Dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic at Technikon Natal, 1997. / There have been few studies performed to determine the combined effects of spinal manipulative therapy with other modalities known to have beneficial physiological effects, especially in terms of mechanical low back pain (Ottenbacher and Difabio 1985). / M

Dissertation submitted in compliance with the requirement for a Master's Degree in Technology: Chiropractic, Technikon Natal, 1996. / The purpose of this study was to compare the effects of McMannis traction and Intermittent traction, both m conjunction with chiropractic manipulation in the treatment of chronic i.e. longer than four weeks, mechanical lower back pain. It was hypothesised by the author that McMannis traction would be the traction treatment of choice, as it enables the joints of the lumbar vertebrae to be moved through their normal anatomical range of motion while being traeticned axially. In addition this type of traction is more specific and allows the therapist to determine the amount of traction that is being applied to the patient because it is being applied manually. Intermittent traction on the other hand is a motorised non-specific traction and affects several joints at one time (Saunders 1979). / M

M.Tech. (Chiropractic) / Myofascial trigger points are very common and can become a painful part of most people’s life at one time or another. According to Travell and Simons (1999), active upper trapezius myofascial trigger points are common in patients presenting with neck pain. Myofascial pain syndrome is a regional muscle disorder that is one of the most common causes of persistent pain in the head, face and neck regions (Rachlin, 2002). The PAIN®GONE pen is a device that produces a high voltage, low frequency pulse for only a brief period of time. The electrical stimulation activates endorphins in the hypothalamus which plays a role in pain relief (Puskas, 2004). The technical system of the device is clinically proven and uses Transcutaneous Electric Nerve Stimulation (TENS), based on the pain gate control theory of Melzack and Wall (1965). The purpose of this study was to determine the efficacy of treating active upper trapezius trigger points with PAIN®GONE therapy combined with cervical spine chiropractic adjustments.This study consisted of two groups, the PAIN®GONE therapy group (Group 1) with fifteen participants and the placebo PAIN®GONE therapy group (Group 2) with fifteen participants. The participants were between the ages of 18 and 40 years of age. Prior to becoming a participant of this study, individuals were assessed according to the inclusion and exclusion criteria, a case history, physical examination, cervical regional examination and upper trapezius muscle palpation to assess for upper trapezius myofascial trigger points. Treatment was applied to the cervical spine by Chiropractic adjustments, and to the upper active trapezius myofascial trigger points via PAIN®GONE therapy or placebo PAIN®GONE therapy, from which the subjective and objective data were based.Each participant was treated six times over a period of three weeks. Prior to the initiation of treatment, each participant was requested to complete a Vernon-Mior Neck Pain and Disability Index questionnaire and Numerical Pain Rating Scale. Algometer readings were obtained for the active upper trapezius myofascial trigger points. The Cervical Range of Motion (CROM) goniometer was used to obtain numerical values for the participant’s active cervical spine ranges of motion in flexion, extension, lateral flexion androtation. Both groups, received treatment to the active upper trapezius trigger points and Chiropractic adjustments to the cervical spine for a total of six treatment sessions. Both subjective and objective data readings were obtained before the 1st, 4th and 7th final consultation...

M. Tech. / OBJECTIVE: The aim of the study was to explore whether dry needle therapy delivered to latent myofascial trigger points of the biceps brachii muscle had an immediate effect on muscle activity and strength . DESIGN: One hundred participants with latent myofascial trigger points of the biceps brachii muscle and who were suitable for the study were drawn from the community. They were al located in to either a controlor treatment group so that each group contained fifty participants . The control and treatment group were divided in such a way to ensure that the two groups were comparable with one another un terms of age and gender. The International Physical Activity Questionnaire was completed by each participant to ensure that the two groups were also comparable with one another in terms of the total amount of physical activity performed per week. The results of this study were statistically analysed by STATKON at the University of Johannesburg.

