Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2003 65 leaves / Low back pain is one of the largest known causes of disability in western society. The purpose of this study was to evaluate the relative effectiveness of combined spinal manipulation and interferential current therapy versus combined oral meloxicam and interferential current therapy in the treatment of acute mechanical low back pain.

Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 96, [20] leaves / Strengthening of the rotator cuff muscles forms an integral part of any rehabilitation programme for the shoulder. Shoulder rehabilitation programmes which incorporate early motion and emphasize strengthening, have a lower incidence of recurrent subluxations and dislocations. If cervical manipulation were proven to increase the strength of the rotator cuff muscles, then this could be used to develop and implement more effective treatment and rehabilitation protocols for patients with musculoskeletal painful shoulders and rotator cuff pathologies, and therefore provide future patients with more effective health care. Studies have shown consistent reflex responses associated with spinal manipulative treatments. These reflex responses have been hypothesized to cause the clinically beneficial effects of decreasing hypertonicity in muscles, pain reduction and increasing the functional ability of the patient, and although spinal manipulation has been shown to affect muscle strength, it has not been extensively researched and it is unclear whether increased muscle strength is yet another reflex effect of manipulation. As the rotator cuff is innervated by nerves arising from the mid and lower cervical spine, it is theorised that dysfunction of the spinal joints adversely affects nerve endings, causing inhibition of nerve function and affecting the rotator cuff. This is congruent with research which describes how there could be a decrease in muscular activity due to interference with the nerve supply of a muscle by means of a spinal joint fixation. In light of this, one could hypothesize that removal of a cervical joint dysfunction by manipulation, could increase motor unit recruitment and muscular activity of the muscles supplied by that cervical level and therefore possibly strengthen the muscles involved. Therefore the aim of this study was to determine whether cervical manipulation could contribute to the strengthening process of the rotator cuff.

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban University of Technology, 2009. / Through the literature review it has become apparent that low back pain is a very real problem in most societies. It has been suggested that there is enough evidence to prove the relationship between low back pain and local muscle dysfunction and that focus in management of these patients should be the rehabilitation of these muscles by exercise. Literature suggests that optimal core muscle strength, control and endurance working synergistically with the rest of the neuromusculoskeletal system is necessary for lumbar spine stability . Arthrogenic Muscle Inhibition is caused by distension and/or damage of a joint and is thought to disable the muscle from contracting all its muscle fibres. When a joint is injured it is thought that AMI causes muscle weakness, which in turn hampers the rehabilitation process of that joint despite complete muscle integrity. Spinal manipulative therapy has been shown to alter the excitability of spinal muscle motor neurons due to the stimulation of mechanoreceptors in the joint capsules suggesting that SMT could be a means to remove this inhibitory action. The literature supports the hypothesis that a decrease in the neurological deficit caused by AMI may result in a faster recovery rate. Aims The aim of this study is to determine the immediate effect of thoraco-lumbar spinal manipulation compared to lower lumbar spinal manipulation on core muscle endurance and activity in patients with mechanical low back pain by assessing the correlation between the objective and subjective measures. Method A prospective, convenience sample with purpose allocation (pre /post) clinical trial was used as the sampling method. Thirty participants where placed in two groups, group one and group two, of fifteen people each. Group one underwent spinal v manipulative therapy between L4 and S1 spinal levels. Group two underwent spinal manipulative therapy in between T8 and L1 spinal levels. The objective and subjective testing was done pre- and post-intervention. The objective data was that of a surface EMG attached bilaterally over the internal oblique as well as a prone abdominal draw in biofeedback test. The subjective data included a pain numerical rating scale (0-100). Results The results showed to partially favour group two (thoraco-lumbar), in both increased endurance time that would prove that AMI does in fact inhibit the transversus abdominis and obliques internus, thus it would hinder the rehabilitative process. Some of the statistics where not in favour of the aims, as there was no difference in the effect of group one or two on the NRS, as both improved consistently. It would be recommended that use be made of fine-wire EMG for testing the activity in both the obliques internus and the transversus abdominis, which would allow for more consistent readings, thus adding strength to the research.

