A dissertation presented in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 2000. / There has previously been a significant number of clinical trials supporting the efficacy of manipulation for the treatment of low back pain. In addition, the use of manipulation for the treatment of sacroiliac syndrome is well recognised. However, the management protocols involving the use of orthotics, used alone, or in combination with manipulation were found to be controversial. Orthotics seem to be frequently used in the clinical setting and yet there is a paucity of controlled clinical research advocating their application. The aim of this study was to determine the relative effectiveness of chiropractic manipulation used in combination with a non-stabilising sacroiliac orthotic (strapping) versus chiropractic manipulation used in combination with a stabilising sacroiliac orthotic in the treatment of sacroiliac syndrome. It was hypothesised that both treatment protocols would be effective in the management of sacroiliac syndrome, and that manipulation used in combination with a stabilising sacroiliac orthotic over a two week period would be more effective than manipulation used in combination with a non-stabilising sacroiliac orthotic, in terms of subjective and objective clinical f-Indings. The study design chosen was a comparative, randomised, controlled clinical trial. Sixty consecutive patients diagnosed with sacroiliac syndrome were randomly assigned either to the group receiving manipulation used in combination with a non-stabilising sacroiliac orthotic or the group receiving manipulation used in combination with a stabilising sacroiliac orthotic. The age range of patients extencled from eighteen to forty-nine, and included thirty-one males and thirty-three females. Statistically patients\x8F\x8F / M

A dissertation in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2002. / Low back pain (LBP) is a significant public health problem that has had a marked impact on quality of life and on health care costs (Weiner, et al. 2000:450). Toussaint, et al. (1999:134) established that the prevalence of sacroiliac joint dysfunction in the population has been noted in the medical literature to be between 19.3% and 47.9%. There is a lack of consensus among medical practitioners, chiropractors, osteopaths, physiotherapists and others as to the most appropriate therapy or management for sacroiliac syndrome. This study was designed to determine the effectiveness of manipulation of the symptomatic sacroiliac joint compared to manipulation of both the symptomatic and the asymptomatic sacroiliac joints in the treatment of unilateral sacroiliac syndrome. Anecdotal evidence would seem to indicate that the direction of the chiropractic manipulation is immaterial to clinical improvement (Till, 1994). Bilateral manipulation of the symptomatic and asymptomatic joints has been used in clinical practice in an attempt to increase the efficacy of chiropractic management for unilateral sacroiliac joint syndrome (Till, 1994, Lewis, 2001 and Nook, 2000). Walker (1992:914) was of the opinion that 'Unless reliability and validity of assessments and effectiveness of treatment procedures can be demonstrated, clinicians should temper their claims of measurement of, and direct effects on, the sacroiliac joint.' This randomized, comparative clinical trial consisted of sixty voluntary subjects each suffering from sacroiliac joint syndrome. There were two groups of thirty subjects, each of whom received five treatments within a three week period. Group one received manipulation of the symptomatic sacroiliac joint / M

This dissertation is submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, 2003. / Knee joint pathologies, in general, are associated with a loss of knee-extensor muscle strength. This weakness has been attributed to arthrogenic muscle inhibition (AMI). Manipulation of the sacroiliac (SI) has been shown to significantly reduce AMI and increase the strength in the quadriceps muscle group. Although both the knee and SI joints have been linked to AMI of the quadriceps muscle group, no studies have been conducted showing that manipulating the tibio-femoral (knee) joint has any effect on quadriceps muscle strength or AMI. The purpose of this study was therefore to verify whether manipulation of the knee (tibio-femoral) joint is as effective as SI joint manipulation in increasing quadriceps muscle strength in PFPS patients. This study also investigated the effect of combining manipulative therapy of the tibio-femoral and SI joints on quadriceps muscle strength in PFPS patients. / M

M.Tech.

Thesis (M.S.)--West Virginia University, 2009. / Title from document title page. Document formatted into pages; contains vii, 94 p. : col. ill. Includes abstract. Includes bibliographical references.

Thesis (D.PT.)--Sage Colleges, 2009. / "May 2009." "A Capstone project for PTY 768 presented to the faculty of The Department of Physical Therapy Sage Graduate School in partial fulfillment of the requirements for the degree of Doctor of Physical Therapy." Includes bibliographical references.

Thesis (D.PT.)--Sage Colleges, 2010. / "May 2010." "A Capstone project for PTY 768 presented to the faculty of The Department of Physical Therapy Sage Graduate School in partial fulfillment of the requirements for the degree of Doctor of Physical Therapy." Includes bibliographical references.