M. Tech. / Abstract Purpose: The purpose of this study was to assess the effects of Diversified Chiropractic adjustments versus Flexion-Distraction Technique in the management and treatment of chronic Lumbar Facet Syndrome. Method: This study consisted of two groups, Group A and Group B, each consisting of 15 participants with chronic Lumbar Facet Syndrome. The participants were between the ages of 20 and 45 years. Potential candidates were examined and accepted based on the inclusion and exclusion criteria. Group A received Diversified Chiropractic Adjustments and Group B received Flexion-Distraction Technique to the lumbar facets. Procedure: Each participant was treated eight times over a period of four weeks. Before the commencement of treatment one, four and eight, the participants completed the Oswestry Low Back Pain and Disability Index questionnaire and the Visual Analogue Scale. A Digital Inclinometer was used to measure lumbar spine ranges of motion. Diversified Chiropractic adjustments were then administered to Group A based on the restrictions obtained during motion palpation. Flexion-Distraction Technique was administered to Group B based also on the restrictions that were obtained during motion palpation. Results: Objective statistically significant differences were noted on flexion and left lateral flexion ranges of motion before treatment, and clinically significant differences we noted on flexion and right lateral flexion after treatment, in favour of Group A. Subjective readings also showed statistically significant differences with regards to Oswestry Low Back Pain and Disability Index and Visual Analogue Scale in favour of both Group A and Group B. Conclusion: The results of the study indicate that both Diversified Chiropractic adjustments and Flexion-Distraction Technique have a positive effect on patients suffering from chronic Lumbar Facet Syndrome. However, Diversified Chiropractic adjustments proved to have a greater overall benefit compared to Flexion-Distraction Technique in the management and treatment of Lumbar Facet Syndrome.

M.Tech. / Soccer is the most widely played sport in the world and, of all the skills required to participate, the instep soccer kick is considered to be the primary offensive action within the game of soccer. Biomechanical analysis of the instep soccer kick has revealed that the action of kicking is characterised by a proximal to distal series of multi-articular movements with distal segmental movements being predetermined by more proximal ones (Kellis and Katis, 2007). According to Smith, Gilleard, Hammond and Brooks (2006), the lower spine and pelvis play a pivotal role in determining the placement and actions of distal segmental motion during the action of the instep soccer kick. The aim of this study was to determine the effectiveness of chiropractic adjustments in soccer players with lumbar facet and sacroiliac joint dysfunctions by assessing the resultant speed of a soccer ball once kicked with an instep soccer kick. By correcting the lumbar facet and sacroiliac joint dysfunction of the affected soccer players, it was postulated that with restoration of joint motion and reduction of pain, the speed of the soccer ball, when kicked, would improve. When kicked the resultant ball speed is indicative of biomechanical kicking success. Thirty male professional soccer players from the Jomo Cosmos football establishment who met the study’s selection criteria were selected and randomly divided into one of two groups. The study group received chiropractic adjustments of dysfunctional lumbar facets and sacroiliac joints and the control group received a placebo treatment in form of a de-tuned stationary ultra-sound head over the effected facets joints for five minutes. Treatment for both groups occurred over a two week period with treatment being administered twice a week, totalling of four treatments per participant. Data capture was collected 3 times over the 2-week period; 1st reading done before the 1st treatment, the 2nd reading before the 3rd treatment and the final reading taken after the 4th and final treatment. Data capture consisted of both subjective and objective readings. The subjective data consisted of the measurements of pain experienced by the participants in the form of a Numerical Pain Rating Scale. Objective data involved the measurement of ball speed once kicked, with the use of a radar speed gun as well as lumbar spine range of motion measurements by means of a Digital Inclinometer. In executing the group comparisons, it was found that both groups would present with contrasting results. The group undergoing the chiropractic adjustments would show an improvement in their ball speed, reduction in their overall pain and increased lumbar spine extension and rotation ROM; where as the group undergoing the placebo treatment experienced a decrease in their ball speed, an increase in their overall pain and decreased lumbar spine ROM. The results obtained from the study demonstrated that the majority of the data was not statistically significant in either of the groups however, from a clinical perspective there was a definite effect on the lumbar spine range of motion, ball speed and pain reduction as a result of the Chiropractic adjustments that would warrant further investigation. There is a definite link with the negative effects that lumbar facet and sacroiliac joint dysfunctions have on the proximal to distal sequence of events that take place during the instep soccer kick. Therefore, treating the lumbar facet and sacroiliac joint dysfunction with chiropractic adjustments allows for better transfer of energy between segments and for greater resultant ball speed. In conclusion, the study demonstrated that chiropractic adjustment of lumbar facet and Sacroiliac joint dysfunctions showed good improvement in the resultant ball speed, reduction in lower back pain and improved lumbar spine extension and rotation ROM. From these results, it would be prudent to incorporate more chiropractic treatment into mainstream soccer and encourage further research into the advantages that chiropractic treatment has in better understanding the biomechanics involved in the instep soccer kick.

