M.Tech. / Terrett (1994) has a theory that diminished blood flow to the brain causes some areas to ‘hibernate’ that is, remain alive, but not function, resulting in diminished mental capacity. He also states that he is sure this is exactly what happens to many people every day, and that it could be the reason they suffer from problems such as tiredness, headache, depression, irritability, difficulty concentrating, poor attention span, visual difficulty, and so forth (Terrett, 1994). Brain function can be detrimentally affected by occipito-atlanto-axial subluxations (Eriksen, 2004). Research showed an improved brain stem evoked response after patients were adjusted. This indicated that the neural messages were going through their brain stems more quickly or with less delay (Shambaugh, Pearlman & Hauck, 1991). The aim of this study was to determine whether spinal manipulative therapy of the cervical spinal segments have any influence on the attention and higherlevel cognitive functioning and processing of an individual who has not received any chiropractic treatment to his/her cervical spine three months prior to the study. Any patient presenting to the University of Johannesburg Chiropractic Day Clinic was considered a potential candidate for the study. The patients were briefly screened through a case history, pertinent physical examination, cervical spine examination and soap note (Appendix E, F, G and H) that were performed at the initial consultation to determine the patients’ suitability for the study. The participants were invited to sign a consent form. In total forty participants were invited to take part in the study. Participants were put into either the adjusting group, or the control group, according to their gender and age. Participants received spinal manipulative therapy to all restricted segments in their cervical spines. Participants in the PDF created with pdfFactory Pro trial version www.pdffactory.com iv control group received detuned ultrasound therapy over the posterior aspect of their cervical spines. Both groups performed the coding test (Appendix D) before their first treatment and after their third treatment, as well as a questionnaire to obtain some personal information and to indicate their present feelings and emotions (Appendix C). The results indicate that there was a statistical difference at the ten percent level of significance in terms of the average number of blocks completed and the average number of blocks filled in correctly for the adjusting group. There was also a statistical difference at the ten percent level of significance in terms of the average number of blocks / symbols changed for the control group. The adjusting group worked more effectively and made fewer mistakes than the control group after the treatment trial was completed. For the chiropractic profession this opens huge potential with regards to the chiropractic benefits and improving the functioning of the society.

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M. Tech. / Low back pain is experienced by approximately 60-90% of the population and is one of the most expensive public health problems today (Shin and Slipman, 2005). Lumbar facet joint syndrome is a common condition, involving about 79% of patients suffering from low back pain (Schleifer, et al., 1994). The aim of this study was to determine the effectiveness of treatment for lumbar facet syndrome with the homeopathic injectable Discus compositum® by using the pressure algometer, Helbig and Lee scorecard system and the Oswestry low back pain questionnaire. This double-blind placebo-control trial, with matched pairs, was conducted at the University of Johannesburg and participants were recruited with posters and by word of mouth. Thirty-two participants that met the inclusion criteria, and were not outside of treatment parameters, were included in the study. These participants were then randomly divided into two groups: Group A was treated with Discus compositum® injectables and Group B was treated with placebo injectables. In addition, participants were matched according to activity levels of more than 3 times per week and activity levels of less than 3 times per week. Participants in both groups were treated four times over a period of two weeks; two treatments per week. A one month post-injection follow-up consultation was carried out in order to determine if the treatment had a lasting effect. The subjective and objective data was analysed by using non-parametric tests in order to establish statistical significance between visits and between groups. The subjective data was obtained by using the Oswestry low back pain and disability questionnaire. The objective data was gathered by using the Helbig and Lee scorecard system as well as the algometer readings. The two sample groups did exhibit statistical differences. The results showed that there was a significant decrease in the pain experienced by the participants, as well as a significant change in the participant’s pain pressure threshold, for both groups. With regards to the diagnostic criteria a higher percentage of participants that were treated with Discus compositum® injections were no longer diagnosed with lumbar facet syndrome according to the Helbig and Lee scorecard system, than those participants that were treated with the placebo injections. In addition, it was determined that a combination of Discus compositum® injections and activity levels of more than 3 times per week proved to be beneficial. Based on the results of this study, one can determine that Discus compositum® is effective in the treatment of lumbar facet syndrome.

