Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of technology, 2002. / Background: Low back pain is a common problem for which many conservative treatments are available. Spinal manipulation is considered one of the most effective of these treatments. Interferential therapy is widely used especially for pain control and often forms part of a treatment protocol. However, there is little clinical evidence to support this usage. Objective: The purpose of this investigation was to evaluate the effectiveness of interferential current therapy as an adjunct to manipulation in the treatment of acute mechanical low back pain in terms of subjective and objective measures. Methods: Sixty subjects suffering from acute mechanical low back pain were recruited through advertising and randomly divided into two groups with thirty patients each. Group A received manipulation and interferential therapy and group B received manipulation only. Both groups received 4 treatments and a follow-up consultation over a 2 week period. Subjective measurements were taken using the Numerical Rating Scale - 101and revised Oswestry low back pain questionnaire. Objective measurements were taken using an algometer and an orthopaedic rating scale. All measurements were taken before treatment on the first, third and fifth consultations. Statistical inter-group analysis was completed using the two sample unpaired t-test and the Mann-Whitney U-test. Friedman's T test was used to evaluate the intra-group information. The null hypothesis was rejected at a = 0.05 level of significance. Results: Both treatment groups A and B achieved a significant improvement in pain and disability over the treatment period. However, no significant differences in terms of pain and disability could be found between the two groups at any stage during, or at the end of the treatment period. / M

M. Tech. / It has been noted in the literature that the sensory system consists of the visual, vestibular and somatosensory systems (Guyton and Hall, 1997; Arnold and Schmitz, 1998; Murphy, 2000; Nakata and Yabe, 2001; Magee, 2002 and Gatterman, 2004). In congruence with the above authors Katz (1996), Gatterman (2004) and Murphy (2000), Morningstar, Pettibon, Schlappi, Schlapp and Ireland (2005) further stated that the postural reflexes can be subcategorised as the following: visual righting reflex, labyrinthine righting reflexes, neck righting reflexes, body on head righting reflexes and body on body righting reflexes. Each of these neurological mechanisms plays a role in balance / equilibrium. Furthermore it has been shown that spinal manipulative therapy has an effect on neurological systems. Therefore it stands to reason that spinal manipulative therapy may have an effect on balance or equilibrium.

A dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic at Technikon Natal, 1998. / The absence oftested theory has resulted in the continued variation of treatment protocols in the treatment of mechanical low back pain. This study was designed to determine the relative effectiveness of specific passive mobilization versus spinal manipulation in the treatment of uncomplicated mechanical low back pain. It was hypothesized that both spinal manipulative therapy and specific passive mobilization would be effective, but that manipulation would be significantly more effective in terms of objective and subjective findings, over the same two week treatment period / M

Thesis (M.Tech-: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 x, 57 leaves, Annexures 1-10 / To determine if serum cortisol levels are increased following Spinal Manipulation Therapy (SMT) to the low back region and to determine the effect of a short rest interval on the cortisol levels

