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Thesis (M.Tech.: Chiropractic) -Dept. of Chiropractic, Durban Institute of Technology, 2005 xiii, 117 leaves of pages : ill. / The purpose of this pre-post crossover clinical trial was to investigate the relative effectiveness of the combination of stretching followed by strengthening, versus the combination of strengthening followed by stretching, of the gluteus medius and iliotibial band (ITB), in the rehabilitation of chronic Iliotibial Band Syndrome (ITBS) in long distance runners. The results were based upon subjective and objective clinical findings, as well as effect on running performance.

Dissertation submitted in partial compliance with the requirements for a Masters Degree in Technology, in the Department of Chiropractic at the Durban University of Technology, 2008 / Introduction: One of the most important responsibilities of a rugby coach towards players is that of injury prevention and advice. Often these responsibilities fall solely on the coach, but sometimes he has the benefit of sports medical personnel at his service. Therefore in order for the coach to best service this sport and industry, his/her knowledge and perception of Chiropractic and other sports medical personnel is critical. Objective: To establish an understanding of Durban rugby coaches’ perceptions and knowledge of Chiropractic to formulate initiatives aimed at bridging gaps and building co-operation between coaches and various medical personnel that they have at their disposal. Methods: A survey was distributed to 149 rugby coaches within 23 high schools and 67 rugby coaches within 24 rugby clubs, resulting in a total of 219 rugby coaches in the greater Durban area received a questionnaire for completion and return. Results: Of the 85 coaches that participated (38.8% response rate), the majority were White (95%), male (99%), with a mean age of 37.36 years and coached at the amateur level (65.1%). School coaches dominated the participants with 67.1% with 61 (71.8%) having obtained a rugby coaching qualification and 26 (30.6%) having another professional sport, fitness or medical qualification besides that of rugby coaching. Most (94.9%) participants referred players to a health professional for examination and / or treatment. This included Physiotherapists, 80% of the time, GPs 70.6% of the time and Chiropractors, 60% of the time. Twenty-nine (34.1%) had a Chiropractor on their medical management team and 28 (96.6%) said it was a positive experience. Of those who did not have a Chiropractor on the team, 82.4% said they would consider it in the future. Over half (65.5%) had personally been treated by a Chiropractor. The 3 most frequent conditions associated with Chiropractic included: Disc herniation (42.6%), low back pain (36.1%) and whiplash (32.8%). Notwithstanding this outcome, the level of knowledge was low with the mean knowledge score (an aggregate knowledge score derived statistically from all questions relating to the knowledge of Chiropractic) of the group was 55.8% (SD 21.9%), even though the range varied from 0 to 96%. Although the coaches’ knowledge of Chiropractic was low, most participants (76.2%) had a favourable view of the Chiropractic profession. Furthermore the coaches perception of Chiropractic related significantly to their knowledge (p = 0.037). In addition the higher their knowledge scores the more positive their view. Conclusion: This study established what knowledge base is available that could promote rugby coaches greater understanding of the Chiropractic profession and related medical personnel. There was a positive association between increased knowledge and a better perception of Chiropractic, suggesting that if knowledge were improved, then perception and attitude towards Chiropractic and related medical personnel would further improve. This increased awareness may improve knowledge, understanding, communication and utilization with the Chiropractic profession and related medical personnel and ultimately these professions within rugby may gain a greater level of acceptance.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic at Durban University of Technology, 2008. / Objectives: To investigate the International Sports Federations’ (IFS) perception and utilization of chiropractors and other sports medical personnel, and to compare results between the executive committees and medical commissions within federations. Methods: A specially designed, quantitative questionnaire was used to collect data from the 65 federations belonging to the General Assembly of International Federations of Sport (GAIFS). The questionnaire distribution took place via e-mail, with the secretary of each federation being requested to forward a copy of the questionnaire to a member of the federation’s executive committee and medical commission respectively. Follow-up telephone calls were also made to further encourage a response from participants. After an 8-week period, returned questionnaires were collected and data was analyzed. Results: From the results obtained (30% response rate), it would seem that perceptions vary greatly. This is most evident when one compares the perceptions of the medical commission members to those of the executive committee members. The medical commission on a whole, appears to favour the more traditional medical professions, while the executive committee seems to be more holistic in their approach to treatment options. In terms of current utilization, chiropractors are currently represented on 16% of medical teams, although chiropractors are able, within their scope of practice, to provide 70% of the federations’ most requested techniques / modalities for competitions. There appears to be little / no criteria governing the selection of medical personnel, however most of the federations agreed that a chiropractor with a post-graduate diploma in sports injuries, would be seen in a more favourable light for selection. Conclusions: The perceptions and utilization of chiropractors and other sports medical personnel varies greatly between federations, which may be due to a number of factors related to the formulation of perception itself. In addition, there appears to be a discrepancy between the opinions of the executive committees and medical commission of the participating federations.

