Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic at Technikon Natal, 2000. / Sacroiliac joint syndrome represents a common cause of lower back pain (Cassidy and Burton 1992:3). However, much controversy exists regarding the most reliable method used to diagnose and determine sacroiliac joint dysfunction (Wiles and Faye 1992). / M

M.Tech. (Chiropractic) / This unblinded, controlled pilot study was conducted in order to compare the effectiveness of chiropractic manipulative therapy with that of a combined therapy involving chiropractic manipulative therapy and myofascial trigger point therapy (dry needling technique and passive stretching), in the treatment of chronic mechanical posterior cervical spine pain. In executing the comparison, it was hypothesised that both treatment protocols would be effective, but that the combined therapy would be the most effective for the treatment of chronic mechanical posterior cervical spine pain, as this treatment protocol has equal emphasis on both the osseous and soft tissue structures. It was hoped that this combined therapy would be more effective in terms of a more speedy recovery and long term effect. This would not only benefit the patient from the point of view of health and quality of life, but financially as well, as less consultation fees would have to be paid. Patients wererecruited into the study by the use of advertisements in newspapers and posters, or from patients entering the Technikon Witwatersrand Chiropractic Day Clinic complaining of posterior cervical spine pain. Only those thirty patients who conformed to the specified delimitations and diagnostic criteria were accepted. These patients were randomly placed into two groups of fifteen patients each. One group received chiropractic manipulative therapy and the other group received the combined therapy. Each patient received twelve treatments over a one month period, ie. three treatments per week. After the treatment period there was a month break from treatment and a follow-up consultation at the end ofthis month. This follow-up period was used to determine the lasting effects of the treatment protocol. The subjective data was collected with the use of two questionnaires, the Neck Pain and Disability Index (Vemon Mior) and the McGill Pain Questionnaire. Further subjective data was collected, in the form of the number of fixations found in the cervical spine by the use of motion palpation and active myofascial trigger points found in the specified areas of the Trapezius and Levator Scapulae muscles. The objective data was obtained from the...

M.Tech. / Background: Chiropractic spinal adjustment therapy has been shown to be an effective treatment for pain as well as many somatic, visceral and systematic complaints. Its use in the treatment of stress, however, remains speculative. Stress is a normal and healthy human response, but it is detrimental to health in excessive amounts. Salivary cortisol is an effective, accurate indicator of the stress response system. Objective: To determine whether thoracic spine Chiropractic adjustment therapy has any direct effect on salivary cortisol levels and subjective stress tests in subjects who rated themselves as having high levels of stress. Methods: Thirty-one participants, who reported having subjective high stress levels, comprising of male and female adults completed the trial, which was designed as a cross-over study. They were divided into two groups. Groups 1 and 2 delivered saliva samples and completed subjective stress questionnaires. Group 1 was then treated with thoracic spinal adjustment therapy for three weeks whilst Group 2 received no intervention. Both groups repeated the tests at the three-week interval. Thereafter, Group 2 received three weeks of the same spinal adjustment therapy, whilst Group 1 received no intervention. Again, both groups repeated the tests at the end of this second three-week interval. All tests were completed at the same time of day for each participant. Salivary cortisol was measured by enzyme-linked immunoassay (ELIZA). The stress questionnaire was recoded and analysed with descriptive statistics. vii Results: Chiropractic spinal adjustment therapy resulted in a statistically significant decrease in subjective stress levels. It did not, however, significantly change salivary cortisol levels. Conclusion: This study has shown that Chiropractic spinal adjustment therapy does not significantly change salivary cortisol levels, but is successful in lowering subjective stress levels over time. It is concluded that Chiropractic plays a role in the reduction of the subjective experience of stress.