M. Tech. / The Rhomboideus muscle is made up of the Rhomboid minor and Rhomboid major muscles. The collective term for theses two separate muscles is commonly referred to as the Rhomboid muscle (Moore, 1999). For the purpose of this study the term Rhomboid muscle will also be referring to the two separate muscles as one, namely the Rhomboid muscle or the Rhomboids. Rhomboid trigger points are one of the main causes of inter-scapular pain because the referral pattern of this muscle is on the medial border of the scapula (Smith, Padgett and Kaufmann, Harrington, An and Irby, 2004). Articular dysfunction associated with Rhomboid trigger points can involve any of the spinal segments from C7 to T5 usually two or three segments are involved. It is therefore, evident that Rhomboid trigger points in conjunction with articular dysfunction can thus be the primary cause of inter-scapular pain (Travell and Simons, 1999).

M. Tech. / Method The purpose of this study was to determine whether spinal manipulative therapy (SMT) of the cervical spinal segments would have any influence on the reaction and response time of a cricket player. It has been suggested that a dysfunctional vertebral subluxation complex can cause a decrease in visual performance. The decreased visual performance may be due to decreased blood flow to the visual centers of the brain. Thirty six participants (3 cricket teams) participated in this study. They were divided into two groups. Group A consisted of eighteen subjects who received spinal manipulative therapy (SMT) of the cervical spine. The eighteen subjects in Group B received detuned ultrasound to the cervical spine The inclusion criteria required the participant to be a male cricket player who was asymptomatic, without any history of cervical spine surgery and without any current injuries (e.g. hand or wrist fractures). The participant had to be between the ages of sixteen and twenty one and have no contra-indications to spinal manipulative therapy. Measure Objective data was obtained by the Wayne’s Saccadic Fixator ® which determined the patients’ visual reaction time. After testing the participants’ visual reaction time, the one group received SMT and the other group received detuned ultrasound. After which all participants’ reaction and response time were retested. vii Results Although there was a decrease in the reaction and response time of the players after spinal manipulative therapy, the objective results showed that due to the small sample size and different baseline values of the participants in this study there was no statistical proof that Chiropractic treatment had a positive influence on the reaction and response time of the participants.

M.Tech. (Chiropractic) / The study evaluated any changes in serum p-endorphin levels before and after a chiropractic adjustment and mobilisation ofthe cervical spine. Three groups of male and female subjects were randomly assigned; the chiropractic group, mobilisation group and detuned ultrasound (control group). Each group consisted of 10 subjects, aged between 18 to 35 with equal numbers of males and females. All subjects were mentally and physically healthy, and were instructed to refrain from nicotine and caffeine intake at least one hour prior to the experiment, as these substances are stimulants and may influence the results. The research protocol involved having blood taken five minutes before the treatment, and repeated five minutes after the treatment. The experimental group received bilateral cervical spine adjustments. The mobilisation group under-went cervical spine mobilisation with oscillatory motion, but no thrust was included. The control group had detuned ultrasound applied to their posterior cervical and trapezius muscles. Blood samples were taken by venipuncture and the p-endorphin levels were analysed using immunoenzymometric assay technique. The results of this study demonstrated that a decrease in p-endorphin levels occurred post intervention in the spinal adjustment group. The mobilisation and detuned ultrasound groups both experienced an increase in p-endorphin levels, but the increase was not statistically significant. This finding allows us to hypothesize that the pain-relieving effects of the chiropractic adjustment, may not be due to a release of p-endorphins, but may be due to the analgesic effect of another system that is not opiate mediated.

M.Tech. (Chiropractic) / The purpose of this study was to assess the prevalence of lower back pain in registered pharmacists in Johannesburg, in terms of workplace and individual factors, in order to establish under which circumstances workplace and individual factors could influence the prevalence of lower back pain in pharmacists. The sample population of registered pharmacists in Johannesburg (N=300) was selected from the register of pharmacists of Gauteng and a questionnaire was sent to the relevant pharmacists. A total of 92 questionnaires were returned and represented a 30,7% response rate. The questionnaire consisted of questions regarding : The prevalences of previous and current lower back pain; the intensities and frequencies of previous and current lower back pain; the location of previous and current lower back pain; the radiation of pain occurring in the lower extremities during previous and current lower back pain; the weakness or numbness perceived in the lower extremities during previous and current lower back pain; the professionals consulted for previous and current lower back pain; the medication administered for previous and current lower back pain. The questions asked regarding individual factors included : age; gender; anthropometry; exercise and smoking; the workplace factors included : number of years in practice; number of hours and days worked per week; bending, twisting and lifting; static work postures and repetitive work. The results were statistically analysed using frequency distributions, cross-tabulations and the Kruskal-Wallis.Chi-squared approximation test. The results were represented by pie charts, frequency tables and cross-tabulations, and descriptively analysed. The overall prevalence of lower back pain in registered pharmacists in Johannesburg was 41,3%. Among other findings, the weight and build were found to be significantly associated with the respondents increased lower back pain. Other significant findings were that respondents who worked more days per week as well as those who had an increased frequency of reaching above shoulder height at work, had an increased incidence of lower back pain. It must be emphasised that great caution should be exercised in attempting to generalise the findings of this survey, 'since workplace and individual factors associated with the lower back pain were based on the respondent's subjective evaluations. This study was not designed to establish cause and effect relationships between individual and workplace factors, and prevalence of lower back pain among pharmacists.

