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M.Tech. / Objectives: To gain statistics on the perception parents in Johannesburg have regarding paediatric chiropractic and to educate the public as to the value of paediatric chiropractic in infants and children and increase the number of paediatric patients presenting to chiropractic practices. Methods: One-hundred-and-fifty questionnaires were completed by willing participants attending various antenatal classes throughout Johannesburg. Thereafter, a brief educational talk on paediatric chiropractic was given to all participants and information brochures were distributed. Results: A total of 34.50% of the participants had been previously treated by a chiropractor, with only 12.80% having been treated during their pregnancy and a further 15.70% who intended to receive chiropractic treatment while they were pregnant. Throughout the various age groups majority (54.20%- 56.30%) of the participants felt that might consult a chiropractor for the treatment of a child, although very little was known about the paediatric conditions that may be treated by chiropractors. Majority of the participants felt that chiropractic treatment of paediatrics and during pregnancy was completely safe. Conclusions: Although the participants were not entirely opposed to paediatric chiropractic (the treatment of children and pregnant mothers) they had very little knowledge regarding the topic of paediatric chiropractic, the conditions it may be successful in treating and the health benefits for children who receive chiropractic treatment. Majority of the participants were interested in furthering their knowledge regarding the topic of paediatric chiropractic.

M.Tech. / The purpose of this unblinded controlled study was to determine the effective of dry needling of the Vastus Medialis Oblique muscle when utilised in conjunction with conservative chiropractic management for Patellofemoral Pain Syndrome (PFPS). The subjects of the trial were treated at the Chiropractic Day Clinic at the University of Johannesburg. Thirty patients suffering from chronic Patellofemoral Pain Syndrome were chosen for the study and they were divided into two groups of fifteen. The first group received conservative chiropractic care which consisted of manipulation of the sacroiliac joint, mobilisation of the knee and patella joints and stretching and strengthening exercises consisting of Quadriceps standing self stretch and Quadriceps setting as the strengthening exercise. The second group received the above treatment but also underwent dry needling of the Vastus Medialis Oblique muscle. The objective data for this research was recorded using a lower limb isometric dynamometer and the subjective data was recorded with a pain scale. Both sets of data were recorded on the first, third and fifth treatments. The results of the trial showed that there was a significant increase in strength with a reduction in pain levels for both groups but there was no statistically significant difference when comparing the two groups. The dry needling group did however improve at a faster rate than the other group but it did even out after the five treatments. What was noteworthy is that the males of the study improved their strength by a much greater extent than the females which is uncommon for PFPS. The end result of this study is that overall, dry needling of the Vastus Medialis Oblique muscle is not highly beneficial in the long term management of PFPS but does have its benefits in the early stages of the treatment in order to relieve the acute pain and increase the Quadriceps muscle strength rapidly.

The first documented case of improved hearing following chiropractic adjustment was by D.D. Palmer in 1895 in which he restored Harvey Lillard’s hearing. Mr Lillard had been deaf for seventeen years. This brought about the birth of a new profession called chiropractic (Terrett 2002). It has been postulated that dysfunction or spinal joint motion restrictions of the cervical spine may lead to irritation of the sympathetic nervous system which may cause decreased blood flow to the auditory nerve via the labyrinthine artery (also known as the internal acoustic artery or internal auditory artery), which in turn may lead to a decrease in hearing acuity (Hawley 1964). The purpose of the dissertation was to determine whether cervical spine joint adjustment had an effect on the hearing acuity in individuals with some level of sensorineural hearing loss. Thirty symptomatic patients of either gender participated in this study. These patients were recruited by the use of advertisements placed in the Chiropractic Day Clinic, University of Johannesburg, Doornfontein Campus and by word of mouth. The inclusion criteria required the patients to present with some level of sensorineural hearing loss, be over the age of fifty years and have no contra-indications to chiropractic adjustments. Objective data was obtained by the Interacoustics Diagnostics Audiometer AD 229b, which determined the level of auditory acuity before and after chiropractic treatment was administered. Middle ear function and acoustic reflex was also tested with the GSI 38 Auto Tymp acoustic reflex machine. The objective results demonstrated that there was no statistically significant increase in auditory acuity following either the chiropractic treatment, or the detuned ultrasound treatment. In conclusion, it was shown that chiropractic adjustments in some patients presenting with sensorineural hearing loss, in the same subjects, exhibited a clinical improvement in hearing acuity however, not a statistically significant improvement following the treatment protocol discussed in the chapters that follow. These improvements suggested that the adjustment resulted in a decrease in sympathetic nervous system stimulation and an increase in blood flow through the labyrinthine artery, and therefore an increase in auditory acuity. These improvements were noted to a larger degree in individuals with a greater sensorineural hearing loss and not across the entire sample population. / Dr. M. Moodley Dr. S.M. Wilcox

OBJECTIVE: To determine and compare the electromyographic effect of cervical and lumbar spinal adjustments on the lumbar paraspinal muscles in subjects with chronic lower back pain. STUDY DESIGN: Thirty subjects with chronic lower back pain underwent 5 spinal manipulative treatments on alternative days over a 2 week period (excluding weekends) to test the electromyographic effect on the lumbar spinal muscles. SETTING: Technikon Witwatersrand Chiropractic Clinic, Johannesburg, South Africa SUBJECTS: Thirty subjects with chronic lower back pain participated in this study. Each of the subjects was assigned to one of three groups using age-matched sampling methods. Group 1 consisted of 10 subjects (mean age of 25 years) receiving lumbar spine and pelvis adjustments (L1 - L5, including Sacroiliac joints); Group 2 consisted of 10 subjects (mean age of 26 years) receiving cervical spine adjustments (Occiput - C7); and Group 3 consisted of 10 subjects (mean age of 26 years) receiving adjustments to the cervical spine, lumbar spine and pelvis. METHODS: Lumbar paraspinal muscle electrical activity was tested before and after the treatment one, three and five using surface electromyography (sEMG). One pair of bipolar electrodes was placed bilaterally over the paraspinal muscles at the level of L3. Subjects were asked to lie down in a prone position with their arms next to their sides. They were then instructed to perform a single voluntary lower back extension exercise by lifting their chests and shoulders as high as possible off the plinth. Each contraction lasted five seconds. The baseline and peak values from the surface electromyographic meter were recorded, analyzed and compared for reference. Information regarding the intensity and quality of the pain experienced by the subjects were also collected at the start of treatment one, three and five using approved research measurements, i.e. the Oswestry Questionnaire and the Visual Analogue Pain Scale. iv RESULTS: Comparison of the results indicated no statistically significant difference between the three groups and their responses to the treatments. Subjectively, all three groups showed trends of improvement, with group 2 showing the greatest percentage of improvement in pain. Objectively, group 2 also showed the greatest percentage of improvement in the resting rate of the paraspinal muscles, assuming that ideal sEMG resting rate is the lowest one possible. Comparing the results of the contraction ability of the paraspinal muscles, both prior to and after spinal manipulative treatment (SMT), group 1 demonstrated the greatest percentage in improvement followed by group 3. Group 3 also demonstrated the most balanced paraspinal muscles at the end of the study. CONCLUSION: In light of these findings it can be concluded that the treatment protocol as represented by group 2 showed the most favourable treatment efficacy in terms of subjective results and resting rate of the paraspinal muscles. The trends shown in this study should be used and tested in future similar research studies incorporating larger sample groups. / Ms. M. Jansen van Rensburg Dr. M. Buchholtz

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