Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 12, xiii, 84 leaves / Plantar Fasciitis (PF) or “painful heel syndrome” is an inflammation of the plantar fascia at its insertion on the medial calcaneal tubercle. Accounting for 7-9% of total sports injuries, this condition is predominantly due to overuse and is notoriously difficult to treat. Traditionally treatment focused on the resolution of the inflammation with the application of such modalities cross frictions / transverse frictions being the modality of choice. With such modalities there are however limitations which include the detection of the appropriate areas in which treatment should be given as well as the treatment depth achieved. The GISTM, however is an advanced form of soft tissue mobilisation that employs the use of specifically designed stainless steel instruments that, when manually brushed over the skin of the affected area, are thought to detect and release scar tissue, adhesions and fascial restrictions. This complementary technique is hypothesized to work in the same manner as cross friction massage, and is thought to achieve quicker and improved outcomes by its detection of the treatment area(s) as well as improving the depth of treatment application. This assertion was however untested. Therefore the purpose of this study was to determine the efficacy of the Graston Technique Instrument-assisted Soft Tissue Mobilisation (GISTM) in the treatment of Plantar Fasciitis in runners.

Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 xvi, 96, [65] leaves : ill. ; 30 cm / Low -Dye taping is a method commonly used in sport participation and normal daily activity (Harradine, Herrington and Wright, 2001). It has been indicated in support of injured structures, decreasing edema and protection against re-injury (Reid, 1992:232). Contrary to these beliefs, studies have shown that low -dye anti-pronatory control is lost after relatively short episodes of exercise (Ator et al., 1991 and Vicenzino et al., 1997). The variations in dynamic foot function with low -dye taping is not well understood, although taping of the foot in low-dye type method has been advocated by many authors (Brantingham et al., 1992, Ryan, 1995 and Chandler and Kibler, 1993). It was the purpose of this study to investigate the maximum ground reaction force and percentage contact time within 10 demarcated regions of the foot in asymptomatic patient with pes planus, cavus and normal medial longitudinal arches at four time intervals over 24 hours. Having established its baseline function it may serve as point of reference for clinical trials that wish to determine the role of taping as part of the management of symptomatic feet.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic at the Durban Institute of Technology, 2008. / Purpose Cricket fast bowlers are prone to the development of Myofascial pain syndrome and in particular active myofascial trigger points in their rotator cuff muscles of the shoulder joint (Scott, et al. 2001). This is due to the severe stresses placed upon the muscles, bones and joints of the shoulder as a result of the high velocity throwing action (Bartlett, et al.1996). In muscles containing active myofascial trigger points a decrease in the stretch range of motion as well as the maximal contractile force is noted, these two factors may negatively affect the speed at which a fast bowler deliver the ball (Travell, Simons and Simons, 1999). Dry needling is viewed as the most effective means of deactivating myofascial trigger points leading to in increase in both the contractile force and range of motion of the affected muscle, which could increase the speed at which the bowler delivers the ball (Wilks, 2003). The aim of the study was to determine the immediate effect of dry needling active myofascial trigger points of the rotator cuff on bowling speed in action cricket fast bowlers. Method The study consisted of 40 participants (randomly split into two equal groups of 20) each with shoulder pain of a myofascial origin. Group A (intervention group) received the dry needling intervention in their most tender active myofascial trigger point. While participants in Group B (control group) received no treatment. Bowling speeds were measured both before and after the intervention, to determine its effect on bowling speed. IV Data was entered into MS Exel spreadsheet and imported into SPSS version 15 (SPSS Inc.,Chicago, Iiiinois, USA), which was used for data analysis. Paticipants were evaluated on bowling speed, Algometer readings and Numerical pain rating Scale (NRS) both pre and post intervention. Participants were also asked if they believed the intervention increased, decreased or had no effect on their bowling speeds. Two sample t-test was used to compare baseline values between the groups. A repeated measure ANOVA was used to compare the rate of change of each outcome over time in the two groups. Pearson’s correlation analysis (intra-group) was used to assess the strength and magnitude of correlations of the changes in the outcomes. The McNemar – Bowker test and Weighted Cohen’s kappa statistics were calculated to assess agreement between perceived and actual levels of change. Results A significant treatment effect was observed in the intervention group were an increase in bowling speed, algometer readings as well a decrease in Numerical pain rating scale(NRS) scores was observed. There was also a perceived increase in the speed the participants delivered the ball in the intervention group. No significant changes were observed in the control group. The findings of this study indicate that dry needling as a treatment modality would be beneficial to fast bowlers in not only increasing their speeds but also the pain experienced as a result of active myofascial trigger points.

