Dissertation submitted to the Faculty of Health in compliance with the requirements for a Master's Degree in Technology: Chiropractic at Durban Institute of Technology, 2005 / Due to sustained partial neck flexion when operating a computer terminal for prolonged periods and by holding a stooped posture being proposed aetiologies for hypertonic posterior cervical muscles and subsequent mechanical neck pain, subjects for this research study were chosen according to their occupation and had to sit at a desk for more the three hours and less than eight hours a day. The purpose of this study was to investigate the effectiveness of proprioceptive neuromuscular facilitation combined with heat therapy as opposed to proprioceptive neuromuscular facilitation combined with cryotherapy in the treatment of mechanical neck pain caused by hypertonic posterior cervical muscles. This was a comparative, randomised, clinical trial consisting of two groups. Group A received proprioceptive neuromuscular facilitation (PNF) combined with heat therapy as their treatment protocol. Group B received proprioceptive neuromuscular facilitation combined with cryotherapy as their treatment protocol. Each group consisted of thirty people between the ages of 25 and 50 who were randomly allocated to their respective groups. It was hypothesized that the analgesic properties related to cryotherapy would result in the treatment group that received PNF stretching combined with cryotherapy yielding better results in terms of objective clinical findings. It was also hypothesized that the therapeutic effects of heat therapy would result in the treatment group receiving PNF stretching combined with heat therapy would yield better results in terms of subjective clinical findings and it is hypothesized that there is an association between the subjective and objective clinical findings between the cryotherapy and the heat therapy groups. The treatment regimen consisted of each participant receiving three treatments over a period of one week and then a one-week follow-up consultation. Subjective data monitored consisted of the Numerical Pain Rating Scale –101 (NRS-101) and the CMCC Neck Disability index. Objective data was collected using the Cervical Range of Motion goniometer (CROM) and the Algometer. At the end of all treatment protocols, statistical (quantitative) analysis was performed to determine whether one treatment protocol was more effective than the other. The analysis of the data collected showed that for all outcomes measured, either of the two treatments was effective overall. Trends suggested optimum treatments were dependent on the age of the patient. Age groups of 46-50 years old, 41-45 years old and the 31-35 years old responded best and improved the most with heat intervention, while age group of 36-40 years old responded best to the cryotherapy intervention. For the youngest age group of 25-30 years old, it did not make a difference whether they received heat therapy or cryotherapy as an intervention. It would seem that the older the patient the more effective the application of heat therapy as a result of the effect of heat therapy on the collagen and elastin fibers within the muscle and its fascia which allowed for increased and sustained improvement of the majority of the age groups represented in this study. Conversely it would seem that the cryotherapy group had only immediate and unsustained effects in the long term, which suggests that the cryotherapy had only a pain relieving function that allowed for the improvement of patients in the study, which when removed resulted in regression to the initial clinical syndrome severity. Most of the outcomes did not show a statistically significant interaction between time, age group and treatment group. The study was underpowered at the age group level, with only 12 subjects per age group. Further studies with a larger sample size in each of the age groups are needed in order to determine whether age is a definitive factor in one treatment being preferred over the other.

