M.Tech. (Chiropractic) / Problem Statement: Ankle sprains are one of the most common acute injuries treated by physicians (Pellow & Brantingham, 2001). Most ankle sprains involve the lateral ankle ligaments, with the anterior tibiotalar ligament being the most commonly affected in injuries involving plantarflexion and inversion. These injuries often result in restriction of movements that will limit gait (Crosbie, Green, Refshauge, 1999). Even in the event of injury to one ankle, the sensorimotor and postural deficits can be bilateral due to central processing of motor control information (Munna et. al., 2010, Monaghan et. al., 2006). The primary aim of a chiropractic adjustment is to increase joint range of motion (Fryer, Mudge, McLaughlin, 2002) and to correct local joint dysfunction (Pellow & Brantingham, 2001). No prior research has been done using the Zebris FDM-system to analyze changes in gait after ankle adjustment. Method: Sixty participants between the age of 15 and 45 years were recruited. The participants were asked to sign a consent form after which a thorough case history, full physical exam and foot and ankle regional examination were performed. Participants were included in the study if they were of the correct age, had a chronic history of minor ankle sprain and had palpable motion restrictions of ankle joint range of motion. Participants were excluded if they had a history of severe ankle injury or ankle surgery, had any contraindications to chiropractic adjustment or were currently undergoing any other treatment that could interfere with the study, including the use of certain medications. Each participant underwent a gait assessment before and after they received a chiropractic adjustment to the restricted ankle joint. Procedure: Objective measurements were obtained using the Zebris FDM-system before and after participants received one chiropractic adjustment using a long axis distraction technique. The Zebris FDM-system uses capacitive force sensors arranged on a platform in a high density. The measuring plate allows dynamic force distribution to be analysed during gait. The length of the Zebris platform allowed successive footfalls to be captured and measurements taken during three full gait cycles were used in the analysis. All data was processed using the WinFDM program to produce a gait report (Zebris Medical GmbH, 2008) Results: A statistically significant change was seen in the single support line on the non-adjusted side. Changes were measured in the other gait parameters although they were not statistically significant. Conclusion: This study has shown that chiropractic adjustment of the ankle joint has an effect on the path of centre of pressure and foot rotation during gait. It also helps clinicians to see that the adjustment has a bilateral effect. Future studies will be able to determine whether this is a positive or a negative outcome as the limits of normal and pathological gait using these parameters have not yet been set. Chiropractors can treat patients with a history of chronic ankle sprain more effectively if they have a better understanding of residual motion restrictions and movement patterns after acute ankle sprain. A future study including several treatments could be beneficial as clinical chiropractic practice would most likely involve more than one treatment of a patient with a history of ankle sprain. In this way the lasting and accumulative effects of chiropractic adjustment could be measured.

M. Tech. / Cervical Facet Syndrome is a condition characterised by neck pain and decreased mobility of the cervical spine (Bovim et al., 1994). It is essentially the dysfunction of the posterior joints in the neck where muscle hypertonicity causes the ligaments to shorten (Gatterman, 1995). There is a high prevalence of Cervical Facet Syndrome in industrialised countries leading to a loss in productivity and costly expenditure in terms of treatment (Jordan et al., 1998). The aim of this research study was to assess the efficacy of treatment with injectables of the Anthroposophical medicine Disci comp. cum Argento on the symptoms of Cervical Facet Syndrome. These symptoms include pain and a decrease in range of motion. Pain was assessed using two questionnaires, namely the Visual Analogue Scale for Pain (Annexure D) and the Vernon Mior Neck Pain Disability Index (Annexure E). Range of motion was measured using the Cervical Range of Motion Goniometer (Annexure F). This was a double-blind, placebo-controlled trial. Thirty participants, male and female between the ages of 18 and 40 who had been pre-diagnosed with Cervical Facet Syndrome were recruited to participate in the research study. The study was conducted over a period of three weeks. On day one, participants were requested to complete a Consent Form (Annexure B), a Participant Profile (Annexure C), and the two questionnaires used to assess pain. Range of motion was measured by the researcher. The group was then randomly divided into two groups with 15 participants per group. The experimental group received subcutaneous injections of Disci comp. cum Argento and the control group received subcutaneous injections of saline. These injections were administered by the researcher and repeated three times a week for two weeks so that each participant received a total of six injections. A final assessment without treatment was completed in the third week. The two questionnaires and range of motion measurements were repeated at the third, sixth and seventh or final assessment. . The results of this study indicated that although both the remedy and placebo groups showed improvements, there was no significant difference in these improvements between the groups for the results obtained for the Visual Analogue Scale for Pain, Vernon Mior Neck Pain Disability Index and measurements of flexion, left rotation and left lateral flexion. There was however, significant differences in improvement between the visits in favour of the remedy group for measurements of extension, right rotation and right lateral flexion.