Submitted in partial compliance with the requirements for the Doctoral Master's Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2018. / Introduction: Myofascial pain syndrome is a condition of collective sensory, motor and autonomic symptoms caused by myofascial trigger points, which are hyper-irritable foci in a muscle and palpated as a taut, tender, ropey band. There are many types of treatment for myofascial pain syndrome; dry needling is one of the most effective forms. Dry needling involves the insertion of a needle into the myofascial trigger points in order to break up the contractile elements and any somatic components that may contribute to trigger point hyperactivity, and to stimulate sensitive nerve ending in the area. Although therapeutic, an unpleasant side effect of dry needling is the post-needling soreness. Various modalities have been utilised to decrease post-needling soreness, such as ice, heat and action potential simulation, to mention a few, however no study has been conducted to date that documents low intensity laser therapy and its effect on post-needling soreness. This study therefore aimed to evaluate the effect of low intensity laser therapy on post-needling soreness in trigger point 2 of the upper trapezius muscle. Methodology: This study was designed as a randomised, controlled pre-test and post-test experimental trial. Forty participants were randomly allocated into two equal groups of 20 participants each. Group 1 received the needling and laser therapy; Group 2 received needling and placebo laser. Algometer and Numerical Pain Rating Scale 11 (NRS 11) readings were taken immediately before the dry needling procedure; after the laser or placebo laser therapy; and again, at the follow-up visit 24 hours later. Subjects used a 24- hour pain diary which was completed at three-hour intervals, to record any post-needling soreness. The NRS 11 scale was used immediately before the needling and again at the follow-up visit 24 hours later. Results: Statistical analysis was done using SPSS version 24.0 to conduct inferential and deductive statistics. A significance of p=0.05 was set. Baseline demographics and outcome measurements were compared between the two groups using t-tests or ANOVA where appropriate. An inter-group analysis revealed that objectively and subjectively all groups experienced some degree of post-needling soreness, which deceased significantly over time. This decrease of pain was not significantly related to the treatment group, and there is no evidence of the differential time effect with the treatment. An inter-group analysis yielded no statistically significant results regarding the effectiveness of the treatments received by the patients. This could be because of the small sample size or because low intensity laser therapy is not a useful intervention. Conclusion: The results from this study revealed that both treatment groups responded equally in the alleviation of pain. It can thus be concluded that low intensity laser therapy had no significant beneficial effects on post-needling soreness. / M

M.Tech. (Chiropractic) / Aim of this study was to compare which treatment either Proprioceptive Neuromuscular Facilitation or chiropractic manipulation, whether by itself or in combination, was more effective and beneficial in the treatment of mechanical neck pain. The effectiveness was measured by the use of a Visual Analogue Scale, Vernon- Mior Neck Pain and Disability Index questionnaire and the measurement of cervical spine range of motion using an analogous cervical spine range of motion inclinometer (CROM). The questionnaire and the measurements were taken prior to the treatments at the first, fourth and seventh consultations.Thirty participants who met the inclusion criteria were randomly placed into three groups of equal size (10 participants each). Group one received a Proprioceptive Neuromuscular Facilitation (PNF) stretching protocol to the cervical spine. Group two received a chiropractic manipulation to the cervical spine. Group three received a combination treatment, first receiving chiropractic manipulation and then a PNF stretching protocol to the cervical spine. Participants were treated six times out of a total of seven sessions, over a maximum of a three week period.Subjective data was collected at the beginning of the first, fourth and seventh consultations. This was done by means of a Visual Analogue Scale and a Vernon-Mior Neck Pain and Disability Index Questionnaire, in order to assess pain and disability levels. Objective data was collected by means of measuring cervical spine range of motion using a cervical range of motion (CROM) inclinometer. Analysis of collected data was performed by a statistician from STATKON, a department of the University of Johannesburg.Clinically significant improvements in group 1, group 2 and group 3 were noted over the duration of the study with reference to pain and disability. Statistically significant changes were seen in all three groups with reference to pain and disability. Group 3 was shown to improve the most with regard to pain and disability. Group 1 had statistically significant improvement with regard to cervical range of motion in the ranges of left and right rotation. Group 2 experienced a decrease range of cervical motion with regard to extension. As the study consisted of a small group of participants further, more extensive studies are needed...

