M.Tech. (Chiropractic) / The aim of this study was to determine the most effective treatment protocol for cervical spine facet syndrome, with regards to treatment frequency. Group one was treated three times weekly, and group two was treated once weekly. Both groups were treated with chiropractic manipulation of the cervical spine over a period of six treatments with a two week follow-up consultation. It was hypothesised that the group treated three times weekly would respond better compared to the once weekly treatment group. The study was a clinical trial involving two experimental groups of fifteen patients each (n=15), total sample size N=30. Volunteers responded to advertisements placed in the local press. Those who met the criteria, in other words suffered from cervical spine facet syndrome, were included in the study. Objective data was acquired using a goniometer to measure cervical spine range of motion. Subjective data was obtained by participants recording their progress on the Vemon-Miorneck pain and disability index and the Numerical pain rating scale. Data obtained from the range of motion testing showed that both groups responded with statistical significance to the treatment, but no statistically significant difference was obtained when the two respective groups were compared to each other. It was also noted that specifically rotation bilaterally for both groups, and left lateral flexion for group 1 (treated three times weekly), showed no statistically significant improvement at all. Statistical analysis of the data obtained from the questionnaires indicated that both groups responded with statistical significance to the treatment, but when group was compared to group 2, no statistically significant difference was noted between the two groups. This rejects the hypothesis that three times weekly chiropractic treatment is more beneficial to the patient, than once weekly chiropractic treatment. This study concluded that there was no statistical difference between the two above mentioned groups and no difference in response to different treatment frequencies. Therefore it shows that less frequent treatment is not to the detriment of the patients' progress and might be of benefit for achieving cost effectiveness.

Very little information exists about the acute presentation of overuse injuries specific to cycling. Although there are studies, mainly in the form of surveys, that do detail the incidence and prevalence of overuse injuries in cyclists or triathletes, they all take place weeks or even months after events or focus on a 1 year injury history. (Weiss 1985, Korkia et al. 1994, Wilber 1995, Manninen and Kallinen 1996 and Salai et al. 1999) The aim of this study was to describe the historical data obtained when patients presented to the Student Chiropractic Sports Council at the Pick ‘n Pay 94.7 Cycle Challenge from the years 2002 to 2004. The focus of the study was on the profile of injuries with which patients presented. This was a descriptive study of historical data obtained by students treating at the Pick ‘n Pay 94.7 Cycle Challenge from the year 2002 to 2004. The data was acquired in the form of SOAP (Subjective, Objective, Assessment, Plan) notes held by the Student Chiropractic Sports Council. The results of this study showed that the most common location of complaints were the anterior and posterior thigh. Musculotendinous strains were by far the most predominant injury with the hamstring being involved more commonly (33.8%) than any other muscle. Overall 72.8% of patients were diagnosed with musculotendinous strains. Further, the results also showed that 55.8% of patients complained of eck or back pain and 59.7% were diagnosed with cervical facet joint, thoracic facet joint, lumbar facet joint or sacroiliac joint dysfunction. / Dr. S. Wilcox Dr M. Moodley

