A dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2006. / 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. / M

Dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic, Durban Institute of Technology, 2005 12, xiii, 84 leaves / Plantar Fasciitis (PF) or “painful heel syndrome” is an inflammation of the plantar fascia at its insertion on the medial calcaneal tubercle. Accounting for 7-9% of total sports injuries, this condition is predominantly due to overuse and is notoriously difficult to treat. Traditionally treatment focused on the resolution of the inflammation with the application of such modalities cross frictions / transverse frictions being the modality of choice. With such modalities there are however limitations which include the detection of the appropriate areas in which treatment should be given as well as the treatment depth achieved. The GISTM, however is an advanced form of soft tissue mobilisation that employs the use of specifically designed stainless steel instruments that, when manually brushed over the skin of the affected area, are thought to detect and release scar tissue, adhesions and fascial restrictions. This complementary technique is hypothesized to work in the same manner as cross friction massage, and is thought to achieve quicker and improved outcomes by its detection of the treatment area(s) as well as improving the depth of treatment application. This assertion was however untested. Therefore the purpose of this study was to determine the efficacy of the Graston Technique Instrument-assisted Soft Tissue Mobilisation (GISTM) in the treatment of Plantar Fasciitis in runners. / M

Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2006 148 leaves / 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.

Thesis (M.Tech.: Chiropractic)--Dept. of Chiropractic, Durban Institute of Technology, 2006. / Brunarski (1984) says that philosophically and historically, chiropractic has been uniquely orientated toward an emphasis on preventative care and health maintenance with a mechanistic and hands-on model for treatment. Instead of reductionism, chiropractors focus on holism, non-invasiveness and the sharing of the responsibilities for healing between doctor and patient. As stated in a Canadian report by Manga et al. (1993), lower back pain is a ubiquitous problem and there are many epidemiological and statistical studies documenting the high incidence and prevalence of lower back pain (Manga et al., 1993). Evans and Oldreive (2000) revealed in a study of the transversus abdominis that low back pain patients had reduced endurance of the transverses abdominis and that its protective ability was decreased. In addition, it was noted that wasting and inhibition of the other core stabiliser and co-contractor, multifidus, was present (Hides et al.,1994), both of which have been linked to the presence of low back pain (Evans and Oldreive, 2000 and Hides et al., 1994). Thus, it stands to reason that manipulation, as an effective treatment for low back pain (Di Fabio, 1992), could be effective in restoring the strength and endurance of the core stability muscles. This is theoretically supported by the fact that a restriction in motion and pain due to mechanical derangement in the low back can be effectively treated by manipulation (Sandoz, 1976; Korr (Leach, 1994); Herzog et al., 1999; Homewood, 1979; Vernon and Mrozek, 2005 and Wyke (Leach, 1994)). Homewood (1979) described that a subluxation may interfere with the nerve supply and result in a decrease in muscular activity. He hypothesized that removal of the subluxation could restore: normal physiological processes, increase muscle activity and; improve functional ability and normalize the torque ratios (Herzog et al., 1999; Korr (Leach, 1994); Nansel et al., 1993 and Rebechini-Zasadny et al., 1981). In terms of an intervention, Rebechini-Zasadny et al. (1981) and Naidoo (2002) demonstrated and inferred that manipulation to the cervical spine could affect the muscular activity supplied by those levels. They, however, suggested further studies of manipulation-induced peripheral changes in the muscles are needed, due to unaccounted for variables and small sample sizes in their respective studies This research aims to address the questions posed by the above literature, hence by investigating a high velocity low amplitude manipulation as a possible added intervention for improving local core stabilizer muscle strength, a management protocol for the chronic mechanical lower back pain could be developed. / M

A dissertation presented in partial fulfilment of the requirements for the Masters Degree in Technology: Chiropractic, 2007. / To establish the profile of the typical patient presenting to private chiropractors in South Africa, in terms of: demographic data; characteristics of the presenting complaint; the knowledge levels of patients on the scope of chiropractic; the diagnosis of the patients; to compare this primary data to existing data from similar international studies. / M

Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 x, 91, [26] leaves : ill. ; 30 cm / If learners are to make a responsible and accountable choice at school of a field of study and occupation, it is imperative that they receive intensive guidance in this regard at school. Appropriate guidance on educational and occupational matters, and orientation of learners with respect to their individual potentials, will enable learners to choose fields of study at school that will correspond to wider occupational fields and that will serve as a meaningful introduction for a reasonable future choice of an occupation. Thus it was the purpose of this study to determine the current knowledge and perceptions of school guidance counsellors (SGC) with respect to the chiropractic profession in South Africa. This study has thus established a knowledge base to facilitate greater understanding and co-operation between school guidance counsellors (SGC) and chiropractors regarding the referral of learners, who may be interested in a profession in the alternative health care industry, to join the chiropractic field as a learner with the intent to become a practitioner.

Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 xii, 62, [18] leaves / The purpose of this study was to determine the comparative effectiveness of cryo-ischaemic compression, using the Cold Tennis-ball Technique, and ischaemic compression, using normal tennis balls, in the treatment of Myofascial Pain Syndrome

Thesis (M.Tech.: Chiropractic)- Dept. of Chiropractic,Durban Institute of Technology, 2005 xx, 116 leaves ; 30 cm / Patellofemoral Pain Syndrome (PFPS) is a common knee problem that affects 25% of the general population. PFPS generally affects adolescents, especially females, young adults and sports men and women. PFPS is defined as anterior knee pain arising from dysfunction of the patellofemoral articulation including its connective and contractile tissues. Literature suggests an extensor mechanism dysfunction as the most probable etiology. The majority of literature suggests that PFPS is associated with restricted patella motion, especially medial glide, resulting from a tight lateral retinaculum and/or tight iliotibial band. The beneficial effect of patella mobilization in the management of PFPS, suggested by the results of a number of studies, further suggests that restricted patella motion may be an integral feature of PFPS, as a causative and/or perpetuating factor. The purpose of this study was to assess the associations between the severity of PFPS (in terms of the objective and subjective clinical measures) and patella mobility (direction of mobility loss and degree of motion loss).

Thesis (M.Tech.: Chiropractic)- Dept.of Chiropractic, Durban Institute of Technology, 2006 xxiv, 139, [17] leaves / This pilot study was a pre-post clinical investigation assessing the influence of component materials on the effectiveness of GTISTM in the treatment of MPS, in terms of clinical outcomes.

Thesis (M.Tech-: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 x, 57 leaves, Annexures 1-10 / To determine if serum cortisol levels are increased following Spinal Manipulation Therapy (SMT) to the low back region and to determine the effect of a short rest interval on the cortisol levels