A dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2002. / Plantar fasciitis (PF) is a syndrome that causes pain at the insertion of the plantar fascia to the medial calcaneal tubercle of the calcaneaus. This syndrome has been described as an overuse injury with subsequent inflammation at the insertion of the plantar fascia to the bone. The literature describes inflammatory changes that occur within the body and attachment of the plantar fascia, together with biomechanical aberrances that may be the result of the PF. The purpose of this study was to determine the relative effectiveness of pulsed ultrasound as an adjunct to foot manipulation in the treatment of plantar fasciitis. The foot manipulations are used to correct the biomechanical abnormalities, while the pulsed ultrasound is used for its anti-inflammatory properties. The combination of pulsed ultrasound and foot manipulation was compared to foot manipulation alone to determine if this ultrasound manipulation combination had any beneficial effect over and above foot manipulation alone. Thus determining whether it is of importance to o approach and treat both aspects of the syndrome described. This was a prospective, randomised, comparative controlled trial. Forty subjects were diagnosed with plantar fasciitis and chosen to participate in the study. They were subsequently divided into two groups (Group A and Group B) of twenty. Group A was the experimental group receiving foot manipulation and ultrasound as treatment, and Group B, the control group received foot manipulation alone as treatment. Each subject received six treatments within a period of three weeks, with a seventh follow-up within one week of the sixth treatment. There was no treatment at the seventh consultation; this was used for obtaining subjective and objective readings. Subjective assessment was by means of the Foot Function Index, and objective was by means of the manual algometer. Both the subjective. and objective readings were taken prior to the first, sixth and at the seventh (final) consultations. / M

A dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic at Technikon Natal, 2002. / Carpal Tunnel Syndrome is defined as a median nerve entrapment beneath the flexor retinaculum in the carpal canal such that it produces symptoms in the hand, wrist and upper extremity. A review of related literature suggests that statistics on the incidence of Carpal Tunnel Syndrome in South Africa are unavailable. In the U. s. A, Carpal Tunnel Syndrome occurs in 1% of the population and is the most frequently diagnosed peripheral neuropathy. Several studies investigating the use of conservative care in managing Carpal Tunnel Syndrome have been performed, but none have compared the effect of wrist joint manipulation and ultrasound in the management of Carpal Tunnel Syndrome, The purpose of this study was to investigate the effectiveness of wrist joint manipulation compared to ultrasound in the management of Carpal Tunnel Syndrome. This randomized controlled clinical trial consisted of a study population offorty patients. The patients were randomly allocated to two groups of twenty each. One group received wrist joint manipulation while the other received ultrasound application to the palmar-radial aspect of the wrist. Both groups received four treatments over a two week period. Subjective measures included the Numerical Rating Scale-I 0 1 Questionnaire and the Carpal Tunnel Pain and Disability Form and objective measures consisted of the grip strength reading and goniometer readings for wrist flexion and extension. Both the subjective and objective measures were taken before the first and third visit and at the fifth follow- up consultation which took place during the following week. Inter-group analysis was done using the Mann- Whitney U test. Friedman's T test was used for intra-group analysis. ct was set at the 0.05 level of significance. The results were illustrated by means of tables and bar- charts. The results indicated that for intragroup analysis, a statistically significant difference existed for both groups, warranting the use of a multiple comparison procedure (Dunn' s procedure) to determine at which stage the treatment made a significant difference. For all the measures except the wrist extension reading in the ultrasound group, most improvement occurred between the first and fifth consultations. For inter-group analysis, no significant difference for any of the measures, except the wrist extension readings, was present between the two groups indicating that both wrist joint manipulation and ultrasound were equally effective in treating Carpal Tunnel Syndrome. The improvement in wrist extension, in the wrist joint manipulation group was significantly better than that in the ultrasound group. Although this study was limited by its single researcher design and could not clarify which treatment protocol was more effective, it supports the existing body of evidence in favour of both wrist joint manipulation and therapeutic ultrasound application in the management of Carpal Tunnel Syndrome / M

