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).

A dissertation presented to in partial fulfilment of the requirements for the Masters Degree in Technology: Chiropractic, Technikon Natal, 1996. / The aim of this study was to determine the effectiveness of adjustments versus mobilisation in the treatment of mechanical neck pain. It was hypothesized that treatment with adjustments over a three week period, with a further three week follow-up period, would be more effective than mobilisation in terms of improving the patients' cervical ranges of motion and their perceptions of pain and disability. / M

M.Tech. (Chiropractic) / Please refer to full text to view abstract

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2013. / Background : It has become practically impossible for practitioners to remain current with clinical developments. Additionally the demand from patients and third party payors for quality evidence is increasing. A systematic review is one manner in which information can be graded, summarised and presented in a succinct format for use by practitioners, patients and third party payors. Objectives : To identify the current knowledge available on the conservative management of iliotibial band syndrome (ITBS) and to evaluate the scientific and methodological rigor of that knowledge. The systematic review of these studies identified the level and type of evidence that currently exists in the support of conservative management of ITBS and the specific interventions and combinations of interventions currently employed. Method : A systematic review of ITBS studies was conducted. ITBS studies were identified using key indexing terms (iliotibial band syndrome, treatment, conservative and intervention) on several databases (EBSCOhost, Google Scholar, Metalib, Pubmed, Science Direct and Springerlink), all studies were included up until the date of ethics approval (21st May 2012) . The gathered studies were screened for compliance with the inclusion criteria, and then reviewed by blinded independent reviewers (reviewer criteria included qualification, clinical experience, academic experience, research experience and discipline). Data collection and analysis : The reviewers rated the methodological rigour of the ITBS studies utilising an appropriate scale (e.g. PEDro Scale). Feedback was collated and analysed for discordance. Studies were then analysed, ranked and followed by a discussion in the context of their clinical outcomes, thus formulating a structured summary of the known clinical data with regards to the clinical management of ITBS. Results: The identified citations (4130) were screened and sorted by study type. This resulted in 167 citations that were reviewed by abstract for compliance with the inclusion criteria. A final total of 23 studies meet eligibility criteria. Eight articles reported on a combination of interventions, four discussed biomechanical and causative factors, and the remaining eleven articles investigated individual interventions in the treatment of ITBS. After review and analysis, combination interventions were supported by the strongest level of evidence, thus advocating the use of a combination of interventions in the management of ITBS in providing better clinical outcomes. Moderate evidence favoured the use of customised orthoses, injectable corticosteroids, phonophoresis and addressing biomechanical and causative factors. However, there was moderate evidence against the use of deep tissue frictions, as no improvement was found. This outcome suggests a need for further evidence to advocate the appropriateness of these interventions in clinical care of ITBS. Hip abductor strengthening and stretch therapy were found to have limited evidence. However, no evidence was found to support the application of active release technique, corrective neuromuscular approach, custom dry floatation cushions and talar joint manipulation in the management of ITBS. This latter outcome indicated a need for studies to investigate their appropriateness or inappropriateness in clinical care. Conclusion : The systematic review of ITBS studies revealed that use of a combination of conservative therapies was found to have the strongest level of evidence, which may indicate its appropriateness in the management of patients suffering from ITBS. Specific combinations of conservative therapies and the use of individual therapies require future research in order to better delineate their contribution to the management of ITBS. Randomised controlled trials are the gold standard for research, as they have the greatest level of methodological quality, and should be used where possible when investigating the efficiency of interventions in the treatment of ITBS. Studies, which were not randomised controlled trials, but adopted the principles of a randomised controlled trial structure, contributed positively towards the methodological rigor of these studies.

Thesis (M.Tech.: Chiropractic)- Dept. of Chiropractic, Durban Institute of Technology, 2006. 130 leaves. / The purpose of this investigation was to evaluate the efficacy of the adjustment of the first rib as an adjunct to the manipulative treatment of mechanical neck pain, according to subjective and objective clinical findings. The results of this study would indicate to Chiropractors which specific types of adjustments, used for the treatment of mechanical neck pain, would potentially increase the cervical range of motion and / or decrease pain experienced by the patient and thus lead to a more effective treatment protocol. The outcome of the study will help clinicians select the more appropriate treatment for patients based on the subjective and objective outcomes.

Dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic, Durban Institute of Technology, 2006. / Chronic Idiopathic Constipation (CIC) is a common patient complaint (Browning 1999) and as such is defined as : “Constipation” being the infrequent or difficult evacuation of faeces, “idiopathic”, denoting the condition occurs in the absence of any known cause and “chronic”, implying a problem that has persisted for a long time (Anderson 1989). It has been suggested that the bony subluxation or motion segment dysfunction in the spine, could produce these symptoms (e.g. altered visceral function) in the segmentally related visceral structures (Korr 1976, Nansel and Slazak 1995, Budgell 2000). In support of this three case reports in the literature suggest that spinal manipulative therapy to effect removal of these bony subluxations or motion segment dysfunctions, may relieve chronic idiopathic constipation (Hewitt 1993, Marko 1994, Redly 2000). However all three cases involved a single patient case analysis, where patients received spinal manipulation and a vast improvement in bowel function within three weeks of the initiation of the intervention was noted. Only one case report measured global wellbeing outcomes and was able to document a steady increase in the patient’s sense of wellbeing (Redly 2000). As a result of the above evidence in the literature, the researcher was led to the following hypotheses regarding spinal manipulation and chronic idiopathic constipation: • That spinal manipulation would affect a decrease in the subject’s abdominal pain intensity and level of constipation and an increase in the subject’s sense of wellbeing and spinal range of motion. • That placebo would affect an increase in the subject’s abdominal pain intensity and level of constipation and a decrease in the subject’s sense of wellbeing and spinal range of motion. • That spinal manipulation would be more effective than placebo in bringing about a decrease in the subject’s abdominal pain intensity and level of constipation and an increase in the subject’s sense of wellbeing and spinal range of motion. / M

A dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute Of Technology, 2006. / Purpose Repetitive strain injuries, especially rotator cuff tendonitis, are increasing and reaching epidemic proportions in certain industries and in most industrialized countries (Yassi et al. 1996). Fatigue of the rotator cuff allows the humeral head to translate anteriorly, with resultant mechanical impingement of the supraspinatus tendon. At this point inflammatory changes become evident (Fu et al. 1995). According to Greenman (1996), muscle energy technique (MET) is a 'manual medicine treatment procedure that involves the voluntary contraction of a patients muscle in a precisely controlled direction, at varying levels of intensity, against a distinctively executed counterforce applied by the operator.' It has been hypothesized that MET can be used to lengthen and strengthen muscles, to increase fluid mechanics and decrease local edema, and to mobilize a restricted articulation (Greenman 1996). However, these statements have been made in the absence or appropriate research in order to support such statements, therefore. the aim of this study was to assess the efficacy of Muscle Energy Technique in the treatment of rotator cuff tendonitis in terms of subjective and objective clinical findings. Methods Objective measures included: Diagnostic ultrasound which was used to evaluate changes in inflammation and thickness of the involved tendon, the algometer was used to assess point tenderness, whilst inclinometer readings were taken to evaluate the associated changes in range of motion that may have taken placei / M

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban University of Technology, 2007. / Each healing encounter, and every treatment, has specific and non-specific treatment effects. Non - specific effects, or placebo effects, are the benefits felt by the patients because of the nature of the healing encounter. Although difficult to quantify and control, a number of authors recognize that the non-specific component of management has an additive effect on the overall clinical outcome. It has been reported that due to the physical interaction and social nature of chiropractic, there is a strong non-specific component in the management process, but to what extent it facilitates in the healing encounter is unknown. It has also been shown that spinal manipulation has a clinical effect which exceeds that of placebo; therefore it is possible for its effect to be muted or amplified, depending on the presence or absence of non-specific effects. For the above reasons this study was conducted in an attempt to map the size of the nonspecific effect in the healing encounter by manipulating the practice setting in which the patients were treated. This was achieved using a prospective, randomised, comparative clinical experiment consisting of 60 individuals with Low Back Pain (LBP), selected by convenience sampling. Individuals were then divided into 2 groups of 30. The IV first group's treatment consisted of the standard diversified method of manipulation in a Clinical Research Setting, and the second group received the same treatment except the treatment took place in a Normal Practice Setting. / M