Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Department of Chiropractic, Durban University of Technology, Durban, South Africa, 2015. / Background: The most common shoulder complaint seen by physicians is shoulder impingement syndrome. There has been limited success with the current conservative treatment that has been provided for this condition. Thoracic spine and rib manipulation is purported to aid in the treatment of this condition; however there is a paucity of controlled investigations. The purpose of this study was to determine the short term efficacy of thoracic and prone rib manipulation on shoulder impingement syndrome. Methods: A randomised, placebo controlled pre-test post-test experimental design was used. Informed consent was obtained and 30 participants were recruited according to inclusion criteria and allocated to either a placebo or intervention group. Intervention consisted of thoracic spinal and rib manipulation. Data was collected, pre and post the first treatment and at a 48 hours follow up. SPSS was used to analyse the data with a p value of 0.05. Results: No statistically significant differences were seen between the groups for pain rating, range of motion of the glenohumeral joint, lateral scapula slide test or scapula isometric pinch test. The shoulder pain and disability index (SPADI) showed significant (p = 0.04) differences between the groups in terms of disability scores, with the intervention group having a great improvement in disability. No clinically significant differences were observed between the groups. Conclusion: Thoracic spine and rib manipulation appears to improve the disability associated with shoulder impingement syndrome, however further research is required with a larger sample size.

Dissertation submitted in partial compliance with the requirements for a Masters Degree in Technology: Chiropractic, Durban University of Technology, 2011. / The relationship between TMD and dysfunction in the cervical spine has been reported in the literature and there are many case studies which have shown favourable results when treatment was aimed at the TMJ, cervical spine relationship. However, the numerous TMD treatment protocols described in the literature concerning this relationship, and the effectiveness of these treatments have not been well established. In spite of this many chiropractors treat TMD. TMD is a multifactoral condition and conservative treatment options need to be further investigated in order to determine if manual interventions directed at the cercival spine in the treatment of TMD are beneficial. Objectives: The purpose of this study was to compare myofascial trigger point therapy and manipulative therapy of either the TMJ, cervical spine or a combination of the two in order to determine their effectiveness for the TMD. Method: Thirty participants with TMD were randomly assigned to one of three treatment groups. Participants in each group received two treatments per week for two weeks with a follow up consultation in the third week. Data were collected before the commencement of the first, second, and fourth treatments and at the follow up consultation. Outcome measures included algometer readings, CROM, Mouth opening readings, NRS and a disability questionnaire. SPSS version 15.0 was used for analysis of the data. A p value <0.05 was considered as statistically significant. Multivariate testing was used for intra- and inter-group comparisons. Profile plots were generated to assess the direction and trend of the effect and to visually compare the trends in the different treatment groups. Results: Inter-group comparisons did not reveal any statistically significant different improvements between the three treatment groups. Conclusion: All groups responded favourably to treatment and showed trends towards improvement. However, statistically analysis revealed that no one treatment protocol was superior to the other. Although no definitive inferences may be drawn regarding the effectiveness of each treatment approach, within group trends indicated that the combination of the two treatment approaches may be preferred. / M

Submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2016. / Background In sport, competitive athletes are required to perform to the best of their ability, with some athletes seeking the use of chiropractic treatment to improve performance. For example, hockey players are required to perform at peak physical function whilst executing a drag flick. The action of a drag flick involves a player hunched over low down in front of the ball and the hook of the hockey stick makes contact with the ball, which is then ball is pushed along the ground with the ball moving slightly up the shaft of the stick. The player then performs ‘slinging’ action, which means they ‘flick’ the ball towards the goal posts. The drag flick is an explosive sequential movement involving the player’s pelvis, trunk and upper limbs, requiring the use of the spine to generate the speed of the stick and ball. As a result any decreased spinal movement could reduce performance. Therefore this study attempted to assess the use of spinal manipulative therapy (SMT) in improving the drag flicking performance of hockey players. SMT has been shown to be a safe and effective way of increasing spinal joint mobility Objectives To determine and compare the effect of placebo and spinal manipulative therapy in terms of subjective and objective measurements on drag flicking performance of premier league field hockey players. Methods A comparative, experimental study of forty asymptomatic premier league hockey drag flickers were divided into two groups of twenty each. Group A received SMT of fixated joints of the spine (cervical, thoracic and lumbar) as determined by motion palpation by an experienced qualified chiropractor. Group B received sham manipulation. Pre and post intervention ROM of the spine and drag flicking speed where measured using CROM, Inclinometer, BROM II and Speed TracX Speed Sport Radar. The subject’s perception of a change in drag flicking speed post intervention was also recorded. SPSS version 21 was used to analyse the data. A p value of 0.05 was considered statistically significant. Results Significant differences in ROM were noticed in the inter-group analysis in cervical: extension; LLF; RR PA, thoracic: extension; LLF, RLF, lumbar: extension, LLF, RLF. There was a significant increase in drag flicking speed post SMT, but between the SMT and sham manipulation groups were not significantly different. A significant correlation was seen between subjects’ perception of change in drag flicking speed post intervention and the objective results obtained. Conclusion The immediate effect of SMT on drag flicking performance of hockey players was inconclusive. The outcomes of this study suggests that SMT results in an increase in the average speed of drag flicking, however further larger studies are required to confirm this. / M