The inability to transport molecules efficiently and easily into cells and across tissues is one of the major limitations of developing drug delivery systems. A novel approach to overcoming this problem could be the use of low-frequency ultrasound to make cell membranes and tissues more permeable. Previous studies show that normally impermeant molecules can be transported into cells exposed to ultrasound; however, the mechanism by which this occurs is not well understood. Our hypothesis is that low frequency ultrasound can reversibly disrupt membrane structure, thus allowing diffusion-driven intracellular delivery of molecules through a breach in the cell membrane. The effects of ultrasound are not limited to uptake of molecules; there can also be significant loss of cell viability after sonication. Therefore, the focus of this work is to determine the mechanisms by which molecular uptake and cell death occur from ultrasound exposure. The long-term goal of this work is to increase the number of viable cells that experience uptake by controlling the effects that cause cell death. Our data have show that large molecules (r ≤ 28 nm) can be taken into cells after exposure to 24 kHz (10% duty cycle for 2 s of exposure time at 0.1 pulse length over a range of pressures) ultrasound and that uptake of these molecules can occur even after sonication ended. In experiments developed to isolate the mechanism(s) of uptake, DU145 prostate cancer cells depleted of ATP energy and intracellular calcium showed no uptake of calcein, a small fluorescent molecule (MW = 623 Da), nor did sonicated lipid bilayers (red blood cell ghosts), suggesting that uptake is calcium mediated and requires active mechanisms in viable cells. Multiple types of microscopy, including electron and laser scanning confocal, showed evidence of large plasma membrane disruptions which support the hypothesis that transport of molecules into cells occurs through repairing wounds. Microscopy studies also indicated that much if the sonication-mediated death can occur by instantaneous cellular lysing and rapid cell death (within minutes post-exposure) due to wound-instigated necrosis; in addition, characteristics of rapidly induced controlled death modes were seen and found to be non-caspase-mediated within an hour after sonication ended.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic Durban University of Technology, 2009 / Aim: To investigate the effect of therapeutic and sham ultrasound on radial artery blood flow (m.s-1) and radial arterial lumen diameter (mm). Subjects: Fifty healthy asymptomatic volunteers between the ages of 18-38 years. Methodology: The subjects were randomly allocated into one of five intervention groups (A-E). Group A received continuous ultrasound at 0.2 W.cm-² for 5 minutes, Group B received pulse ultrasound at 0.2 W.cm-² for 5 minutes, Group C received continuous ultrasound at 1.5 W.cm-² for 5 minutes, Group D received pulse ultrasound at 1.5 W.cm-² for 5 minutes and Group E received sham ultrasound at 0 W.cm-² for 5 minutes. Baseline radial artery blood flow (m.s-1) and radial artery lumen diameter (mm) readings were taken prior to the commencement of the therapeutic or sham ultrasound application using a Doppler ultrasound. At four minutes of application (during the therapeutic or sham ultrasound application), another set of blood flow and arterial lumen diameter measurements were taken. The final blood flow and arterial lumen diameter measurements were taken one minute after the therapeutic or sham ultrasound application was stopped. Results: The mean (± SD) radial artery blood flow and radial artery lumen diameter at baseline was 0.197 (± 0.060) m.s-1 and 2.4 (± 0.6) mm respectively. In Group A, the mean (± SD) radial artery blood flow during ultrasound application and one-minute after ultrasound application was 0.193 (± 0.070) m.s-1 and 0.179 (± 0.073) m.s-1 respectively. The mean (± SD) radial artery lumen diameter in Group A at the two time intervals was 2.2 (± 0.5) mm and 2.2 (± 0.3) mm respectively. In Group B, the mean (± SD) radial artery blood flow during ultrasound application and one-minute after ultrasound application was 0.187 (± 0.067) m.s-1 and 0.195 (± 0.041) m.s-1 respectively. The mean (± SD) radial artery lumen diameter in Group B at the two time intervals was 2.4 (± 0.4) mm and 2.3 (± 0.5) mm respectively. In Group C, the mean (± SD) radial artery blood flow during ultrasound application and one-minute after ultrasound application was 0.225 (± 0.088) m.s-1 and 0.186 (± 0.071) m.s-1 respectively. The mean (± SD) radial artery lumen diameter in Group C at the two time intervals was 2.4 (± 0.7) mm and 2.7 (± 0.8) mm respectively. In Group D, the mean (± SD) radial artery blood flow during ultrasound application and one-minute after ultrasound application was 0.215 (± 0.080) m.s-1 and 0.200 (± 0.081) m.s-1 respectively. The mean (± SD) radial artery lumen diameter in Group iv D at the two time intervals was 2.4 (± 0.8) mm and 2.4 (± 0.7) mm respectively. In Group E, the mean (± SD) radial artery blood flow during ultrasound application and one-minute after ultrasound application was 0.200 (± 0.067) m.s-1 and 0.182 (± 0.075) m.s-1 respectively. The mean (± SD) radial artery lumen diameter in Group E at the two time intervals was 2.5 (± 0.7) mm and 2.3 (± 0.5) mm respectively. There was no significant change in radial artery blood flow and radial artery lumen diameter over time in any individual group or between groups (p > 0.05; repeated measures ANOVA). There was an overall weak positive correlation between radial artery blood flow and radial artery lumen diameter at baseline (r = 0.508), during (r = 0.541) and after (r = 0.532) the therapeutic or sham ultrasound application. Conclusion: The results of this study showed that continuous, pulse or sham ultrasound had no significant effect on radial artery blood flow and radial artery lumen diameter. Furthermore, active ultrasound (continuous and pulse) was not superior to sham ultrasound in significantly affecting blood flow in a muscular artery.