M.Tech.

M. Tech. / Objective: This study was conducted in order to compare the effectiveness of Chiropractic spinal manipulative therapy (SMT) combined with guided imagery versus only guided imagery in the treatment of chronic neck pain and stiffness. Chiropractic SMT is aimed at treating neck pain as well as increasing the range of motion (ROM) of the neck. Guided imagery is aimed at reducing stress levels within the patient with a secondary effect of reducing tension in the neck muscles. This study therefore also has a secondary purpose to assess the effects of stress on chronic neck pain. It was hypothesised that Chiropractic SMT combined with guided imagery would be more effective in the reduction of chronic neck pain than guided imagery or alone. This is based on the fact that Chiropractic SMT has been exhaustively proven to be effective in treating chronic neck pain as well as increasing cervical range of motion. Guided imagery has also been proven to be effective in reducing stress even though there has not been enough research on its effect on chronic neck pain and cervical range of motion. Methods: Patients were recruited by means of placing advertisements in and around the University of Johannesburg. Patients that presented to the Chiropractic day clinic with chronic neck pain between the ages of 18 and 30 were included in this study. The participants were then randomly placed in one of two groups. Group A received four sessions of Chiropractic SMT combined with two sessions of guided imagery while Group B received two sessions of guided imagery relaxation techniques and four sessions of detuned ultrasound (U/S). The researcher performed all the sessions of Chiropractic SMT and detuned U/S while Dr A. Fourie (a registered Counselling Psychologist) performed the Guided Imagery sessions. In the initial visit patients in both groups had to undergo a history taking, physical examination and cervical spine regional examination. They were required to sign subject information and consent form and complete a Neck Disability Index (NDI) Questionnaire, Numerical Pain Rating Scale and the Stress Questionnaire. The researcher measured their cervical range of motion on the first and last treatments. The objective and subjective data was collected on the first visit and again on the final visit.

M.Tech. (Chiropractic) / The aim of this study was to compare the effectiveness of two different treatment methods for myofascial pain and dysfunction syndrome of the Gluteus Medius muscle. This was done in order to determine whether or not a combined treatment of the integrated neuromuscular inhibition technique (INIT) and sacroiliacjoint (SU) adjustive therapy was more effective than the INIT applied in isolation, in the treatment of the Gluteus Medius myofascial pain and dysfunction syndrome (OMMPDS). Participants were recruited using advertisement posters placed throughout the University of Johannesburg Doomfontcin Campus and were treated at the University of Johannesburg Chiropractic Day Clinic. Thirty participants, between the ages of eighteen and fifty years, who were suffering from lower back pain and presented with Gluteus Medius rnyofascial trigger points (Trl's) and an SIJ dysfunction were selected for the study. They wcre randomly assigned into one of two groups, consisting of fifteen subjects each. as they entered into thestudy. Group one received the INIT to the affected Gluteus Medius muscle. Group two received a combination of the INIT to the affected Gluteus Medius muscle and an SIJ adjustment. Patients attended four sessions over a period ofeight days and were treated on all of these sessions. Subjective and objective data were recorded on all sessions. Subjective data was recorded using the McGill Pain Questionnaire and the Numerical Pain Rating Scale. Objective data was recorded using the Universal Goniometer, to measure hip ranges of motion of the affected Gluteus Medius muscle, and the Wagner Pressure Algometer to measure pain-pressure threshold of the affected Gluteus Medius muscle Trl's, All of the data were statistically analyzed using Repeated Measures and Independent t-Tcsts, P-values were calculated to determine the statistical significance of the datu. The results of the study indicate that both treatment methods nrc effective in treating GMMPDS. However a combined treatment approach of INIT and SIJ adjustive therapy was more effective in achieving a greater therapeutic response compared to INIT alone.