M.Tech. (Chiropractic) / Introduction: The most common chronic pain condition in modern society is neck pain (Jensen and Harms-Ringdahl, 2007). Chronic neck pain is a common complaint for many, from young patients to older patients with stressful work situations. According to Graham, Gross and Goldsmith (2006) neck disorders are common, disabling to various degrees and costly. Various structures in the cervical spine capable of transmitting pain include facet joints, intervertebral discs, nerve root dura, ligaments, and muscles (Manchikanti, Singh, Rivera and Pampati, 2002). According to Rochester (2009) chiropractors treat patients with chronic neck pain by using spinal manipulative therapy (SMT) to address a segmental joint hypomobility within the cervical spine as determined by joint motion palpation and endplay assessment. Traction is commonly used for the treatment of the spine by various physical therapists. It may be included as part of a chiropractic treatment protocol. According to Hooper (1996) traction involves the application of both manual and mechanical forces to draw adjacent body parts away from each other resulting in decompressed irritated tissues, realign parts, and relaxing tight structures. There are several types of cervical traction. The short and medium term improvement for chronic neck pain as well as the comparative effect of manual cervical traction versus mechanical cervical traction in combination with spinal manipulative therapy has not yet been established. Aim: This particular research study aimed to compare the short to medium term efficacy of manual cervical traction with mechanical cervical traction combined with spinal manipulative therapy with regards to decreased pain and improvement of cervical spine ranges of motion in patients with chronic neck pain. Methodology: Participants who met the inclusion and exclusion criteria were eligible to participate in this study. Advertisements were placed on notice boards around the campus of the University of Johannesburg and participants were recruited from the use of advertisements as well as word of mouth to partake in this research study. Thirty participants who suffered from chronic neck pain, volunteered for this comparative research study. This study was a randomized comparative study, where participants were randomly selected to be either in Group 1 or in Group 2. Group 1 received manual cervical traction whereas Group 2 received mechanical cervical traction. Both groups received spinal manipulative therapy to the restricted motion segments found in the cervical spine. Participants received seven trial sessions, with six treatments, over a period of two weeks. At the final 7th visit, one month after the sixth visit, no treatment was performed. Subjective and objective measurements were recorded at each visit. The subjective measurements of this particular study consisted of the Numerical Pain Rating Scale (NPRS) and the Vernon-Mior Neck Disability Index to evaluate the participants’ sensitivity to pain and disability. The objective measurements of this study included the Cervical Spine Range of Motion instrument to assess the participants’ cervical spine movement. Results: Both groups demonstrated a statistically significant improvement over time with regards to pain and disability, as well as increased range of motion to the cervical spine. The greatest percentage improvement with regards to range of motion was in lateral flexion and rotation of the cervical spine. Conclusion: According to the results of this study, it could be concluded that either manual cervical traction or mechanical cervical traction in combination with spinal manipulative therapy can be used effectively in the treatment of chronic neck pain as part of a chiropractic treatment protocol. Both groups proved to have a statistically significant improvement with regards to pain and disability as well as increased cervical spine range of motion...

M.Tech. (Chiropractic) / Cervicogenic Headache is a common musculoskeletal disorder afflicting people worldwide. It causes decreased productivity and mild to severe disability and thus has a large socio-economic impact on society. Much research is needed to improve the successful management of patients afflicted with this disorder. The aim of this study is to compare the effectiveness of spinal manipulation alone and spinal manipulation in conjunction with cervical stabilization exercises in the treatment of cervicogenic headache. Thirty eligible participants conforming to the North American Cervicogenic Headache Society classification of cervicogenic headache were solicited and randomly assigned to two groups of fifteen. Group 1 received spinal manipulative therapy to the full spine. Group 2 received spinal manipulative therapy to the full spine as well as cervical stabilization exercises. Patients were treated eight times over a four-week period with a six-week follow-up consultation thereafter. Objective and subjective measurements were taken at. the first, fourth, eighth and six-week follow-up consultations. Objective measurements consisted of cervical spine range of motion measurements. Subjective measures consisted of the Vernon-Mior neck pain and disability index and the numerical pain rating scale. Both groups displayed numerical improvements in all cervical spine ranges of motion. Both groups had statistically significant improvements in cervical spine right lateral flexion, while group 1 only had a statistically significant improvement in cervical spine left lateral flexion. Both groups displayed statistically significant improvements in the subjective measures. However, neither group had a statistically significant improvement over the other. It can be concluded that neither spinal manipulative therapy nor spinal manipulative therapy in conjunction with cervical stabilization exercises is more effective than the other. Thus rehabilitation of the cervicogenic headache patient yielded no measurable added benefit to spinal manipulative therapy only. However, results indicate that if more rigid or complex application of cervical spine stability training is incorporated, superior results may be achieved.