Submitted in partial compliance with the requirements for the Masters’ Degree in Technology: Chiropractic, Durban University of Technology, 2013. / Background: Motor learning theories indicate that training improves motor performance by reducing variability and increasing task control. Elastic tubing and tyre resistance training methods may allow for the development of control over the dynamics of spinal manipulation. This study thus aimed to determine whether training with elastic tubing and tyre resistance, in conjunction with the standard manipulative training at the Durban University of Technology, resulted in the development of control of the dynamics of manipulation compared to training with the standard training alone. Methods: A quantitative, prospective, experimental cohort design was used. Fifty-three participants were randomly allocated into tyre or elastic tubing resistance training intervention groups, or the control group. All groups continued with the standard manipulative training at the Durban University of Technology. The dynamics of manipulation were measured with the Dynadjust pre-, mid- and post-training. The SPSS was utilised to compute the parametric and non-parametric analyses. Results: The results showed no statistically significant differences over time for any of the measured dynamics of manipulation. None of the groups (excluding the control group for S-I manipulation) developed control of the relationships between the dynamics. Overall, there was no difference between the groups with regards to development of control of the dynamics. Conclusion: The results suggest that the additional training methods, should be carefully considered when employed over a short term. Study limitations include the sample size and the effect of outliers, therefore any firm conclusions drawn from this study are required to be interpreted with caution.

Thesis (M.Tech.: Chiropractic), Durban Institute of Technology, 2003. / Low back pain is one of the largest known causes of disability in western society. The purpose of this study was to evaluate the relative effectiveness of combined spinal manipulation and interferential current therapy versus combined oral meloxicam and interferential current therapy in the treatment of acute mechanical low back pain. / M

Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 96, [20] leaves / Strengthening of the rotator cuff muscles forms an integral part of any rehabilitation programme for the shoulder. Shoulder rehabilitation programmes which incorporate early motion and emphasize strengthening, have a lower incidence of recurrent subluxations and dislocations. If cervical manipulation were proven to increase the strength of the rotator cuff muscles, then this could be used to develop and implement more effective treatment and rehabilitation protocols for patients with musculoskeletal painful shoulders and rotator cuff pathologies, and therefore provide future patients with more effective health care. Studies have shown consistent reflex responses associated with spinal manipulative treatments. These reflex responses have been hypothesized to cause the clinically beneficial effects of decreasing hypertonicity in muscles, pain reduction and increasing the functional ability of the patient, and although spinal manipulation has been shown to affect muscle strength, it has not been extensively researched and it is unclear whether increased muscle strength is yet another reflex effect of manipulation. As the rotator cuff is innervated by nerves arising from the mid and lower cervical spine, it is theorised that dysfunction of the spinal joints adversely affects nerve endings, causing inhibition of nerve function and affecting the rotator cuff. This is congruent with research which describes how there could be a decrease in muscular activity due to interference with the nerve supply of a muscle by means of a spinal joint fixation. In light of this, one could hypothesize that removal of a cervical joint dysfunction by manipulation, could increase motor unit recruitment and muscular activity of the muscles supplied by that cervical level and therefore possibly strengthen the muscles involved. Therefore the aim of this study was to determine whether cervical manipulation could contribute to the strengthening process of the rotator cuff. / M

A dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2005. / Low back pain has been shown to be associated with inhibition of the lower limb musculature. This inhibition is called arthrogenic muscle inhibition (AMI). Sacroiliac joint dysfunction has been linked with AMI of the ipsilateral and contralateral quadriceps and hamstring muscles. Sacroiliac manipulation has been shown to significantly reduce ipsilateral AMI, however no studies have been conducted to illustrate the effect of sacroiliac manipulation on contralateral AMI. Neither have their been studies to show the presence or extent of spinal dysfunction between the levels of L2-L5 and its significance on muscle inhibition in the quadriceps and hamstring muscles, nor the effect of manipulation of these levels on AMI of the quadriceps and hamstring muscles. The purpose of this study was therefore to determine whether spinal manipulation has an effect on AMI of the contralateral limb as well as that of the ipsilateral limb. / M

M.Tech. / Purpose: To determine what effects flexion distraction will have on males with chronic lumbar facet syndrome, in reference to intersegmental range of motion and pain. Method: Thirty male participants with chronic lumbar facet syndrome received flexion distraction technique. The trail consisted of seven visits over two to three weeks. Treatment was performed on the first to sixth visit, readings and questionnaires were completed on the first, fourth and seventh visits. Data collection was concluded before treatment on the mentioned visits. Subjective data consisted of the Oswestry Disability Index (ODI) and the Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2). Objective data included global lumbar range of motion measurements using the Baseline Digital Inclinometer, and segmental lumbar range of motion by means of the Radiographical Midplane Angle method. Results: Objectively, clinical significance of the intersegmental lumbar range of motion increased from the L1/L2 to the L4/L5 level (2.2% - 17.7%), but showed no statistical significance. In relation to the maximal motion possible at these levels, the increase in motion escalated from 0.8% at the L1/L2 segment to 9.2% at the L4/L5 segment. The global lumbar range of motion showed clinical significant increase in all of the ranges except for extension, however statistical significance was found in right lateral flexion only (p = 0.045). The greatest increase in motion was observed in left lateral flexion (15.72%) and a decrease in extension (3.72%) was illustrated. Subjectively, the group showed statistical significant improvement in both the SF-MPQ-2 (p = 0.000) and ODI (p = 0.000). Clinical meaningful change was noted throughout the subjective data, which resultantly showed a 66% and a 67% change in pain respectively. Conclusion: Flexion distraction has shown to have clinical significant effects on segmental and thus global range of motion, and great clinical meaningful change in pain levels and pain perception. Thus specific segmental mobilisation does affect the segmental motion.