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2012. / Background : A lack of peaceful sleep and adequate neck support during sleep has been described as a significant contributing factor to the development of chronic non-specific neck pain. Health-care practitioners often prescribe a cervical pillow for the treatment of chronic non-specific neck pain despite the ambivalent findings of several studies. Recently Simmons South Africa introduced the Simmons Beautyrest® pillow which it claims is able to support the cervical spine and promotes a restful sleep. This study, therefore, set out to determine the potential of the Simmons Beautyrest® pillow in alleviating chronic non-specific neck pain. Objective : This study aimed to determine the effectiveness of the Simmons Beautyrest® pillow compared to the participant’s usual pillow (the control) in terms of objective and subjective findings in the management of chronic non-specific neck pain. Methods : Forty individuals, aged 18 to 45 years of age, experiencing chronic non-specific neck pain were recruited via convenience sampling. The study was a single-blinded, cross-over interventional study. All participants underwent a case history, physical and cervical orthopedic examination. Objective (algometer and Cervical Range of Motion measurements) and subjective (Numerical Pain Rating Scale, Neck Disability Index, Sleep and pain diary) outcome measures were obtained at each of the five consultations over a four week period, with the cross-over occurring after two weeks. SPSS version 18.0 was used to analyze the data. Demographic data was analyzed using the Chi square tests and t-tests. The consultations were averaged for each phase of the cross over design to result in a two treatment, two period cross over design. Repeated measures ANOVA testing was used to evaluate the effect of the intervention on subjective and objective measurement according to the method of Dallal (Esterhuizen, 2011). The sleep and pain diary data was analyzed using repeated measures ANOVA and Wald chi square test. Results : A significant difference in the perceived comfort levels between the two pillows (p < 0.001) was observed with the Simmons Beautyrest® pillow having a higher comfort rating. A significant decrease in NRS scores (p = 0.018); NDI scores (p < 0.001); and NRS scores on awakening (p < 0.001); neck stiffness rating on awakening (p < 0.00); headache rating on awakening (p = 0.043) was observed in relation to the Simmons Beautyrest® pillow. A significant improvement (p = 0.001) in algometer readings was observed when using the Simmons Beautyrest® pillow when compared to participants usual pillow. A significant increase in mean right lateral flexion measurements was observed in both groups when using the Simmons Beautyrest® pillow (p = Conclusions : The Simmons Beautyrest® pillow was effective in improving chronic non-specific neck pain. It was regarded as comfortable and provided relief with regards to the clinical features of non-specific neck pain. / Simmons South Africa Company

BACKGROUND:To evaluate the feasibility of image-guided radiotherapy based on helical Tomotherapy to spare the contralateral parotid gland in head and neck cancer patients with unilateral or no neck node metastases.METHODS:A retrospective review of 52 patients undergoing radiotherapy for head and neck cancers with image guidance based on daily megavoltage CT imaging with helical tomotherapy was performed.RESULTS:Mean contralateral parotid dose and the volume of the contralateral parotid receiving 40Gy or more were compared between radiotherapy plans with significant constraint (SC) of less than 20Gy on parotid dose (23 patients) and the conventional constraint (CC) of 26Gy (29 patients). All patients had PTV coverage of at least 95% to the contralateral elective neck nodes. Mean contralateral parotid dose was, respectively, 14.1Gy and 24.7Gy for the SC and CC plans (p<0.0001). The volume of contralateral parotid receiving 40Gy or more was respectively 5.3% and 18.2% (p<0.0001)CONCLUSION:Tomotherapy for head and neck cancer minimized radiotherapy dose to the contralateral parotid gland in patients undergoing elective node irradiation without sacrificing target coverage.

No description available.

Dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic, Technikon Natal, 1998. / Mechanical neck pain is an extremely common condition. At any specific time, as many as 12% of the adult female population and 9% of the adult male population experience pain in the neck, with or without associated arm pain, and 35% of people can recall an episode of previous neck pain (Bland 1994:3). However, to date little research has been conducted to investigate which treatment protocolIs may be the most effective in the management of mechanical neck pain syndromes. The aim of this study was to investigate whether the combination of chiropractic manipulative therapy and intermittent, mechanical cervical traction would be more effective in the treatment of mechanical neck pain than chiropractic manipulative therapy alone. It was hypothesized that chiropractic cervical manipulative therapy and the combination of chiropractic cervical manipulative therapy and intermittent, mechanical cervical traction would both be effective in the treatment of mechanical neck pain. Moreover, with reference to objective and subjective clinical findings, it was hypothesized that the combination of chiropractic cervical manipulative therapy and intermittent, mechanical cervical traction would be more effective in the treatment of mechanical neck pain than chiropracic manipulative therapy alone. / M