A dissertation presented in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 2000. / The absence of tested theory has resulted in a continued variation in protocols for the treatment of mechanical low back pain. This study was designed in order to determine the relative effectiveness of spinal manipulation versus spinal manipulation in conjunction with a low back strapping in the treatment of mechanical low back pain in the phase of dysfunction. / M

Dissertation submitted in partial compliance with the requirements for the Master's Diploma in Technology: Chiropractic, Natal Technikon, 1997. / The purpose of this study is to evaluate the usefulness of the Gonstead Listing System as a reliable indicator of the direction in which to adjust the sacroiliac joint in subjects with sacroiliac joint dysfunction, in terms of their subjective and objective clinical findings. The hypothesis is that the direction of manipulation is clinically insignificant in causing a decrease in the subject's clinical findings. This information is necessary in order for chiropractors to formulate a more cost-effective treatment protocol for their patients. / M

Purpose: Trigger points may occur when muscle is subject to direct trauma, sustained tension, fatigue, radiculopathy, joint dysfunction and emotional stress, which may cause aberrant nerve conduction and dysfunction of the motor neurons. Any of these factors may increase the possibility of overload stress to a muscle and may convert a latent trigger point to an active one. In humans, due to muscle attachments, spinal manipulation causes reflex relaxation of associated and distal musculature. The purpose of this study was to assess the effects of upper cervical spine manipulation, specifically C1, on pain tolerance of trigger points over the erector spinae muscles in show-jumping horses. Method: This study consisted of two groups, the experimental and the control group, each consisting of ten horses. Potential candidates were examined and accepted based on the inclusion and exclusion criteria. The only method of treatment that was administered to each horse was chiropractic manipulation to the most restricted side of the UPPER CERVICAL SPINE joint complex, from which the objective findings were based. Procedure: Both groups were examined for trigger points within the Erector Spinae muscles and these trigger points were assessed, via an algometer, for spot tenderness. All horses were then examined for a cervical restriction of the upper cervical spine. Only the experiment group had the restriction corrected by a chiropractic manipulation and thereafter both groups were reassessed two minutes later, and then again two weeks later, via an algometer, for spot tenderness within the same trigger points. Results: Statistically significant changes were found when comparing the algometer readings before the adjustment with the algometer readings after the adjustment on the right. Otherwise no statistically significant differences were found when comparing algometer readings before the adjustment with the algometer readings after the adjustment on the left, or when comparing the algometer readings before the adjustment with the algometer reading two weeks later bilaterally. Conclusion: The results were inconclusive with regards to immediate and prolonged effects of upper cervical spine manipulation, specifically C1, on pain tolerances over the erector spinae muscle. As this study was directed to a small group of subjects, accurate conclusions cannot be formulated due to the insignificant findings obtained from the study and further research needs to be performed on the effects of upper cervical spine manipulation on trigger points in horses. / Dr. Ashleigh Deall Dr. Alex Niven Dr. Chris Yelverton

M.Tech.

Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 97 leaves ; 30 cm / In symptomatic sacroiliac syndrome, nociceptors located within the capsule and ligaments of the sacroiliac joint are said to be activated which in turn act on inhibitory interneurons that synapse with the motor neuron pool of the muscles of that joint (muscles responsible for hip flexion, extension, abduction and adduction fall within the sacroiliac motor neuron pool). These inhibitory interneurons relay information that decreases the recruitment ability of that motor neuron pool. This is termed Arthrogenic muscle inhibition (AMI) and it has been stated that the number of motor units innervating a muscle relates positively to the strength of that muscle and hence may have an effect on the functional ability of that muscle. However, it has been proposed that spinal manipulation activates mechanoreceptors (Wyke receptors) from structures in and around the manipulated joint causing changes in motor neuron excitability through the altered afferent input and thereby causing an increase in motor neuron recruitment and a decrease in AMI. Furthermore, it has been found that sacroiliac joint problems have often been related to reduced or asymmetric range of motion (ROM) of the hip and / or lack of proprioceptive ability in the ipsilateral limb. In light of the above, manipulation has been found to cause a re-establishment of normal muscle tone and joint kinematics, therefore relaxing the muscles in that area and restoring normal ROM of the involved joint. This study presents the results of sacroiliac manipulation on objective hip measures (including peak torques, ROM and proprioception).