Purpose: The purpose of this pilot study was to assess the effects of Diversified Manipulation versus Sacro-Occipital Technique in the management and treatment of Sacroiliac Syndrome. Method: This study consisted of two groups, a Diversified group consisting of 15 subjects with Sacroiliac Syndrome and a Sacro-Occipital Technique group consisting of 15 subjects with Sacroiliac Syndrome. The subjects were between the ages of 18 and 55 years. Potential candidates were examined and accepted based on the inclusion and exclusion criteria. The Diversified group received Diversified Manipulative therapy to the sacroiliac joint, while the Sacro-Occipital group received SOT Category 2 blocking, from which the subjective and objective findings were based. Procedure: Each successful candidate was treated six times over a two-week period. Before the commencement of the treatment one, three and six, the candidate completed the Oswestry Back Pain and Disability Index questionnaire and the Numerical Pain Rating Scale. Digital Inclinometer readings were taken of the thoracolumbar and lumbosacral regions of the spine. Sacroiliac Manipulation was then administered to the Diversified group based on the restrictions obtained during motion palpation. Category 2 blocking was administered to the Sacro-Occipital Technique group based on the SOT Category 2 categorization test findings. The same treatment was administered at each of the six treatment sessions. Results: Objective statistically significant differences were noted on lateral flexion range of motion, in favour of the Sacro-Occipital Technique group. Subjective readings also showed statistically significant differences with regards to Oswestry Back Pain and Disability Index and Numerical Pain Rating Scale in favour of both the Diversified group and the Sacro-Occipital Technique group. Conclusion: The results of the study indicate that both Sacro-Occipital Technique and Diversified have a positive effect on patients suffering from Sacroiliac Syndrome. However, Sacro-Occipital Technique proved to have a greater overall benefit compared to Diversified manipulation in the treatment and management of Sacroiliac Syndrome. It should be emphasized that the present study was a pilot study to determine the effects of Diversified manipulation versus Sacro-Occipital Technique in the management of Sacroiliac Syndrome. Accurate conclusions could not be formulated due to the remainder non-significant statistical findings obtained from the study; therefore further research needs to be conducted on this comparative study. / Dr. B. Losco Dr. C. D. Losco

Objectives: To determine the efficacy of chiropractic spinal manipulative therapy (CSMT) in the resolution of the persistent or chronic middle ear effusion that is associated with otitis media. This treatment was compared to the insertion of tympanostomy tubes with regards to parent perception and satisfaction. Methods: Thirty patients under the age of seven that were diagnosed as having persistent or chronic middle ear effusion were assigned to receive either tympanostomy tubes or chiropractic treatment according to parental choice. Results: After chiropractic treatment, an objective improvement in the middle ear status was noted by serial tympanography, demonstrating resolution of middle ear effusion. This was noted in 64.3% in the right ear, where a type B tympanogram improved to a type A or type C tympanogram, and in 58.3% in the left ear, where a type B improved to a type A or C tympanogram, or a type C improved to a type A tympanogram. After chiropractic treatment, subjective improvements were noted in the patient’s health, hearing, speech and language, behaviour and social skills, balance, gross and fine motor skills, otalgia and the amount of disturbed nights. Additional benefits from chiropractic treatment were noted in 93.3% of cases. Conclusions: The manner in which the middle ear effusion was resolved by chiropractic manipulation is by normalising the function of the eustachian tube. Eustachian tube dysfunction is a commonly reported aetiological factor in the development of otitis media with effusion, yet previously there was no treatment type to address this problem. Improvement of middle ear effusion occurred in 58.3-64.3% of cases, indicating that chiropractic spinal manipulative therapy could be a viable treatment option to correct the eustachian tube dysfunction. / Dr. Harold Humphries Dr. Chris Yelverton