Thesis (M.Tech.: Chiropractic)-Durban University of Technology, 2008. xviii, 83, [29 ], 25 leaves / Golfing literature today recommends to both the amateur and professional golfers to try and achieve maximum performance with each golf club (Seaman, 1998 and Bulbulian, Ball and Seaman, 2001). This encourages golfers to use a state of maximum spinal rotation in their golf swing in order to achieve optimal performance (Seaman, 1998), thus resulting in back pain becoming endemic in the golfing population. Thus if it is considered that performance, in terms of the golf swing, is mainly influenced by; • the strength and power of the torso, i.e. the low back and abdominal muscles (Chek, 2003), • as well as muscle balance and flexibility, i.e. those muscles which are responsible for the static and dynamic postural stability of the golf swing (Chek, 2003). It then stands to reason that any decrease in the range of motion of the lumbar or thoracic spine of the amateur golfer, in terms of biomechanics, could affect their performance (Nordin and Frankel, 2001). In this regard it is hypothesised that altered biomechanics could be that of asymptomatic segmental joint dysfunction . In terms of interventions Kirkaldy-Willis and Burton (1992) explained the effect of SMT in the treatment of low back pain, similarly Bergmann et al. (1993) and Vernon and Mrozek (2005) further proposed the following effects of spinal manipulative therapy (SMT): • SMT may stretch or break intra-articular adhesions that form from immobilised facet joints due to acute synovial reactions. • SMT allows entrapped menisci to exit the facet joint in which it became entrapped. • If the capsule of the facet gets lodged between two adjacent articular surfaces, the process of SMT could allow this to be freed. • SMT re-aligns misaligned spinal segments to conform to the centre of gravity. It was thus assumed that if these mechanical and reflex mechanisms occur in the symptomatic amateur golfer, they should also occur in the asymptomatic amateur golfer. Currently however very little is known about the effects of spinal manipulative therapy (SMT) on asymptomatic segmental joint dysfunction. Objective: Therefore, the purpose of this study was to evaluate the immediate and short term effect of spinal manipulative therapy (SMT) on asymptomatic amateur golfers in terms of performance indicators. Methods: Forty three asymptomatic participants were randomized to four equal groups consisting of ten participants each (and three drop outs). Three of the groups received a single intervention, i.e. spinal manipulative therapy (SMT) while the last group acted as a placebo control group and received no intervention. Objective measurements were taken using the EDH Sports-FlightScope Pro Electronic Swing Analyser. All objective data collection took place pre and post SMT. Statistical analysis included various statistical methods and correlation analyses, by means of the latest version of SPSS. Results and conclusions: The main findings were that certain outcomes seem to be better with lumbar manipulation alone (smash, horizontal azimuth) and others better with thoracic manipulation alone (CHV, vertical azimuth, distance), but none are better with both lumbar and thoracic manipulation. Therefore in terms of future studies of this nature the treatment groups should be analysed separately and the research powered for such analyses (e.g. larger sample sizes).

Mini-dissertation in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic, in the Department of Chiropractic at the Durban University of Technology, 2009 / The aim of this study was to investigate the relative effectiveness of Transeva and spinal manipulative therapy for mechanical low back pain. The objectives evaluated the effectiveness of only administering Transeva therapy alone, or Spinal manipulative therapy alone as well as Transeva therapy with Spinal manipulative therapy on mechanical low back pain with respect to the patients’ subjective and objective responses to the respective treatment group. The final objective was to correlate the subjective and objective data collected to determine the effectiveness of each of the therapies in comparison with another. Design: A sample of thirty patients diagnosed with mechanical low back pain were accepted into the study. These patients were randomly divided into three groups of 10, which received different treatment protocols for mechanical low back pain. Outcome Measure: The following outcomes were measured; a decrease in pain (measured with the Numerical Pain Rating Scale (NRS), a decrease in disability (measured with the Roland-Morris Questionnaire), a decrease in local tenderness (measured with the pressure Algometer) and an increase in lumbar range of motion (measured with the Inclinometer). The data was collected prior to treatment one, prior to treatment four and at the sixth follow-up visit. Results and Conclusion: All groups improved with the treatments they received; however, no single treatment was statistically better than any other treatment intervention tested. However, the Spinal manipulative therapy group had a statistically significant faster reduction in pain on the NRS readings with p=0.048.