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 1998. / Purpose: The purpose of this study was to determine the relative effectiveness of two seemingly different approaches to manipulation of the cervical spine in the treatment of cervical spine dysfunction. The researcher postulated that a manual manipulation would have a greater effect in reducing pain and increasing range of motion that accompanies cervical dysfunction than an instrumental, low force, high velocity thrust delivered by means of an Activator Adjusting Instrument. The reason for this is that it provides greater joint movement. Methods This randomised controlled trial consisted of two treatment groups. Each group consisted of 15 subjects, between the ages of 16 and 65 years, selected from the general population and randomly allocated to treatment group A or B. Group A received instrumental thrusts delivered by an Activator Adjusting Instrument (AAI), while group B received standard diversified manual manipulations to the dysfunctional joints in the cervical spine. Each subject was assessed by using subjective measures of the CMCC Neck Disability Index, Numerical Pain Rating Scale and McGill Short- Form questionnaire; and the objective measure of degrees of cervical range of motion obtained using a cervical goniometer (CROM). Two tailed statistical analysis was conducted at a = 0.05, using the non-parametric Wilcoxin Signed Rank Test and the Mann-Whitney U Test comparing intra-group and inter-group data respectively. Further assessment of the data was conducted using power analysis. This data as well as the descriptive statistics were presented in tables and bar charts. / M

A dissertation presented in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 2000. / The literature shows neck pain, including cervical facet syndrome, to be a common problem. It also provides evidence that inflammation plays a role in cervical facet pathology. Prescription of nonsteroidal anti-inflammatory drugs (NSAIDs) is the first line treatment of allopathic physicians for neck pain. Traumeel S is a complex of homoeopathic remedies indicated in a variety of anti-inflammatory, traumatic and degenerative disorders. It has been clinically shown that Traumeel S is effective in the treatment of inflammation. There is a paucity of clinical research into the treatment of acute neck pain, including cervical facet syndrome, with antiinflammatory agents. The aim of this study was to compare the relative effectiveness of piroxicam, an NSAID, with Traumeel S in the treatment of acute cervical facet syndrome. The study was a double-blind, comparative, clinical trial. Fifty consecutive patients complying with all inclusion criteria were randomly assigned to either the Traumeel S group or the piroxicam group. Each patient in the NSAID group received 40 mg of piroxicam per day for the first two days and 20 mg per day for the following 5 days. The Traumeel S group received the same dosage of placebo piroxicam capsules and 3 Traumeel S tablets in crushed form, per day. Placebo Traumeel Stablets, also in crushed form, were taken 3 times a day by the NSAID group to facilitate blinding. III Patients were assessed on days 1, 3 and 7 of the trial. Subjective assessment involved two questionnaires: the CMCC Neck Disability Index, and the NRS-101 / M

Dissertation submitted in the partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 1997. / Symptomatic cervical spondylosis is a common condition in patients over the age of forty. This condition has been successfully treated by means of chiropractic adjusting. However, to date little research has been conducted to investigate whether the combination of chiropractic adjusting and an alternative therapy may be more effective than just chiropractic treatment alone. The purpose of this study was to investigate whether the combination of chiropractic adjusting and an Anthroposophical remedy, Disci comp.cum Stanno, would be more effective in the treatment of symptomatic cervical spondylosis than chiropractic adjustments alone. It was hypothesized that cervical spine manipulation, and the combination of chiropractic adjusting and the Disci remedy would both be effective in the treatment of symptomatic cervical spondylosis. Moreover, with reference to objective and subjective clinical findings, it was assumed that the combined chiropractic adjustments and the Disci remedy would be more effective than chiropractic adjusting alone. The study was a controlled, double-blind clinical trial consisting of thirty patients, fifteen comprising the control group and fifteen the experimental group. The age range of the sample group was from forty to seventy-nine years. The patients were randomly divided into the two groups. The control group was treated with chiropractic adjustments to the / M