The sacroiliac joints are a source of low back pain (1) and sacroiliac joint disorders are a common occurrence in clinical practice (2). Sacroiliac dysfunction is considered to be the most common cause of sacroiliac joint pain and subsequent lower back pain (3). However, the anatomical location of these joints and the lack of a satisfactory criterion standard (the “gold standard”) make the diagnosis of sacroiliac joint dysfunction difficult (4). Nevertheless, many different sacroiliac joint tests have been described to detect the sacroiliac dysfunction however none have been validated against any independent criterion standard (5). Furthermore, numerous invalidated tests attempt to diagnose the type of sacroiliac joint dysfunction although they also lack that satisfactory criterion standard (4, 5). The Sacral Base Pressure Test has been shown in a previous study to have good validity as an indicator of sacroiliac dysfunction (6). This study aimed to reconfirm the validity of the Sacral Base Pressure Test in diagnosing sacroiliac joint dysfunction. It also determined the predictive powers of the test in determining which type of sacroiliac joint dysfunction was present. Sixty-two participants underwent a double-blind experimental study where the results from the Sacral Base Pressure Test were compared against a cluster of previously validated tests of sacroiliac joint dysfunction. The cluster of tests gave the diagnosis against which the Sacral Base Pressure Test’s validity and predictive powers were determined. The cluster of tests included Standing Flexion Test, the Iliac Springing Test, Spine Test and Supine Long-Sitting Test. The former two tests only determined the presence of the sacroiliac joint dysfunction, whilst the latter tests also determined the type of dysfunction present. The results occurring in the Sacral Base Pressure Test, namely the external rotation of the feet, were measured using a digital inclinometer. There was no statistically significant difference in the results of the Sacral Base Pressure Test between the types of sacroiliac joint dysfunction. Only when the Sacral Base Pressure Test was performed on the right of the patient and when it analysed right-sided dysfunction types, was there a slight statistically significant difference (P = 0.0529) evident in the results. In terms of the results of validity, the Sacral Base Pressure Test was useful in identifying positive values of sacroiliac joint dysfunction but was not useful in identifying the negative values. The Sacral Base Pressure Test did not accurately diagnose patients with positive test results, however it was fairly helpful in correctly diagnosing patients with negative test results. The Sacral Base Pressure Test had only a “slight” agreement with the diagnosis according to the Landis and Koch Guidelines for Kappa interpretation. At this stage of research into the Sacral Base Pressure Test, the results are varied. In this study, the test was not a clinically useful test for determining the presence of sacroiliac joint dysfunction or the type of dysfunction present. Further research comparing the agreement of the Sacral Base Pressure Test or other sacroiliac joint dysfunction tests with a gold standard of diagnosis is necessary. / Dr. E.K. Urli Dr. J. Breitenbach Dr. C. Yelverton

Dissertation submitted to the Faculty of Health Services in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, at Technikon Natal, 2001. / This study aims to provide insight into the relative effectiveness of two different approaches in the treatment of sacro - iliac syndrome. Until recently, the sacro - iliac joints were not commonly considered to be mobile enough to suffer from detectable restriction of motion (Panzer and Gatterman 1995:453). Kirkaldy - Willis et al. (1992:126) however, states that sacro - iliac syndrome is a well defined and common type of dysfunction. Frymoyer et al. (1991 :2114) also reports sacro - iliac syndrome to be common, although it is frequently overlooked as a source of low back pain. This study will attempt to determine whether manipulation of the sacro - iliac joints together with Proprioceptive Neuromuscular Facilitation (P.N.F.) stretching of the piriformis muscles is a more effective treatment for sacro - iliac syndrome, than manipulation alone. This will be accomplished by determining which approach yields the best patient response in terms of subjective and objective clinical findings. The study conducted was a randomised clinical trial consisting of two groups of 30 patients each. The patients were randomly allocated into the two groups. All patients received four treatments over a two - week period. Group one received manipulation of the sacro - iliac joints alone, while Group two received manipulation of the sacro - iliac joints together with P.N.F. stretching of the piriformis muscles. Only the sacro - iliac joint on the side of the sacro - iliac syndrome was manipulated, and only the piriformis muscle on the side of the sacro - iliac syndrome was stretched. If any patients became asymptomatic within the treatment period, then the treatment was terminated. The patients were however required to return for all the remaining consultations for observational purposes. The results of the Numerical Pain Rating Scale, Oswestry Low Back Disability Index questionnaire, inclinometer and algometer readings, as well as the sacro - iliac orthopaedic tests, were recorded before the first and second treatments, and immediately following the fourth (final) treatment. / M

Dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropratic, Technikon Natal, 2002. / McGregor et al ( 1998) stated that approximately 50 – 80 % of the population in Western society will experience low back pain at some point. According to Cibulka and Koldehoff (1999), the sacroiliac joint is a common cause of low back pain that is overlooked. This study aimed to provide insight into the relative effectiveness of three different approaches in the management of sacroiliac syndrome. Giles and Muller (1999) concluded that spinal manipulative therapy was an effective form of treatment for spinal pain syndromes whilst Burgos et al (2001) states that the use of transcutaneous non-steroidal anti-inflammatories in the management of musculoskeletal conditions is a common therapeutic strategy. This investigation aimed to determine the relative effectiveness of spinal manipulative therapy combined with transcutaneous flurbiprofen (TransAct® patches ) versus spinal manipulative therapy combined with either menthol or non-medicated placebo patches in the management of sacroiliac syndrome, in terms of objective and subjective measures. / M