Dissertation submitted in partial compliance with the requirements for the Masterà ¢ s Degree in Technology: Chiropractic, Durban University of Technology, 2008. / Objectives: To determine the short-term effect of an inhaled, short-acting 2-agonist bronchodilator on chest wall expansion (cm) and lung function parameters (FEV1, FVC and FEV1/FVC%) in chronic moderate asthmatics. To determine the short-term effect of spinal manipulation (SMT) and ribcage mobilisation on chest wall expansion (cm) and lung function parameters (FEV1, FVC and FEV1/FVC%) in chronic moderate asthmatics. To determine the short-term effect of a combination of SMT, ribcage mobilisation and an inhaled, short-acting 2-agonist bronchodilator on chest wall expansion (cm) and lung function parameters (FEV1, FVC and FEV1/FVC%) in chronic moderate asthmatics. Methods: Forty-five chronic moderate asthmatics who met all the inclusion criteria of the study were divided into three groups of fifteen each. Group A received a short-acting 2-agonist bronchodilator, Group B received SMT and ribcage mobilisation and Group C received a combination of SMT, ribcage mobilisation and a short-acting 2-agonist bronchodilator. Baseline measurements and testing included chest wall expansion and the lung function parameters FEV1, FVC and FEV1/FVC%. These measurements were repeated 15 minutes post-intervention. Data was analyzed using SPSS version 15.0. Results: There were no statistically significant changes between pre- and post-intervention in the short-acting 2-agonist bronchodilator group with respect to any of the chest wall expansion measurements. There was a statisticallly significant increase in FEV1 between pre- and post-intervention in the short-acting 2-agonist bronchodilator group (p = 0.008). There was a statistically significant increase in the mean pre- and post-intervention axillary chest wall expansion (p = 0.014) as well as the mean of the half-way measurement (p = 0.014) and the overall mean chest wall expansion value (p = 0.001) following SMT and ribcage mobilisation. There were no statistically significant changes in any of the lung function parameter values following SMT and ribcage mobilisation. There was a significant increase for the half-way measurement in chest wall expansion (p = 0.018) in the combination of SMT, ribcage mobilisation and the inhaled, short-acting 2-agonist bronchodilator group. There were no statistically significant changes in any of the lung function parameter values in the combination of SMT, ribcage mobilisation and an inhaled, short-acting 2-agonist bronchodilator. For FEV1, the effect in the short-acting 2-agonist bronchodilator group vs. the SMT and ribcage mobilisation group was statistically significant (p = 0.018). There was no statistical difference in any of the chest wall expansion measurements and FVC and FEV1/FVC% parameters between all three groups. Conclusions The results did not point specifically to one intervention over another for all outcomes. SMT and rib mobilisation had no effect on the lung function parameters, at least in the short term. There was a statisticallly significant increase in FEV1 between pre- and post-intervention in the short-acting 2-agonist bronchodilator group.

A dissertation presented in partial compliance with the requirements for the Master's Degree technology: Chiropractic, Durban Institute of Technology, 2002. / Low back pain is estimated to effect 60-90% of the world's population sometime during their lives while 20-30% of people suffer from low back pain at any given time (Cassidy and Burton, 1992:3). Locally, epidemiological studies into low back pain have revealed incidence rates of 57.6% amongst black South Africans (Van der Meulen, 1997) and between 70 and 80% amongst Indians and Coloureds (Docrat, 1999). The use of spinal manipulation with the emphasis on restoring joint mobility, has been proven to be one of the most effective and cost effective approaches in the management low back pain of a mechanical origin (Di Fabio, 1992). McMorland (2000), showed in a study of 199 patients, that spinal manipulation resulted in an average of 52.5% and 52.9% reduction in low back pain and disability respectively. Panjabi (1992:1) has postulated a theory of a 'neutral zone' around which the passive lumbar spine operates. He describes the neutral zone as a region of intervertebral motion around the neutral posture where little resistance is offered by the passive spinal column. It is, according to Panjabi (1992:1), possible for this neutral zone to increase with injury to the spinal column or with weakness of stabilising muscles, which could result in low back pain. The trunk muscles therefore have to be able to co-contract isometrically to control the neutral zone and protect the spinal tissue from excessive motion (Richardson et aI.1990). The transversus abdominis muscle and multifidus muscle have been identified as playing an important role in the complex synergistic interaction of the trunk (Norris, 1995). The above concept involving muscles attempting to maintain a neutral zone is commonly referred to as 'core stabilisation' (Norris, 1995). / 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

A dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2002. / Headaches have been described as the most common medical complaint in society (Dalessia 1987:3), and Tension-type headaches constitute approximately 80% of these (Martin 1993:22). Although Episodic tension-type headache is more prevalent than Chronic tension-type headache and may have a greater societal impact, Chronic tension-type headache has by far a greater individual impact (Schwartz et aI, 1998) on the patient. The exact causes of Chronic tension-type headaches are not known and, as a result, treatment is commonly symptomatic in nature and aimed at reducing pain. To date, treatment commonly involves the use of drugs and with it comes the threat of drug-induced side-effects (Bendtsen et aI, 1996). The purpose of this study was to investigate two non-pharmacological treatments in the management of Chronic tension-type headaches, namely the relative effectiveness of Spinal Manipulative Therapy (SMT) in conjunction with Trans-cutaneous Electrical Nerve Stimulation (TENS), as compared with SMT and placebo TENS. ABSTRACT It was hypothesized that SMT in conjunction with TENS would provide a greater immediate and short-term benefit in comparison to SMT and placebo TENS in the treatment of mild / M