M.Tech. (Chiropractic) / Purpose: The effectiveness of cervical spine adjustments for improving spinal function and relieving pain has been well established. However, the mechanisms responsible for these changes after spinal adjustments are still being researched. Further scientific evidence regarding the neurological and physiological effects following spinal adjustments is warranted. Evidence suggesting that spinal dysfunction has an effect on central neural processing is growing. A number of palpation from the first to the sixth visit. The seventh visit consisted of gathering data only. Results: Clinical and statistical improvements in the entire group were shown over the course of the treatment with regards to cervical spine range of motion, touch pressure threshold and neck pain and disability. Conclusion: The results show that lower cervical spine adjustments do have an effect on touch pressure threshold, cervical spine range of motion and neck pain and disability in patients with chronic cervical facet syndrome. Touch pressure threshold returned to optimal function, cervical spine range of motion increased and neck pain and disability decreased in all participants over time. authors have suggested that spinal dysfunction may lead to altered sensory input to the central nervous system (Murphy and Taylor, 2008). Aim: The aim of this study was to determine the effect of C6, C7 and T1 spinal adjustment therapy on those individuals with posterior neck pain due to chronic cervical facet syndrome and its influence on touch pressure threshold, neck pain and disability as well as cervical spine range of motion. Method: This study consisted of a single group of thirty participants between the ages of eighteen and fourty-five. The potential participants were examined and accepted according to the inclusion and exclusion criteria. The only method of treatment administered to each participant was cervical spine adjustments delivered to restricted C6, C7 and Tl segments in the lower cervical spine. Subjective and objective findings followed. Procedure: Treatment consisted of seven visits. Subjective and objective data was taken at the first, fourth and seventh visit. Objective data consisted of cervical spine range of motion readings taken using a Cervical Range of Motion measuring instrument (CROM), and touch pressure threshold results obtained via the Semmes Weinstein monofilaments. Subjective data was taken in the form of a Vernon Mior Neck Pain and Disability Index. Cervical spine adjustments were applied to restricted segments in the lower cervical spine (C6, C7, Tl), identified through motion

M.Tech. / Purpose: The cervical facet joints have attracted relatively little attention as possible sources of neck pain and referred pain. Multiple authors have described the management of cervical facet joint pain but not the cause (Manchikanti et al., 2002). Method: This study consisted of one group of 100 participants. The participants were between the ages of 18 and 40 years. Potential participants were examined and accepted based on the inclusion and exclusion criteria. All the participants received a cervical spine adjustment. Objective and subjective readings were taken. Procedure: The participants were seen only once. The Visual Analogue Scale was completed by each participant before treatment. Algometer readings were taken over the most restricted cervical spine facet joint and cervical spine range of motion (CROM) machine readings were taken measuring the ranges of motion of the cervical spine. The participants received an adjustment to the most restricted cervical spine facet joint as determined by motion palpation. The CROM machine and algometer readings were taken again immediately after the adjustment and the algometer readings were taken again 10 minutes later. Results: In terms of subjective measurements based on the Visual Analogue Scale, all participants experienced clinically significant pain before starting the trial.In terms of objective measurements based on algometer readings, a clinically significant difference was found as the pressure pain threshold increases over a period of time. In terms of the CROM machine readings there was a clinical improvement from the pretreatment ranges of motion to the post-treatment ranges of motion. The algometer and CROM readings were statistically incomparable to begin with. Conclusion: The results proved that there was a statistical significant noted immediately after the adjustment and 10 minutes later, however, this does not mean much as thegroups were not comparable to begin with. A statistically significant difference was noted for all ranges of cervical spine motion (flexion, extension, right and left lateral flexion and rotation), thus showing that the cervical spine adjustment was successfully delivered to the restricted segments.