No description available.

No description available.

M.Tech. / The term „myofascial‟ is derived from the word „myo‟ meaning muscle and „fascia‟ meaning connective tissue. Myofascial pain syndrome is a regional pain syndrome characterized by the presence of myofascial trigger points (Mense and Simons, 2001). The most crucial component of myofascial pain is muscle shortening from contracture (or „spasm‟). In fact, myofascial pain does not exist without muscle shortening. Prolonged shortening not only causes pain in the muscle but also physically pulls on tendons, thereby straining them and distressing the bone and joints they insert into and act upon (Gunn, 2002). Trigger points are most often discussed in the setting of myofascial pain syndromes, in which widespread or regional muscular pain is associated with hyperalgesia, psychological disturbance and significant restriction of daily activities (Huguenin, 2004).

Dissertation presented in partial compliance with the requirements for a Masters Degree in Technology: Chiropractic, Technikon Natal, 1998. / Very few studies of medial tibial stress syndrome type II address the treatment of the condition. There is a need to find a method of hastening the recovery of the condition. Therefore the objective of this study was to determine whether application of ultrasound therapy to medial tibial stress syndrome type Il would influence the recovcrv of this condition. / M

Thesis (M.Tech.: Chiropractic)-Dept.of Chiropractic, Durban Institute of Technology, 2003 / Medial Tibial Stress Syndrome Type II (MTSS), otherwise known as shin splints, accounts for approximately 13% of injuries in American runners. Van Mechelen (1992) reported that 37-57% of recreational runners experience an injury over the course of a year, from which 54-75% of all injuries are caused by overuse. The American Medical Association defines shin splints as “pain and discomfort in the leg from repetitive activity on hard surfaces, or due to forceful, excessive use of foot flexors. The diagnosis should be limited to musculoskeletal inflammations excluding stress fractures and ischemic disorders.” (Thacker et al., 2002) Treatment protocols vary from biomechanical interventions (orthotics), to non-steroidal anti-inflammatory drugs and modalities such as ultrasound all with varying degrees of success (Noakes, 2001). Apart from therapeutic interventions it is the overriding symptom of pain, which patients are left with (Noakes, 2001). A therapeutic intervention called periosteal pecking has received increased interest with regards to symptomatic treatment of shin splints. Periosteal pecking is a form of *dry needling in which the tip of the needle contacts the periosteum (Raso,1997). The aim of this study is to establish the effect of periosteal pecking in the clinical setting with and against that of an established intervention, namely therapeutic ultrasound.

Thesis (M.Tech.: Chiropractic) - Dept. of Chiropractic, Durban Institute of Technology, 2003 1 v. (various pagings) / This study was a prospective, randomised, double blinded, placebo controlled, comparative clinical trial to establish the efficacy of therapeutic ultrasound and compare the effectiveness of the two waveforms of ultrasound in the treatment of myofascial pain syndrome.