Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic at Durban Institute of Technology, 2004. / The purpose of this study was to investigate the association between the role of Myofascial Trigger Points of the lower extremity to the clinical presentation of lIiotibialband Friction syndrome / M

A dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Technikon Natal, 1996. / Myofascial trigger points are a frequently overlooked and misunderstood phenomenon in medical curricula, yet with correct diagnosis and appropriate treatment the prognosis is usually excellent. Many effective treatments have been devised for myofascial trigger points, but the problem is that there is very little research to substantiate which of these treatments are the most effective. The aim of this randomised uncontrolled study was to justify the hypotheses which stated that both dry needling and saline injection would prove to be effective in the treatment of myofascial trigger points, with saline injection proving to be the most effective of the two. Patients were obtained for this study by convenience sampling, whereby any patients presenting to the Chiropractic clinic at Technikon Natal with neck,\xB7 upper back or shoulder pains were considered for the study. Of these patients, only those who conformed to the specified delimitations and diagnostic criteria were accepted. The sample size of thirty patients was randomly divided into two treatment groups of fifteen, one of which received saline injection and the other dry needling of active myofascial trigger points. Both groups were educated with regards to the nature and perpetuating factors of the condition, \xB7andwere instructed to follow a specific stretching programme. / M

A dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic at Technikon Natal. 2001. / The purpose of this investigation was to determine the relative efficacy of Action Potential Therapy (APT) as opposed to placebo Action Potential Therapy in the treatment of myofascial pain syndrome. The study was a prospective, randomized, placebo controlled study. The study consisted of two groups of thirty subjects each, which were selected from the Durban Metropolitan area. Only subjects diagnosed as having active trigger points in either the trapezius or gluteus medius muscle were accepted into the study. Each subject received four treatments over a period of seven to ten days. Group one received an active form of Action Potential Therapy while group two received placebo Action Potential Therapy. Subjective assessment was by means of the short form McGill pain Questionnaire and the N wnerical Pain Rating Scale-l Ol. Objective assessment was by means of an algometer and the Myofascial Diagnostic Scale. Readings were taken twice for each patient. The first assessment was conducted at the initial consultation prior to the first treatment, and the second assessment was completed during the last consultation after the treatment. Intra-group comparisons were made using the parametric two-sample paired t-test and the nonparametric Wilcoxon signed rank test. For the inter-group comparison, the parametric twosample unpaired t-test and non-parametric Mann-Whitney unpaired U test were used. Statistical analysis was completed at a 5% significance level. / M

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, 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, 2003 1 v. (various pagings) / The purpose of this study was to investigate the immediate and short term effectiveness of dry needling the primary, active Biceps TrP on the pain experienced during shoulder flexion and abduction range of motion, as well as on an associated bicipital tendonitis and satellite TrP’s.

Thesis (M.Tech.: Chiropractic) -Dept. of Chiropractic, Technikon Natal, 2002 1 v. (various pagings) / The purpose of this clinical trial was to evaluate the efficacy of Magnesium phosphate, as an adjunct to dry needling, in the treatment of Myofascial Pain Syndrome (MPS), in terms of objective and subjective clinical findings. MPS is a frequently encountered condition. If not treated adequately, this condition can lead to long term, recurrent pain, as well as patient and physician frustration. Many treatment protocols have been examined with contradictory results and research into epidemiological studies and combinations of various treatment protocols are lacking.

Thesis (M.Tech.: Chiropractic) -Dept. of Chiropractic, Durban Institute of Technology, 2003 103 leaves / The purpose of this study was to investigate the efficacy of dry needling latent myofascial trigger points, in the treatment of Myofascial Pain Syndrome.

Dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic, Durban Institute of Technology, 2005. / The purpose of this study was to determine the efficacy of Therapeutic Faradic Stimulation in patients with Myofascial Pain Syndrome of theTrapezius and Levator Scapula musculature. This study was a quantitative pilot placebo controlled clinical trial. The sample size used was 60 patients selected from the Durban Metropolitan Area. Only patients between the ages of 30 and 50, who were office workers and were diagnosed with active trigger points in either the Trapezius and/or the Levator Scapula muscles were accepted into this study. The sample was divided into 3 groups of 20. One group received Faradic Stimulation in the form of the Transeva, another group received Placebo Transeva and the third group received Pulsed Ultrasound. Each patient received 2 research treatments with a maximum of 72 hours between treatment 1 and 2, and the third free Chiropractic treatment being a week later. Data (both subjective and objective) were obtained from the patients at the first and second consultations, prior to treatments and at the third follow up before treatment. Subjective data were obtained with the Short form McGill pain questionnaire, the Numerical Pain Rating Scale and the CMCC Neck Disability Index. Objective data were obtained from the Pressure Algometer and the CROM Cervical Range of Motion Instrument. Statistical Analysis of the data was conducted using the SPSS (version 9) software suite. This Statistical software program was manufactured by SPSS Inc, 444N. Michigan Avenue, Chicago, Illinois, USA. Various Descriptive and Inferential Statistical techniques were used. The Descriptive procedures used were various tables and graphs and a few summary statistics including but not limited to means, proportions and percentages. Inferential Statistics included iv various Hypothesis testing techniques. Due to the size of our samples, namely 20 in each group, non-parametric Statistical Tests were used. All the tests were set at type 1 error at 5%, or mentioned differently = 0.05. If our p value as reported was less than 0.05 we declared a significant result and our Null Hypothesis was rejected. Evaluation of the statistical analyses revealed significant improvements with regards to subjective and objective data for mostly the Attenuated Faradic Treatment (Transeva) group. Although significant Placebo and Ultrasound effects were obtained initially after the first treatment, the Transeva group showed more favourable results between consultations two and three, giving a good indication of the progression of the treatment regimen. Comparison between groups showed a significant difference with regards to CMCC Neck Disability Index scores, NPRS 101 questionnaires, CROM extension and right lateral flexion readings and Algometer readings. It was concluded that the Transeva is an effective form of treatment for the active trigger points of Myofascial Pain Syndrome of the Trapezius and Levator Scapula musculature in terms of both subjective and objective clinical findings. Suggestions were made to double-blind further studies as this will aid in reducing researcher bias toward a favoured treatment protocol. This study and observations made by the author with respect to Myofascial Transeva treatment are hoped to contribute to the limited literature available on this modality.

Dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic, Durban University of Technology, 2011. / Background: Myofascial Pain Syndrome is a condition characterized by the development of hyperirritable foci in muscle. Treatments include modalities such as cryotherapy, electrotherapy, ultrasound, ischeamic compression and dry-needling, the latter of which is reported to be the most effective. A side-effect of dry-needling is post-needling soreness which results from bleeding in the area of needle insertion. The application of heat as a therapy to an injured area has been reported to decrease pain by blocking nociceptors, decreasing muscle spasm, and increasing connective tissue extensibility. Objectives: To determine the relative effectiveness of heat therapy immediately after dry-needling versus dry-needling alone on post-needling soreness in the deltoid muscle of asymptomatic subjects. This was done in terms of subjective and objective clinical findings. Methodology: This study was designed as a randomised, parallel-controlled clinicaltrial. Thirty asymptomatic subjects were used. Each subject acted as their own control in that both the left and right arms of each subject were dry-needled. One of the arms received heat therapy after the dry-needling procedure while the other arm acted as a control. Algometer readings, a Numerical Pain Rating Scale-101 (NRS- 101) and a 24 Hour Pain Diary were used as assessment tools. Algometer and NRS-101 readings were taken before and after the dry-needling procedure and during the 24 hour follow up visit. Subjects used a 24 hour pain diary which was filled out at 3 hour intervals, to record the development of post-needling soreness. Independent samples t-test and Pearson’s chi square test were used to compare age and gender between the treatment groups. Repeated measures ANOVA testing was used to compare the effect of heat treatment with no heat treatment in the 60 arms over the three time periods of assessment for the outcomes which were 4 5 measured as continuous variables (NRS-101 and algometer). For binary outcomes such as the presence or absence of pain at any time point, Fisher’s exact tests were used to compare the heat treated with the control arms in the left and right arms separately. A p value of less than 0.05 was considered as statistically significant. Results: Both the objective and subjective measurements from the heat intervention and control groups revealed the development of post-needling soreness. There was a slight trend of heat therapy decreasing post-needling soreness in terms of subjective (NRS-101 and pain diary) and objective (algometer) findings which was however, not found to be statistically significant. Conclusion: Although the results of the study revealed no statistical evidence of a beneficial effect of heat therapy on objective or subjective findings clinical significance could not be excluded due to the observed trend of heat therapy decreasing post-needling soreness in terms of subjective (NRS-101 and pain diary) and objective (algometer) findings. Further investigation is recommended.