M.Tech. / The primary focus of this study was to compare different treatment protocols namely Chiropractic Adjustive Therapy of the Sacroiliac Joint, lschaemic Compression of Trigger Points within the Piriformis muscle and Chiropractic Adjustive Therapy of the Sacroiliac Joint combined with lschaemic Compression of Piriformis Trigger Points in the treatment of a dysfunctional Piriformis muscle, to see which of the chosen treatment protocols would be the superior choice in treating the dysfunctional muscle. It was hypothesised that all the chosen treatment protocols would be effective in treating a dysfunctional Piriformis muscle, while it was hoped that the Chiropractic Manipulative Therapy of the Sacroiliac Joint would be the superior choice in treating a dysfunctional Piriformis muscle. Participants were recruited via posters and flyers in and around the University of Johannesburg Campuses. Forty five participants were recruited and randomly divided into three groups (Groupl received Chiropractic Manipulation of the Sacroiliac joint, Group 2 received Chiropractic Manipulation of the Sacroiliac joint combined with lschemic compression of the Piriformis muscle and Group 3 received only lschemic compression of the Piriformis muscle) by drawing a number from a box marked one, two and three for the different treatment protocols. The participants were given a consent and information leaflet which they had to sign and any questions they had were answered to the best of the researcher's ability. All the participants received five treatments and Algometer measurements were taken before and after every treatment and Numerical Pain Rating Scale forms were completed by the participant before treatment one and after treatment five. The results showed a significant decrease in pain perceived by the participants in all the different groups on the Numerical Pain Rating Scale and on the Algometer measurements. When looking at the Numerical Pain Rating Scale Scores the group that received ischaemic compression (Group 2) had the most improvement and when comparing the Algometer Measurements between the groups, the group that received only the Chiropractic Adjustive Therapy of the Sacro-iliac Joints (Group 1) had the best improvement.

M.Tech. (Chiropractic) / OBJECTIVE: The aim of this study was to determine the effectiveness of a single treatment approach of flexion distraction or diversified lumbar adjustments, compared to the combined treatment of flexion distraction in conjunction with diversified lumbar adjustments. STUDY DESIGN: A total of 30 participants were used, they all presented with chronic low back pain (LBP) of mechanical origin. SETTING: University of Johannesburg Chiropractic Clinic, Johannesburg, South Africa. SUBJECTS: The participants were divided randomly into one of 3 groups: Group 1 was treated with diversified lumbar adjustments. Group 2 was treated with flexion distraction directed at the lumbar spine. Group 3 was treated with a combination of diversified lumbar adjustments and flexion distraction. Each participant was treated 6 times over a 3 week period, with a 7th consultation where subjective and objective measurements were taken with no treatment. METHODS: Group 1 was adjusted on a chiropractic table in a seated or side lying posture. Group 2 was treated lying prone on the Cox Flexion Distraction Table. Group 3 was treated with a combination of the above treatments. Flexion distraction was applied to all participants in group 2. It was applied over the segments that were found to be restricted during motion palpation. One set of 10 repetitions was performed under distraction in each range of motion (ROM). Mobilisation of the restricted joints was executed until full and complete ROM was detected. To ensure that the participant was comfortable and received the best treatment possible Velcro straps were used to secure them onto the flexion distraction table. Diversified chiropractic adjustments were done on the flexion distraction bed or the chiropractic tables in the University of Johannesburg Chiropractic Day Clinic. Spinous Hook (Pull), Thigh-Transverso-Deltoid, Transverso-Deltoid and Push-Pull Technique were the names of the adjustments used to treat participants in group 1 or group 3. PROCEDURE: Subjective data was collected using the Oswestry Low Back Pain and Disability Questionnaire (ODQ) and the Numerical Pain Rating Scale (NPRS), which were completed by the participants prior to the 1st and 4th consultations and then again on the 7th consultation. Objective data was collected using the Digital Inclinometer. The ROMs measured were forward flexion, extension, left lateral flexion, right lateral flexion left rotation and right rotation of the lumbar spine. This data was collected by the researcher prior to the 1st and 4th consultations and then again on the 7th consultation. RESULTS: This study was done to try and establish the most effective approach in the management of chronic mechanical LBP using the different treatment approaches. When comparing the results obtained from the study it can be seen that all 3 groups were effective at reducing pain levels using the NPRS. There was a significant change that occurred on the 7th consultation when looking at the NPRS values. The statistics were then further analysed and a statistically significant difference was shown to have occurred between groups 1 and 3. This indicates that the chiropractic adjustment used alone, was the best treatment protocol compared to groups 2 and 3. The ODQ values showed that the treatments for all 3 groups were effective at getting the participants back to normal activities of daily living over the treatment protocol, with no preference between any of the treatment protocols. Statistically significant changes were found to have occurred in only some ranges of motion of the lumbar spine within certain groups. Clinical improvements regarding ROM were evident in group 1 concerning flexion, left rotation and right rotation. A clinical decrease was found in extension, left and right lateral flexion with group 1. Clinical improvements concerning group 2 were found in extension, left rotation and right rotation. Flexion showed a clinical decrease in ROM values of group 2. Statistically significant improvements were found with left and right lateral flexion in group 2. Group 3 showed positive clinical results with left and right rotation. Flexion and left and right lateral flexion ROM showed decreased values clinically in group in group 3. Extension showed a statistically significant decrease in group 3. These results indicate that chiropractic adjustments used alone, were the best treatment protocol compared to group 2 and 3 when using the NPRS. The ODQ values showed that there was no preference between either of the treatment protocols with regards to normal activities of daily living.