Introduction: The prevalence of obesity in South Africa and throughout the world is increasing. Obesity is related to hypertension, atherosclerosis, diabetes, dyslipidemia and other sub-clinical conditions. Aim: To establish the prevalence of obesity and related risk factors among nurses in a public health hospital in KwaZulu-Natal. Methods: The design entailed a cross-sectional survey among 250 randomly selected nurses (22-64 years) working in King Edward Hospital (KZN). Obesity was measured using anthropometric and derived parameters of stature, body mass, body mass index (BMI) and waist to hip ratios (WHR). Related risks were determined using a screening questionnaire. Results: The mean body mass and BMI observed was 84.42 ± 17.49 kg and 32.60± 6.34 kg/m2, respectively with 76.10% of the sample being overweight or obese (64.80%; BMI~30). The mean waist circumference (93.01±12.73 cm) fell into the high risk category. A large proportion (30.4%) reported experiencing lower back pain. A significant crude odds ratio (OR) was found between obesity and the risk for lower back pain with an OR of 2.53 (CI 1.12 - 5.71). An increased but insignificant risk was observed in obese individuals for hypertension (OR 1.85: CI 0.63 - 5.40). Stressed individuals (PSS> 13) had an increased but insignificant risk for obesity (OR 1.78: CI 0.70 - 4.50) but a significantly increased risk for lower back pain (OR 8.59: CI 2.00-36.85; p:S0.05). Only 79 of the 250 nurses (31.6%) from our sample reported doing vigorous exercises on a regular basis and the nature of their exercise programs did not protect against the risk of obesity (OR 2.18: CI 1.03-4.60; p:S0.05). Discussion and Conclusion: A high prevalence of obesity and related risk factors among this population of nurses in a public hospital, and potentially in the nursing occupation at large, should be addressed within the context of employee wellbeing. The need for education on appropriate diet and exercise programming in order to prevent hypokinesis and associated diseases of lifestyle is evident. Key words: Nurses, Body Mass Index, Obesity, Low Back Pain, Hypertension, Stress, Hypokinesis / Thesis (M.Sport Sc.)-University of KwaZulu-Natal, Durban, 2010.

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2005. / The purpose of this study was to determine whether dry needling of myofascial trigger points (TrP's), found in the shoulder rotator myotatic unit, had an effect on the peak torque and total work parameters of the shoulder myotatic unit and by inference, the relative external rotation strength deficit in over-head throwing athletes. Athletes who perform overhead throwing sports such as: baseball, javelin, swimming/waterpolo and tennis, are susceptible to sustaining a micro-traumatic injury of the rotator myotatic unit of the shoulder, owing to repetitive high velocity mechanical stress placed on the shoulder at the extreme ranges of motion. The inherent structure of the shoulder, with three external rotators and five internal rotators, causes a muscle imbalance before an activity, such as throwing occurs, and this can predispose an athlete to Repetitive Stress Injuries (RSI) as a result of overuse or overload. The incidence and activation of TrP's in shoulder muscles can be accounted for on the basis of mechanical stress such as overuse / overload and thus could change muscle fiber co-ordination (muscle activity) and precipitate a painful lesion. It can be seen in current literature that TrP's produce a number of signs and symptoms such as: spasm of other muscles, weakness of involved muscle function, loss of co-ordination and decreased work tolerance of the involved muscle . Therefore the TrP's present in the shoulder rotator unit could contribute to changes in internal/external rotation ratios in over head athletes, and thus by deactivating or eliminating these TrP's, it is possible that these ratios may be / M

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The detrimental nature of movement variability has recently been reconsidered with suggestions that it has a functional role to play in performance. Movements in golf can be attributed to the organismic, task and environmental constraints from which they emerge with these swing movements affecting shot outcomes. A three-dimensional analysis of address position variability revealed that higher skilled golfers present reduced alignment variability in angular relationships between the shoulders and stance compared to less skilled counterparts. Whilst there were no group differences in impact variability, both points in the swing displayed reducing variability from proximal to distal aspects of the kinetic chain. With the popularity of strength and conditioning growing within the golfing world it has become important for coaches to be able to assess golfers’ physical constraints. Two-dimensional analysis, representative of that used in coaching environments, assessed the relationship between the overhead squat and deterioration of posture in the golf swing. Results showed small but significant relationships between this test and golf swing postural kinematics. An 8-week intervention to address overhead squat physical constraints resulted in no change in 3D swing kinematics. Strength and conditioning as a stand-alone intervention provides no benefits to postural kinematics suggesting the need for coaching.

This thesis examines the effects of psychosocial factors and physical activity on antibody response to vaccination in healthy young, older, and HIV+ populations. Chapter Two found that a brisk walk prior to vaccination did not improve antibody response to pneumococcal or influenza vaccinations in young (18-30yrs) or older (50-64yrs) adults. Chapter Three examined whether a lifestyle physical activity intervention affected antibody response to pneumococcal vaccination in sedentary middle-aged women. There was no effect on antibody response, body composition or fitness measures, although there was an improvement in quality of life for the intervention group. Finally, Chapter Four investigated the relationship between psychosocial and physical activity status and antibody response to vaccination in HIV+ patients. Antibody response to some strains of the pneumococcal vaccine were predicted by higher physical activity levels (pn1, pn6b, pn18c), greater social support (pn3) and lower life events stress (pn1). However, the majority of analyses found that antibody response to vaccination was not affected by these measures. In conclusion, neither acute nor chronic walking interventions improve antibody response to vaccination, and only limited relationships are seen between psychosocial factors, physical activity status and antibody response to a variety of vaccinations.