M.Tech. (Chiropractic) / Purpose: The purpose of this randomised comparative study was to establish the effects which these modalities had on pain perception and range of motion in patients with acute cervical facet syndrome. This was done by comparing manual cervical spine traction alone; to cervical spine adjustments alone to manual cervical spine traction applied post cervical spine adjustments. Method: A total of 30 participants were recruited for this study by placing advertisements in and around the University of Johannesburg, Doornfontein Campus. Participants had to meet the requirements of the inclusion criteria and were excluded if they were found to be unfit for this particular study. The 30 participants were asked to draw a number out of a bag which therefor randomly divided them into three groups of 10 participants each. Procedure: Participants in group A received manual cervical traction alone as their treatment. Participants in group B received cervical spine adjustments alone as their treatment. Finally, participants in group C were treated by performing manual cervical spine traction after the cervical spine adjustment. Each participant was treated a total of six times over a two week period. Measurements were taken on the first, fourth and a seventh consultation. Results: Regarding the Subjective readings, there was an improvement with regards to the Numerical Pain Rating Scale values for all three groups, but the combination group of manual cervical spine traction performed post cervical spine adjustment, showed the greatest improvement over the trial period on intra-group analysis. No statistical significant changes were found on inter group analysis. There was an improvement in Neck Pain Disability Index values for all three groups, but the cervical spine adjustment group showed the greatest improvement over the trial period on intra-group analysis. No statistical significant changes were found on inter group analysis. Regarding the Objective readings, there was an improvement in pressure algometer readings for all three groups, but the cervical spine adjustment group showed the greatest improvement over the trial period on intra-group analysis. No statistical significant changes were found on inter group analysis. There was an improvement in Cervical Range of Motion readings for all three groups, but the combination group of manual cervical spine traction performed post cervical spine adjustment showed the greatest improvement for flexion, extension and bilateral rotation on intra-group analysis. However, for bilateral lateral flexion, the cervical spine adjustment group showed the greatest improvement on intra group analysis. No statistical significant changes were found on inter group analysis. Conclusion: There were clinically significant improvements within each of the three groups on intra group analysis but no clinically significant differences were found on inter group analysis. Therefore, none of the groups could be singled out as being the best treatment approach for acute cervical facet syndrome. With regards to the Chiropractic profession the outcome of this study therefore suggests, that the chiropractic adjustment alone is sufficient in treatment of acute cervical facet syndrome as none of the groups proved to be superior.

M.Tech. (Chiropractic) / The purpose of this study was to compare the immediate effect of upper versus lower cervical manipulation on the vertebral artery blood flow in asymptomatic individuals. Thirty patients of both genders between the ages of 18-45 years of age, volunteered to participate in this study. Each participant presented with at least one upper and one lower rotary cervical facet restriction. Each participant was randomly placed into either Group 1 whom received upper cervical manipulation, or Group 2 whom received lower cervical manipulation. Any participants who presented with positive VBAI signs or symptoms were excluded from this study. The Medison SonoAce 8000 Ultrasound System was used to objectively measure the blood flow as close to C1-C2 region as possible, contralateral to the side of the adjustment contact. Three measurements were recorded in total which included neutral, pre-manipulation and post-manipulation. As this study included asymptomatic participants, no subjective data was collected. Statistical analysis was performed where the intragroup analysis was done using the Paired Sample t-test and inter-group analysis was done using the Independent Samples t-test to check for statistically significant results less than the p-value of 0.05. There were no statistically significant results found in Group 1 and Group 2 in isolation in the intragroup analysis as well as when compared in the intergroup analysis. Upper cervical manipulation resulted in a slight percentage increase in mean blood flow velocity. Lower cervical manipulation resulted in a decreased end diastolic blood flow velocity after manipulation which indicated the possibility of vertebrobasilar occlusion, however, it did not result in much change with regards to mean blood flow velocity. In addition, upper as well as lower cervical v manipulation had a minimally insignificant dilating effect on the diameter of the upper vertebral artery which may have been due to reflex vasodilation. This study demonstrated no statistically significant changes in isolation in the intragroup analysis as well as when compared in the intergroup analysis. Lower cervical manipulation did however have a moderate influence on the upper vertebral artery blood flow but overall was still less stressful in comparison to upper cervical manipulation. Additional studies are suggested to clarify these findings further.