M.Tech.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / Nos Ãltimos anos, a sÃndrome metabÃlica tem despertado profundo interesse e debate na comunidade cientÃfica. A ascensÃo epidemiolÃgica deste distÃrbio ocorre nas mais diversas populaÃÃes e faixas etÃrias, somada à sua capacidade de agregar vÃrios fatores de risco para doenÃas cardiovasculares, como aumento das medidas antropomÃtricas, dislipidemias aterogÃnicas, hipertensÃo arterial sistÃmica, alteraÃÃes do metabolismo dos carboidratos, estado prÃ-inflamatÃrio e prÃ-trombÃtico. Mencionada sÃndrome està associada ao maior risco de desenvolver diabetes mellitus tipo 2, doenÃa coronariana precoce e altas taxas de morbimortalidade para complicaÃÃes cardiovasculares. Teve-se como objetivo geral analisar a circunferÃncia do pescoÃo como possÃvel marcador para a sÃndrome metabÃlica em estudantes de uma universidade pÃblica de Fortaleza-CE. Trata-se de um estudo exploratÃrio, quantitativo, transversal e observacional realizado de marÃo de 2010 a junho de 2011 na Universidade Federal do CearÃ, com 702 universitÃrios das seis grandes Ãreas do conhecimento. Participaram do estudo 440 mulheres e 262 homens com idade entre 16 e 58 anos. Percebeu-se associaÃÃo entre a CP e os dados sociodemogrÃficos; 43,9 % dos homens e 7,1% das mulheres apresentaram CP elevada, sendo estatisticamente significante, p < 0,0001 em ambos os sexos. SituaÃÃo semelhante se deu com a idade (p< 0,001), com a situaÃÃo laboral (p<0,031) e com o semestre (p < 0,012). Em relaÃÃo à prÃtica de atividade fÃsica, 22,4% dos sujeitos que praticam algum tipo de atividade fÃsica regular tiveram a CP elevada (p < 0,503). O IMC tambÃm se mostrou estatisticamente significante com p<0,0001. A CP denotou correlaÃÃo positiva com todos os componentes da sÃndrome metabÃlica segundo os critÃrios do NCEP/ATP III. Conforme se concluiu, a CP à um marcador preditor para sÃndrome metabÃlica numa populaÃÃo de universitÃrios. Contudo, ressalta-se a importÃncia de outros estudos sobre essa temÃtica. / In recent years, the metabolic syndrome has aroused profound interest and debate in the scientific community. The epidemiological ascent of this disorder occurs in a wide range of populations and age groups, in addition to its capacity to aggregate various risk factors for cardiovascular illnesses, such as increased anthropometric measures, atherogenic dyslipidemias, systemic arterial hypertension, alterations in carbohydrate metabolism, pro-inflammatory and pro-thrombotic status. This syndrome is associated with a greater risk of developing type 2 diabetes mellitus, early coronary disease and high morbidity and mortality levels for cardiovascular complications. The general aim was analyze neck circumference as a possible marker for the metabolic syndrome in students at a public university in Fortaleza-CE. An exploratory, quantitative, cross-sectional and observational study was developed between March 2010 and June 2011 at University Federal of CearÃ, involving 702 college students from the six large knowledge areas. Study participants were 440 women and 262 men between 16 and 58 years of age. An association was perceived between neck circumference (NC) and sociodemographic data: 43.9% of men and 7.1% of women showed altered NC, with statistical significance at p < 0.0001. A similar situation occurred for age (p< 0.001), occupational situation (p<0.031) and the semester (p < 0.012). Concerning physical exercise, 22.4% of the subjects who exercise regularly displayed altered NC (p < 0.503). The BMI also showed statistical significance with p<0.0001. NC indicated a positive correlation with all metabolic syndrome components according to NCEP/ATP III criteria. In conclusion, NC is a predictive marker of the metabolic syndrome in a population of college students. The importance of further research on this theme is highlighted though.