M.Tech. (Chiropractic) / To compare the effectiveness of biomechanical pelvic blocking to segmental drop piece adjustments in the treatment of sacroiliac joint dysfunction. Method: Thirty participants were randomly divided in two equal groups. Group A (n = 15) received biomechanical pelvic blocking and Group B (n = 15) received segmental drop piece adjustments. The trial consisted of seven treatment visits over a period of three weeks, of which the first six were treatment sessions, with the final seventh session serving the purpose of obtaining final post-treatment data. Data was obtained only at the first, fourth, and seventh visits. Subjective data was obtained by having each participant complete a numerical pain rating scale and the oswestry low back pain and disability questionnaire. Objective data consisted of pain pressure threshold over the posterior superior iliac spine by using a pressure algometer. Results: The subjective results showed that there was a decrease in the numerical pain rating scale (NPRS) reading scores over the treatment visits for both groups. Group A had a statistically significant decrease (p = 0.000) in the NPRS reading scores between visit 1 and 4, and a statistically significant decrease (p = 0.000) between visit 4 and 7. Group B showed that there was a statistically significant decrease (p = 0.001) from visit 1 to 4, and a statistically significant decrease (p = 0.002) between visit 4 and 7. According to the Mann-Whitney test both groups showed a statistically significant decrease in their NPRS readings over the treatment period (p = 009), however Group A had a greater decrease in pain than Group B when looking at the mean score values. This indicates that both biomechanical pelvic blocking and segmental drop piece adjustments delivered to the dysfunctional sacroiliac joints are effective in decreasing pain. Over time, statistical analysis showed that there was a decrease in oswestry pain and disability for both groups A and B when looking at the Friedmann and Wilcoxon-signed rank test. Group A showed a statistically significant decrease (p = 0.012) from visit 1 to 4, and a statistically significant decrease (p = 0.002) for visit 4 to 7. Group B also showed that from visit 1 to 4, there was a statistically significant decrease (p = 0.001), and from visit 4 to 7 there was a statistically...

M.Tech. (Chiropractic) / This study aims to compare full spine manipulation versus cervical spine manipulation in the treatment of acute cervical facet syndrome with regards to pain, disability, cervical spine range of motion and pain threshold. This study was a comparative study that consisted of two groups of fifteen participants each. The participants were between the ages of eighteen and forty with an equal male to female ratio. The potential participants were examined and accepted according to the inclusion and exclusion criteria for the study. The method of treatment that was administered was determined by group allocation. Group 1 received Chiropractic manipulative therapy delivered to restriction(s) throughout the different regions of the spine and Group 2 received Chiropractic manipulative therapy delivered to restriction(s) of the cervical spine only.

M.Tech. (Chiropractic) / Please refer to full text to view abstract

M.Tech. (Chiropractic) / Purpose: This study was undertaken in order to demonstrate the effects of static magnetic field therapy on acupuncture points in the treatment of those suffering from mechanical neck pain. Isolated spinal manipulative therapy of the cervical spine was compared to spinal manipulative therapy of the cervical spine in conjunction with magnetic field therapy on acupuncture points using both objective and subjective measurements. Before the execution of this study, it was hypothesised that both treatment protocols would be effective in the treatment of mechanical neck pain, although the combined therapy would be more effective. Method: Patients were recruited by way of advertisements placed in and around the University of Johannesburg, Doornfontein campus and their health clinic. Thirty patients with mechanical neck pain were recruited and randomly divided into two groups. Group one received manipulation to the affected joints of the cervical spine and group two received manipulation to the cervical spine combined with magnetic field therapy on acupuncture points. Procedure: Each patient in each group attended six treatment sessions; three in the first week and three in the second week. The Vernon Mior Neck Pain and Disability Index and the Numerical Pain Rating Scale (subjective measurements) were completed by each patient and the Cervical Range of Motion instrument (objective measurements) was used to collect readings from each patient in both the control and experimental groups, subjective and objective measurements were taken before treatment one, three and six. Specific treatment protocols were then adhered to. Results: The results indicated that both treatment protocols were effective in reducing mechanical neck pain although not one group was more effective than the other. Both groups improved subjectively and objectively as they had cervical spinal manipulation directed at joint dysfunction. Conclusion: The experimental group who received spinal manipulative therapy to correct joint dysfunction in conjunction with magnetic field therapy on acupuncture points was not more effective than the control group who received spinal manipulation only, in the treatment of mechanical neck pain.

M.Tech.