M.Tech. (Chiropractic) / Purpose: The aim of this comparative study was to compare the effects of spinal adjustment with static passive stretch to the cervical spine, and spinal adjustment with proprioceptive neuromuscular facilitation to the cervical spine in the treatment of chronic posterior neck pain with regards to pain, disability and cervical spine range of motion. These effects were based on a questionnaire consisting of a Numerical Pain Rating Scale, a Vernon-Mior Neck Pain and Disability Index Questionnaire, and on cervical spine ROM readings taken using an analogous cervical spine ROM inclinometer. The questionnaire was completed and the ROM readings taken prior to treatment at the first, fourth and seventh consultation. Method: Thirty participants who met the inclusion criteria were randomly diversified in number and gender between two groups of equal size (15 participants each). Group one received spinal adjustment/s to restricted cervical spine joints followed by static passive stretching. The second group received spinal adjustment/s to restricted cervical spine joints followed by proprioceptive neuromuscular facilitation. Participants were treated six times out of a total of seven sessions, over a maximum three week period. Procedure: Subjective data was collected at the beginning of the first and fourth consultations, as well as on the seventh consultation by means of a Numerical Pain Rating Scale (NPRS) and a Vernon-Mior Neck Pain and Disability Questionnaire in order to assess pain and disability levels. Objective data was collected at the beginning of the first and fourth session, as well as on the seventh consultation by means of a cervical spine range of motion inclinometer in order to assess cervical spine range of motion. Analysis of collected data was performed by a statistician. Results: Clinically significant improvements in group 1 and group 2 were noted over the duration of the study with reference to pain, disability, and cervical spine range of motion. Statistically significant changes were noted in group 1 and group 2 with reference to pain, disability, and cervical spine range of motion over time except for cervical spine extension range of motion.

M. Tech. / OBJECTIVE: To determine the most effective treatment protocol in the treatment of Upper Crossed Syndrome by comparing objective results gained from Spinal Manipulative Therapy and a stretching program only and a combination of these treatments directed at the shoulder girdle and cervical spine. DESIGN: The study was a clinical trial in which three experimental groups of fifteen participants each were compared to each other. These participants were recruited from the local general population and were selected on the basis of inclusion and exclusion criteria, presenting with Upper Crossed Syndrome and demonstrating unremarkable clinical and radiological findings.

M.Tech. (Chiropractic) / This study aims to determine whether muscle energy technique of the psoas muscle can be used as an effective treatment for low back pain with lower crossed syndrome or whether it is better to be used alone or in conjunction with spinal adjustments with regards to pain and disability, lumbar range of motion and degree of lumbar lordosis. Thirty participants who met the inclusion criteria were randomly allocated to one of three different groups of ten participants each. Group 1 had muscle energy technique performed on the psoas muscle of each participant. Group 2 received spinal adjustment/s over the restricted joint/s in the lumbar spine. Group 3 received spinal adjustment/s over the restricted joint/s in the lumbar spine in conjunction with muscle energy technique on the psoas muscle. All participants were assessed over a four week period. All groups attended six treatment sessions over three weeks of which muscle energy technique and/or spinal manipulation was performed. In the fourth week only measurements were taken and no treatment was administered.Subjective data was collected at the first and fourth consultations prior to treatment, as well as on the seventh consultation by means of a Numerical Pain Rating Scale and Oswestry Low Back Pain Disability Questionnaire to assess pain and disability. Objective data was collected at the first and fourth consultations prior to treatment, as well as on the seventh consultation by means of a digital inclinometer for assessing active lumbar range of motion and a flexible ruler for measuring the degree of lumbar lordosis. Analysis of collected data was performed by a statistician.Statistically significant improvements were seen in Groups 1, 2 and 3 over the duration of the study with regards to pain, disability and lumbar range of motion as well as degree of lumbar lordosis. The data gathered in this study showed statistically significant changes in Groups 1, 2, 3 with regards to lumbar range of motion, lumbar lordosis, pain and disability, with Group 3 showing the most statistically significant changes with regard to pain and disability...

A dissertation submitted in partial compliance with the requirements for a Masters Degree in Technology: Chiropractic, Durban Institute of Technology, 2003. / The purpose of this study was to compare the relative effectiveness of manual manipulation versus the Activator Adjusting Instrument in the management of acute facet syndrome of the lumbar spine / M

M. Tech. / Purpose: Many studies have shown the effect of treatment of the cervical spine on parts distant to the spine itself, which are linked anatomically, biomechanically or neurologically, e.g. the temporomandibular joint (Curl, 1994). Curl (1994) reports a neurological link between the cervical spine and the temporomandibular joint, and Reggars (1994) reports a biomechanical link between the temporomandibular joint and cervical spine. These links may affect the cervical spine when adjusting the temporomandibular joint. For these reasons, further study is necessary to establish the possibility of temporomandibular joint involvement in the formation of neck pain, and the possibility of chiropractic manipulative therapy delivered to the temporomandibular joint as a successful alternative treatment for neck pain. The purpose of the study was to determine the effectiveness of chiropractic adjustment of the temporomandibular joint, compared to cervical spine adjustment of the upper cervical spine as a treatment form for neck pain, with regards to pain, disability and cervical spine range of motion. Method: This study consisted of two groups of 15 participants between the ages of eighteen to thirty-five, similar in age and gender ratios. The potential participants were examined and accepted according to the inclusion and exclusion criteria. The method of treatment administered to each participant was determined by group allocation. Group 1 received chiropractic adjustment techniques delivered to the temporomandibular joint and group 2 received cervical spine adjustment techniques delivered to restrictions of the upper cervical spine.