M.Tech. / Osteoarthritis (OA) is a common and severely disabling disease (I). Chiropractic mobilisation functions well to improve mobility, relieve pain and promote healing (2). Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used for the treatment of OA. Their role in OA, however, is not clearly understood (3). Adverse side effects and the cost of NSAIDs also remain a problem (4). Seatone is a health supplement that has therapeutic properties that provides symptomatic relief of OA by means of its anti-inflammatory action (5,6). Seatone produces a slow, but progressive relief from pain and stiffness and improves quality of life (7' 8). The purpose of this study was to determine the effect of Seatone on the treatment of OA. This was achieved by comparing Chiropractic mobilisation (in preference to Chiropractic manipulation) in conjunction with oral administration of Seatone to Chiropractic mobilisation or oral administration of Seatone alone, by means of subjective and objective measurements. The study required forty-five subjects, above the age of thirty-eight years, suffering from OA of the knee joint, according to the classification criteria (Appendix A). The subjects were screened according to the exclusion and inclusion criteria and all the relevant forms, questionnaires and clinical examinations were completed. The subjects were randomly assigned to one of three treatment groups. Treatment was conducted over a period of eight weeks. Objective or goniometer readings and subjective measurements were done prior to and following treatment to determine the effect of the therapies. The subjective measurements were taken from the Numerical Rating Scale (NRS), the Visual Analogue Scale (VAS) and the McGill Pain Questionnaire. The Cincinnati Knee Rating System, a comprehensive knee questionnaire, was completed at the initial and final consultation. A combined treatment of Chiropractic mobilisation and oral administration of Seatone or oral administration of Seatone alone showed a greater mean improvement than Chiropractic mobilisation alone, in mobility. There was no significant difference in the assessment of pain between the three groups. However, results show that Seatone has a positive effect in the treatment of OA of the knee, for improving mobility.

M.Tech. (Chiropractic) / The aim of this study was to compare the effects of chiropractic manipulative therapy with and without stripping massage of the sternocleidomastoid, with regards to pain, disability, cervical range of motion and head repositioning accuracy in the treatment of chronic mechanical neck pain. The aim was determined by using the Vernon-Mior Neck Pain and Disability Index, Numerical Pain Rating Scale and the Cervical Range of Motion measuring instrument (CROM).The study consisted of thirty participants that had an equal male to female distribution. An age range was set and individuals had to be between eighteen and fourty. Participants were chosen according to inclusion and exclusion criteria that were set before the study commenced. Treatment received by the participants was dependent on which group they were allocated to. Group One received just chiropractic manipulative therapy to three restricted segments of the cervical spine. Group Two also received chiropractic manipulative therapy to three restricted cervical segments and had stripping massage of both sternocleidomastoid muscles.Treatment consisted of six treatments sessions and with the seventh visit only readings were taken. Treatments were carried out twice weekly so that the treatment time period fell over a three week study period. Participants were asked to complete the subjective data before the first, fourth and seventh visit. Subjective data was gathered by using the following: Numerical Pain Rating Scale and a Vernon-Mior Neck and Pain Disability Index Questionnaire. The objective data that was recorded by the researcher consisted of the cervical range of motion that was gathered by using the Cervical Range of Motion (CROM) machine and the head repositioning accuracy. Participants then received either chiropractic manipulative therapy to the restricted cervical spinal segments or a combination of stripping massage to the sternocleidomastoid muscles as well as chiropractic manipulative therapy, depending on their groupallocation. All data gathered by the researcher and then analysed by a statistician at the University of Johannesburg...

