M.Tech. (Chiropractic) / This study was undertaken to evaluate the effectiveness of chiropractic treatment of chronic lower back pain in conjunction with the use of the Cory knee cushion during sleep as compared with chiropractic treatment alone. The cushion is used in an attempt to improve sleeping posture. It was proposed that both treatment protocols would be effective, but that the combined therapy would show better results. An unblinded, controlled pilot study was conducted. Patients responding to advertisements were recruited from the general population. Thirty patients who conformed to the specified criteria and delimitations were accepted into the study and placed randomly in one of two possible treatment groups. One group received chiropractic adjustments in conjunction with the use of the Cory knee cushion during sleep, the other received chiropractic adjustments alone. Comparisons were performed by means of objective (lumbar spine range of motion) and subjective (Oswestry Pain and Disability Questionnaire, MCGiIl Pain Questionnaire and Visual Analogue Scale) assessments over the eight-week treatment period, with comparisons made at treatments one, four, seven, nine and ten. The results were recorded and the data was statistically analysed using two-sample ttests, paired t-tests, sign rank tests and Mann-Whitney tests. The results indicated that there was a generalised improvement in both of the treatment groups in terms of lumbar spine range of motion and pain relief. While group one attained a better range for rotation after the month break, this was an isolated improvement. Under the circumstances of the research, neither group showed considerably superior results over the other, as there was no statistically significant difference between the groups. Thus, the full benefit of sleeping with a cushion between the knees in an attempt to improve sleeping posture will need additional investigation in order to be of-use as an adjunct to chiropractic treatment.

M.Tech. / Purpose: Lateral epicondylitis has been identified as one of the most common conditions affecting the upper limb. The exact pathophysiology of this condition is still under investigation; however it is believed to be an overuse injury which affects the common extensor tendon at the tenoperiosteal and/or the musculotendonous junctions. Despite the frequent occurrence of lateral epicondylitis and its considerable symptoms there is little scientific evidence to support the effectiveness of any treatment methods. As yet one treatment method has not been proved more effective than the other. The purpose of this comparative study was to determine whether manipulation combined with dry needling of the common extensor tendon and extensor muscle belly of the forearm, was more effective than cross friction of the common extensor tendon combined with manipulation with regards to a decrease in pain and an increase in pressure pain threshold. Method: This study consisted of 32 participants between the ages of 18 – 40. Possible participants were examined and accepted according to the inclusion and exclusion criteria. Once accepted the participants were assigned into two groups each consisting of equal amounts of males and females. The first group received manipulation of their elbow combined with dry needling of their common extensor tendon and extensor muscle belly of their forearm. The second group also received manipulation of their elbow but this was combined with cross friction of their common extensor tendon. Procedure: Each participant received six treatment sessions and one follow up session. Objective data and subjective data was taken at the beginning of the first, fourth and seventh session. Objective data consisted of algometer readings that were taken on the common extensor tendon, the lateral epicondyle of the humerus and the extensor muscle belly. The subjective data collected was in the form of the Numerical Pain Rating Scale and the short form of the McGill Pain Questionnaire. The manipulation of the elbow was then administered based on the restrictions identified during motion palpation. This was followed by either dry needling of the common extensor tendon and the extensor muscle belly of the forearm or cross v friction of the common extensor tendon. The information collected was analysed by means of Friedman and Wilcoxon Signed Rank tests.Results: Statistically significant improvements in all measurements were noted over the course of the treatments for all participants in both groups. However there was no statistically significant difference between the improvements of the dry needling group compared to that of the cross friction group. Conclusion: The results illustrate the effectiveness of the individual treatments over the treatment period. However it is still inconclusive whether one treatment method is more effective than the other. As this study was directed to a small group of participants, accurate conclusions could not be formulated to prove the effectiveness of one treatment method over that of another. Due to the insignificant findings obtained in this study, further studies need to be performed to determine which method of treatment is most effective when treating lateral epicondylitis.

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 1997. / Epidemiological studies on low back pain (LBP), conducted in a number of countries, strongly suggest that LBP is internationally a very common condition, imposing a significant social and economic burden on society. It however appeared that the epidemiology of LBP among the black population of South Africa had not yet been investigated. The purpose of this study was to determine the prevalence of LBP in the formal black South African township of Chesterville, and to assess the extent to which LBP adversely affects the lives of the residents, in order to establish the need for specialized low back care in this community. A further aim of the study was to assess the associations between certain individual factors and the prevalence ofLBP. A population-based epidemiological survey on LBP was conducted on a sample of 1 000 residents of the township of Chesterville. After a pilot survey of 25 households suggested that the characteristics of the households in Chesterville were fairly similar with respect to the objective of the study, a clustered sample of 300 lots was selected from a layout map of Chesterville. All residents, aged 13 or older, living on these lots were interviewed by the researcher until a sample of 1 000 subjects had been achieved. The total population of Chesterville is approximately 20 000; hence the sample size covers 5% of the population of study. / M

A dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 1999. / There have been few studies conducted to determine the effects of stretching as a therapy on its own in the treatment of low back pain. In response to this, the objective of this study was to evaluate the relative effectiveness of stretching the hamstring muscles on low back pain experienced by cyclists. Thirty two cyclists with low back pain were screened for lumbar facet syndrome, sacroiliac syndrome and myofascial pain syndrome of the quadratus Iumborum, gluteus medius and gluteus maximus muscles and randomly divided into two groups of sixteen. Detuned ultrasound was applied to the hamstring muscles of the patients in the placebo group twice a week for three weeks. Patients in the experimental group were involved in a stretching program whereby the hamstring muscles were passively stretched for three sets of thirty seconds duration, two days a week for three weeks. Both groups were evaluated in terms of subjective clinical findings by utilising the Oswestry Low Back Pain Disability Questionnaire, the Numerical Pain Rating Scale-101, and theti / M

A dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 1996. / The purpose of this investigation was to determine the efficacy of chiropractic treatment in the management of primary dysmenorrhea. The sample consisted of 30 patients who were randomly assigned to 2 groups, the control and experimental. This single blind study consisted of 16 visits, twice a week for the first 4 weeks and thereafter once a week for the next 8 weeks. During a menstrual cycle, prior to commencement of treatment, the patients were required to complete a Short-Form McGill Pain Questionnaire on the last day of dysmenorrhea and a Numerical Pain Rating Scale 101 on each day of experienced menstrual pain. These questionnaires were completed at home. Treatment for the experimental group consisted of soft tissue massage of the lumbar and thoraco-lumbar paravertebral. musculature combined with spinal manipulative therapy of the areas of fixation in the' lumbar and sacra-iliac regions. The control group received purely soft tissue massage of the lumbar and thoraco-lumbar paravertebral musculature. The areas of fixation were determined by motion palpation, joint challenge and tenderness to spinal palpation. There was no follow-upvisit conducted in this study. An analysis of the data revealed a statistically signiflcant improvement in the experimental group in terms of the Short Form McGill Pain Questionnaire (p=< 0,001) as well as for the control group (p=< 0,01), whilst in terms of the Numerical Pain Rating Scale 101 the experimental group showed an improvement (p=< 0,05) but the control group failed to show a significant change (p= 0,068). / M

A dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2005. / It has generally been accepted that 60 to 80% of the general population will suffer from low back pain at some point in their life. (Kirkaldy - Willis, 1992). The use of manipulation for the treatment of low back pain is well documented but lumbar mobilization has undergone comparatively little investigation (Goodsell et al., 2000). Furthermore, there remains little evidence to advocate the use of Muscle Energy Technique (MET) in the form of a randomized clinical trial (Wilson, 2003). The purpose of this study was to determine whether patients with acute and sub-acute low back pain would demonstrate a reduction in disability after being treated with MET or specific passive mobilization. Both interventions are joint mobilization techniques the only difference being that one is passive and the other (MET), is an active technique / M

M.Tech.

M.Tech. / Objective. Previous studies have provided evidence of cervical manipulation as an effective treatment in the management of cervicogenic headache reduction, however there is no record of studies ascertaining the effectiveness of biomechanical pelvic blocking in such treatment. This controlled clinical trial aimed at establishing biomechanical pelvic blocking as an alternative treatment for cervicogenic headaches yielding similar results. Methods. In this study 30 participants between the ages of 18 and 60, symptomatic of cervicogenic headaches were included in the clinical trial. These 30 participants divided in to three groups of equal size by means of random selection. Group A received cervical spine manipulation only, group B received biomechanical pelvic blocking and group C was treated by means of both cervical spine manipulation and biomechanical pelvic blocking. The design of this pilot study was such that the spinal manipulative therapy was the control between the groups, therefore allowing us to identify whether biomechanical pelvic blocking was effective in the treatment of cervicogenic headaches. The patients were treated 6 times, twice weekly over a period of three weeks. Objective data collected on the first, third and sixth visits by means of the Saunders digital inclinometer. Cervical Range of Motion digital inclinometry measurements taken were that of forward flexion, extension and both right and lateral flexion. Subjective data collected by means of The Numerical Pain Rating Scale and Mc Gill Pain Questionnaire as well as the Neck Disability Index. The Numerical Pain Rating Scale and the Mc Gill Pain Questionnaire measured the headache pain intensity and the Neck Disability Index ascertained the degree of cervical disability as well as neck pain intensity experienced by the patients. These questionnaires were completed by the patient on the first, third and sixth consultation. Results. In terms of the digital inclinometry assessment, statistically significant results existed although not consistently for the same group per ROM. Extension showed Group C demonstrating the greatest increase in terms of cervical extension range of motion. Statistically significant difference existed between the groups for extension ROM. Forward flexion calculated as the most improved for group C however, no statistically significant difference existed. Group A proved most effective in increasing both cervical left and right lateral flexion range of motion. The reliability of digital inclinometer in obtaining accurate measurements is questionable. The subjective data although overall no statistically significant difference was noted between the groups for the period of the treatments, a definite clinical significance was established, group A did show the greatest overall improvement in pain intensity. Group C followed group A, the difference between these groups indicating the small relevance of the pelvic blocking. The Neck Disability Index demonstrated the greatest improvement within group C followed by group A and then group B. This marked improvement in group C in comparison to group’s A and B is suggestive of the immediate effects of cervical manipulative therapy as well as the spinal compensation due to treatment of the pelvis by the means of blocking. As this questionnaire, serves to establish the patients’ perception in terms of cervical pain and disability it indicated the biomechanical pelvic blocking to be questionably effective in the improvement in neck disability and pain.

M.Tech. / This research study was conducted as an unblinded controlled pilot study. The aim of this research was to investigate the effects of spinal manipulation in conjunction with proprioceptive rehabilitation on proprioceptive ability with regards to balance in patients with mechanical low back pain. Candidates for the research were recruited through advertisements in the local newspapers, posters put up at the Technikon Witwatersrand Doornfontein Campus as well as at the Technikon Witwatersrand Day Clinic. Candidates that fitted the selection criteria were selected to participate and were randomly divided into three groups. Each group consisted of 10 patients. Group A received chiropractic manipulation of the lumbar spine and sacroiliac joints ...

M.Tech.