M.Tech. (Chiropractic) / The aim of the study was to compare the efficacy of treating the active levator scapulae trigger point (TP1) with either chiropractic adjustments combined with ischemic compression or chiropractic adjustments combined with ultrasound therapy in physically active people in order to determine which of the two treatment protocols was superior.This study was a comparative study consisting of two groups of fifteen participants each. Participants were between the ages of eighteen and forty-five and there was an equal male to female ratio. Prior to becoming a participant in this study individuals were assessed according to the inclusion and exclusion criteria. The International Physical Activity Questionnaire, a clinical case history, full physical examination, a cervical regional examination and examination of the levator scapulae muscle for an active central trigger point (TP1) were completed. The method of treatment for each participant was determined by random group allocation. Group 1 received cervical spine chiropractic adjustments combined with ischemic compression to the active levator scapulae trigger point. Group 2 received cervical spine chiropractic adjustments combined with ultrasound therapy to the active levator scapulae trigger point. Subjective and objective readings were based on the above treatment protocols.Treatment consisted of seven consultation sessions over a three week period. There were six treatment visits with the seventh visit used only for data collection. There were two treatments each week with at least two days in between visits. The third week consisted of three visits with the last visit used only for data collection. Subjective data was collected from the Vernon-Mior Neck Pain and Disability Index Questionnaire and the Numerical Pain Rating Scale. Objective data was collected from the pressure algometer readings. Subjective and objective data was collected before treatment on the first and fourth visits and on the seventh final data collection visit. Analysis of the data collected was done by a statistician. The chiropractic adjustments used were based on motion palpation findings on the treatment visits and re-assessed on each visit.Clinically significant improvements regarding neck pain and disability and trigger point severity were seen in both Group 1 and Group 2 over the three week period. Group 2 showed greater improvements in all subjective and objective readings over the three weeks compared to Group 1.

M.Tech. (Chiropractic) / This study was conducted in order to compare the effectiveness of the lumbar spine manipulation versus the foot manipulation/mobilisation for people suffering with chronic low back pain. This research aims to compare the effects of lumbar spine manipulation alone, foot manipulatioil/mobilisation alone or the combination of the two in people suffering with chronic low back pain. Candidates for the study were recruited from the local surrounding area, and through information pamphlets distributed through the Technikon Witwatersrand Doornfontein. The candidates were asked to participate in the study, which was held at the Technikon Witwatersrand Chiropractic day clinic. Only -those candidates that conformed to the selection criteria were allowed to participate in the study. The candidates were assigned to one of three groups. Eac.h group had ten candidates. Group 1 received lumbar spine manipulation alone. Group 2 received foot manipulation/mobilisation alone. Group 3 candidates received lumbar spine manipulation and foot manipulatioil/mobilisation. Subjective data was collected using the Numerical Pain Rating Scale 101 and the Oswestry Low Back Pain and Disability Questionnaire. Objective data was collected using the electronic inclinometer to measure lumbar spine range of motion in flexion, extension, right and left lateral flexion and right and left anterior rotation. The paired Hest was used for statistical analysis, where a statistically significant difference was found; the Student-Newman-Keuls test was performed to identify which statistically significant difference between the groups was found. The results of this study indicate that lumbar spine manipulation alone would appear to have responded better in terms of lumbar spine range ofmotion...

A dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic, 2002. / The purpose of this study was to determine the effectiveness and relative effectiveness of a topical Capsaicin cream and knee joint mobilization in the treatment of Osteoarthritis (OA) of the knee. / M

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2017. / Aim: There is a paucity in the literature regarding the effectiveness of the Impulse Adjusting Instrument® (IAI) in treating myofascial trigger points (MFTPs) and regarding the effectiveness between dry needling and the IAI in the treatment of MFTPs. There are many limitations and an array of contraindications for dry needling. Therefore, an alternative method should be sought as this will be beneficial to the patient. Thus, the aim of this study was to determine the effectiveness of the IAI compared to dry needling in the treatment of MFTPs found in the upper trapezius muscle. Methodology: This study was a randomised single-blinded clinical trial. This study consisted of 41 participants between the ages of 18 and 40 who were divided into two groups. The participants were randomly allocated into their respective groups using a blinded allocation method that was drawn up by the statistician. Groups were divided into dry needling (Group one (n=18)) and IAI (Group two (n=23)) treatment groups. Subjective neck pain level was determined using a numerical pain rating scale (NRS). The neck disability index (NDI) subjectively assessed the effect neck pain had on the participants’ activities of daily living before and after treatment. The Patients Global Impression of Change (PGIC) tool was used to determine the participants’ subjective impression of treatment outcomes since the beginning of the treatment. Objective pain pressure thresholds (PPT) were measured with an algometer. Objective cervical range of motion (CROM) in lateral flexion (LF) was measured with a goniometer. Each participant had four visits over a two week period, which included three treatments and a final visit for final measurements. Data was analysed using IBM SPSS version 23. Repeated measures ANOVA was used to examine the effect on each outcome measure. Directional trends in effectiveness were drawn up using profile plots to assess the direction and trends of the effects. A p value of < 0.05 was considered to be statistically significant. Results: Intra-group and inter-group statistical analysis revealed all subjective measurements improved in both groups with no significant differences between the groups. With respect to objective measurements, there was no statistical improvement in LF CROM and dry needling had no improvement in PPT. Impulse Adjusting Instrument trigger point therapy showed an increase in PPT, however, when compared to dry needling there was no statistical difference in PPT. Conclusion: The conclusion for this study states that the trends in each of the outcomes suggest that the IAI is as effective as dry needling for the treatment of MFTPs. / M

M.Tech. (Chiropractic) / Neck pain is a common and costly complaint in society and many are made to believe that their neck pain is caused by pinched nerve, compressed disk, arthritis or displaced cervical vertebrae, when in reality the pain may be solely due to referral from myofascial trigger points in overworked or traumatized muscles of their upper back and shoulders. Travel and Simons (1999) demonstrated trapezius muscle of the neck, back and shoulder as the main cause of mechanical neck pain and stiffness. The aim of this study was to compare the effects of trigger point therapy using an activator instrument versus myofascial dry needling in combination with cervical spine adjustment in the treatment of those with acute or chronic neck pain associated with active trigger point 1 (TrP 1) or trigger point 2 (TrP 2) of upper trapezius muscle, with regards to pain and disability, pressure pain threshold and cervical spine range of motion. The clinical study consisted of forty participants, from the ages of 18 and 45, randomly allocated into two groups of twenty individuals each. Potential participants were examined and accepted based on inclusion and exclusion criteria. Group 1 received activator trigger point therapy to upper trapezius TrP 1 or 2 with chiropractic adjustment to restricted segments of the cervical spine, and group 2 received myofascial dry needling of upper trapezius TrP 1 or 2 with chiropractic adjustment to restricted segments of the cervical spine. Participants were treated four times over a period of two weeks. Subjective data was collected using the Vernon-Mior Neck Pain and Disability Index and a Visual Analog Scale. Objective data was collected using an algometer to measure pressure pain threshold of trapezius TrPs muscles, and a goniometer to measure cervical spine range of motion. All data was collected at the first and third visits prior to treatment, and at the fifth visit. The statistical analysis was conducted using nonparametric tests. Friedman’s test was used to assess whether neck pain, disability, cervical spine range of motion and pressure pain threshold varied over the three time intervals. Wilcoxon Signed Ranks Pair test was used for assessment of comparability of the results in each group separately, and the Mann-Whitney U test was used for comparison of the accumulated data in the two groups.