M.Tech. / Purpose: Posterior mechanical neck pain is considered a debilitating musculoskeletal problem and is one of the most common reasons for visiting an emergency department (Murphy, 2000). Anti-inflammatory creams and gels are readily available to individuals suffering from musculoskeletal pain. The purpose of this study was to determine the effectiveness of Traumeel®S ointment together with chiropractic spinal manipulative therapy as a treatment form for posterior mechanical neck pain, with regards to pain, disability and cervical spine range of motion. Method: This study was a comparative study and consisted of two groups of fifteen. The participants were between the ages of eighteen and forty-five, with a half male to female ratio. The potential participants were examined and accepted according to the inclusion and exclusion criteria. Group A received chiropractic spinal manipulative therapy followed by the application of aqueous cream over the upper trapezius muscle area of the posterior neck. This was the placebo group. Group B received chiropractic spinal manipulative therapy followed by the application of Traumeel®S ointment over the upper trapezius muscle area of the posterior neck. This was the experimental group. Objective and subjective findings were based on the above treatment protocols. Procedure: Treatment consisted of seven consultations over a three week period. Objective and subjective readings were taken at the beginning of the first, fourth and seventh consultations. Subjective readings were taken from the Vernon-Mior Neck Pain and Disability Index as well as from the Visual Analogue Scale (VAS). Objective readings were taken from measurements taken from the Cervical Range of Motion device (CROM). At the first to the sixth consultations participants received spinal manipulative therapy with either the application of aqueous cream or the application of Traumeel®S ointment depending on whether they were in group A or group B. Results: Clinically and statistically significant improvements in both group A and group B were seen over the course of the study with regards to cervical spine range of motion, pain and disability. Conclusion: The results show that both treatment protocols were effective in decreasing cervical spine pain and disability and increasing cervical spine ROM. Group B receiving Traumeel®S ointment did show a greater increase in cervical spine ROM clinically, but statistically there was no significant difference between the two groups.

Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2006 xvii, 176 leaves / Core strengthening has become a major trend in the rehabilitation of patients suffering with lower back pain. Clinical trials have shown that core strengthening is beneficial for patients with low back pain. According to the literature, core strengthening consists of activating the trunk musculature in order to stabilize hypermobile symptomatic joints and thus lessen mechanical stress to the spine. Spinal manipulative therapy has also proved itself to be beneficial, particularly in the case of post-natal low back pain sufferers, as manipulation may correct hypomobility associated with spinal subluxations. Literature suggests that spinal manipulative correction of spinal subluxations in combination with core stability exercises, that stablise symptomatic hypermobile joints, may have more advantages than using these interventions singularly in the treatment of post-natal low back pain. However, the combination of a core stability muscle training program with spinal manipulative therapy has yet to be investigated. In order to choose the most appropriate therapy for managing this condition, it is essential for research to be carried out to identify the most effective treatment, which would allow for better overall management of low back pain during the post-natal period. Therefore this study was designed to establish the effectiveness of a combined protocol of spinal manipulation and core stability exercises in the treatment of post-natal mechanical low back pain and to establish whether this protocol should be utilized routinely in the management of this condition.

Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 xiii, 70 leaves ; 30 cm / Although studies of manipulation-induced peripheral changes in the muscles have been done, inconsistencies noted by the author’s call for further investigation into the reflex effects of manipulation. Additionally, according to the literature, no effective treatment protocol for the painful shoulder has been found. Therefore this research aimed at addressing these discrepancies by quantifying the immediate effect of cervical spine manipulation in terms of peak torque on rotator cuff musculature in asymptomatic patients with both a cervical spine dysfunction and without. And thus by investigating cervical manipulation to the C4-C7 spinal segment, as a possible added intervention for improving rotator cuff muscle peak torque, a more efficient and effective management protocol for the painful shoulder could be attained. Thus the aims for this study included: 1) To evaluate whether manipulation has an effect on rotator cuff peak torque or not, utilizing the Cybex Orthotron II Isokinetic Rehabilitation System; 2) To ascertain whether manipulation of the specific levels has an effect on the rotator cuff peak torque or not and 3) To ascertain whether the presence or absence