M.Tech. (Chiropractic) / Mechanical neck pain is the general term that refers to any type of pain within the cervical spine caused by placing abnormal stress and strain on muscles of the vertebral column. This is a very common musculo-skeletal disorder within the population, with 45% to 54% reporting neck pain at any given time of their lives (Martinez-Segura, Fernandez-de-las-Penas, Ruiz-Saez, Lopez-Jimenez and Rodriguez-Blanco, 2006). A vast majority of individuals do not experience a complete resolution of symptoms and as such often becomes a chronic pain (Cote, Cassidy, Carol and Kristman, 2004). Chronic pain by definition is one which is present for a period longer than six weeks (Segen, 2002). Accompanying the neck pain is often a limited or reduced range of motion within the cervical spine. Some studies suggest that hyper-tonicity and strain of the supporting muscles within this region due to an altered biomechanics also contributes to the pain and dysfunction (Armstrong, McNair and Williams, 2005 and Dall’Alba et al. 2001). One of the major muscle groups involved in this is the posterior cervical musculature. This is a general term used to describe the muscles located on the posterior aspect of the neck and includes longissimus capitis, semispinalis capitis, semispinalis cervicis, rotatores and multifidus (Dalley and Moore, 2006). Chiropractic adjustment therapy has been shown to have many effects of the body and especially the cervical spine including a decrease in pain perception and muscle hypertonicity (Kirkaldy-Willis and Cassidy, 1985), an increase in cervical range of motion (Bergmann, Peterson and Lawrence, 1993) as well as an increased skin pain tolerance level (Terrett and Vernon, 1984). Dry needling therapy has also been proven to have similar effects, including, a reduction in pain perception, an increase in range in motion of the specific linked biomechanical section, and most importantly a reduction of muscle tension (Travell and Simons, 1993). The purpose of this study was to see if a synergistic effect of the two above mentioned treatments would occur when combined under one treatment protocol. The aim of this study was to determine how effectively cervical adjustment therapy, dry needling of the posterior cervical muscles and a combination of the two treatments was in treating chronic mechanical neck pain with regards to pain, disability and cervical spine range of motion over a three week period. Participants were recruited from the University of Johannesburg Chiropractic Day Clinic. They were eligible to participate in the study once they met the inclusion and exclusion criteria. Participants were recruited by means of word of mouth as well as with the use of advertisements that were placed around the respective campuses of the University of Johannesburg. Thirty participants who presented with chronic mechanical neck pain, volunteered for this comparative study. This trial is a randomised controlled clinical trial which used convenience sampling. Group A received a combination treatment of dry needling and cervical manipulation. Group B received cervical adjustment only while group C received dry needling of the posterior cervical musculature alone. participants were treated for a total of 6 visits. Subjective and objective measurements were done at visits 1, 4 and a final visit 7 during which only measurements were taken. These effects are based on Vernon-Mior Pain and Disability Index, Numerical Pain Scale Rating, Pressure Algometer as well as Cervical Spine Range of Motion measuring instrument (CROM). The results of this trial indicated that all three treatments were effective in treating chronic mechanic neck pain. While one treatment was not statistically more effective than the other the dry needling and cervical manipulation alone produced a superior result. While combining these treatments was effective the synergistic effect one would expect was not as evident.

A dissertation submitted in partial compliance with the requirements for a Masters Degree in Technology: Chiropractic at Technikon Natal, 2000. / This study compared the relative effectiveness of low intensity laser therapy as opposed to dry needling in the treatment of active myofascial trigger points. The purpose of this study was to determine the more effective method of treating active myofascial trigger points, in terms of subjective and objective clinical findings. This study was a comparative, uncontrolled, unblinded pilot study. It was also intended to expand upon the little understood pathophysiology and treatment of muscular pain, in both chiropractic and medical curricula (Gatterman 1990: 285). / M

A dissertation in partial compliance with the requirements for a Masters Degree in Technology: Chiropractic at Technikon Natal, 2000. / Myofascial trigger points are a common problem for patients as weJl as physicians. According to some authors Myofascial Pain Syndromes encompass the largest group of unrecognised and under-treated medical disorders. At present, needling techniques seem to be most effective in treating myofascial trigger points, however, many chiropractors claim that manipulation alone is sufficient for trigger point amelioration. The aim of this study was to determine the effectiveness of chiropractic manipulation to the level of main segmental nerve supply versus dry needling in the treatment of selected muscles with myofascial trigger points. / M

A dissertation completed in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic at Technikon Natal, 2002. / The purpose of this retrospective investigation was to analyze and critique, the Chiropractic Students' Sports Questionnaire in order to refine the questionnaire and establish its face validity with reference to field hockey. / M