Clayden (1997: 126) noted that there is no firm evidence that the causative mechanism of infantile colic may be attributed to intestinal, biliary or renal causes. The authors further stipulated that cow’s milk intolerance and gasto-oesphageal reflux are seldom responsible. Effective treatment and management of infantile colic is necessary as the difficulties associated with inconsolable crying may persist and although infantile colic is not detrimental to an infant's health, it places tremendous stress on the family (Balon 1997). Moderate to severe cases of infantile colic, as stated by Lund et al. (1998), may involve uncontrollable crying for many hours during day and night, every day. The authors noted that it is destructive to infant and family, as there is a risk that the condition may negatively affect the mother-child bond after three months (Becker et al. 1998) and result in the infant sustaining non-accidental injury (Lissauer and Clayden 1997: 126). In view of the fact that infantile colic responded favourably to spinal manipulation, Wiberg et al. (1999) suggested that the discomfort and colicky symptoms of infantile colic might have a musculoskeletal origin rather than the assumed yet unproven gastrointestinal origin. This hypothesis is supported by the effective treatment response observed in spinal manipulative studies on infantile colic (Wiberg et al. 1999). It leads to the suggestion that either spinal manipulation may be useful in treating visceral disorders, as spinal manipulation has been postulated to cause somatovisceral spinal reflexes (Gatterman 1990: 204), or that infantile colic may be a musculoskeletal disorder, which may explain why spinal manipulation is effective in treating infantile colic. The motion palpation of infants’ spines remains controversial (Volkening 2000). Extensive literature searches have not revealed studies that have ascertained if spinal joint dysfunctions are responsible for the colicky symptoms. The observed clinical improvement (which was noted as a decrease in crying time of the infants) of the treatment groups has lead to the conclusion that removal of spinal joint dysfunctions may play a large part in the alleviation of symptoms of infantile colic (Klougart et al. 1989; Mercer 1999: 39; Wiberg et al. 1999). In studies by Klougart et al. (1989), Mercer (1999:15), Wiberg et al. (1999), only infants suffering from infantile colic were included, therefore it is yet to be determined whether symptoms seen in infants suffering from infantile colic, possibly as a result of spinal joint dysfunction, also occur in healthy infants with no symptoms of infantile colic. As mentioned by Gottlieb (1993), manual assessment of spinal joint dysfunctions in infants is well within the means of current practice in spinal manipulation and will be beneficial, as it may help to determine if there is a correlation between spinal joint dysfunctions and the prevalence of infantile colic. This study may result in more effective diagnosis and management of this benign, yet distressing condition. The purpose of the study is to determine if the prevalence of spinal joint dysfunctions is influenced by whether or not infants suffer from infantile colic.

Thesis (M.Tech.: Chiropractic) - Dept. of Chiropractic, Durban Institute of Technology, 2004 1 v. (various pagings) / Chiropractors are treating spinal joint dysfunction in infants that present with conditions such as infantile colic. Authors conducting research into spinal joint dysfunction in infants have used static and motion palpation to identify these spinal lesions in the infants. The reliability of static and motion palpation used in infants for the assessment of spinal joint dysfunction has not yet been established. The lack of a reliable assessment tool for spinal joint dysfunction in infants reduces the inferential validity of the research studies assessing the efficacy of chiropractic treatment in infants. It is therefore necessary to establish the interexaminer reliability of static and motion palpation in infants. The purpose of this study was to determine the interexaminer reliability of static and motion palpation for the assessment of spinal joint dysfunction in healthy infants aged two to ten weeks

Thesis (M.Tech.: Chiropractic) - Dept. of Chiropractic, Durban Institute of Technology, 2004 xvi, 100 leaves / There is a growing base of evidence demonstrating the important relationship between altered mechanics of the lower limb and low back pain. Sagittal plane blockage, specifically at the first metatarsophalangeal joints but also at the ankle joints, has been implicated as playing a role in the process of chronic mechanical low back pain. The purpose of this study was to determine whether a link could be found between chronic mechanical low back pain and sagittal plane blockage of the feet and ankles.