M.Tech. (Chiropractic) / The aim of this study was to determine whether improving a patient’s sleep ergonomics with the use of a cervical memory foam pillow was beneficial when combined with. A total of thirty participants volunteered to take part in this study - fifteen females and fifteen males. All were between the ages of eighteen and forty years old. The participants were randomly placed into one of two groups, each group consisting of fifteen participants. Group 1 received chiropractic manipulation to the restricted segment/s of the cervical spine, while Group 2 received both chiropractic manipulation to the restricted segment/s of the cervical spine and a Sleep Active® Memory Foam® cervical spine pillow. The participant of Group 2 were given their pillow and were given instructions on how to use the pillow at home whilst sleeping, and were requested to sleep with this pillow throughout the duration of the study. Procedure: In this study each participant received six chiropractic treatments over a period of three weeks and one final follow-up visit where no treatment was administered. Subjective and objective data was recorded at the beginning of the first, fourth and seventh consultations. The subjective data included the Numerical Pain Rating scale (NPRS), Vernon-Mior Neck Pain and Disability Index, the sleep component of the Vernon-Mior Neck Pain and Disability Index (component 7) and a modified Pittsburg Sleep Quality Index (PSQI). Objective data included measurement of cervical spine range of motion with the use of a goniometer. Results: Statistical analysis performed included the non-parametric tests to determine if significant statistical results were found over time. The Friedman and Wilcoxon Signed Rank Tests were performed for intra-group analysis and the Mann-Whitney U Test for intergroup analysis. Further correlation studies were conducted using the parametric, Pearson’s Test. The statistical analysis revealed significant statistical changes for intra-group results for both Group 1 and Group 2 and also significant statistical results for the intergroup analysis of the NPRS. The Vernon-Mior Neck Pain and Disability Index and the PSQI, yielded similar results - significant statistical changes within the intra-group analysis were found. The sleep component of the Vernon-Mior Neck Pain and Disability Index (Component 7) showed no significant statistical change for the participants of Group 1, however, a significant statistical change was found for the participants of Group 2. No significant statistical difference was found between the groups for the intergroup analysis, over time. Correlation studies between pain (NPRS) and sleep (Sleep Component of the Vernon-Mior Neck Pain and Disability Index) were included in the statistical analysis. It was found that no correlation between sleep and pain existed for those participants in Group 1, whereas Group 2 showed a trend between pain and sleep. The objective data collected from this study (cervical spine range of motion) was inconclusive. Conclusion: The results demonstrated that addressing sleep ergonomics with the use of Sleep Active® Memory Foam® Pillows to be an effective addition to a chiropractic treatment protocol when treating patients diagnosed with chronic cervical facet syndrome. Additionally, a relationship between sleep and pain was shown to exist and poor sleep should be considered when treating patients with chronic pain syndromes.

M.Tech. (Chiropractic) / This study aimed to compare the immediate effects of a cervical spine adjustment on gait in participants who had asymptomatic cervical spine dysfunction. Method: This study consisted of 1 group of 60 participants between the ages of 18 and 50 years of age. The group was mixed unevenly in terms of gender. The potential participants were examined and accepted according to the inclusion and exclusion criteria. Each participant underwent a pre adjustment gait analysis followed by cervical spine adjustment and then a post adjustment gait analysis. Procedure: Treatment consisted of a single treatment. The objective data was recorded via the Win FDM system pre and post cervical spine adjustment. The measurements were taken this way to give a reliable, dynamic analysis of gait in an easy to read print out. Analysis of collected data was performed by a statistician. The manipulative techniques used were directed towards dysfunction cervical spine joints which were identified via motion palpation. Results: The results of the gait analysis were obtained from the WinFDM analysis and analyzed by STATKON. Objective data was collected from 60 participants of both genders. All participants underwent a pre and post adjustment gait analysis for comparison...

M.Tech. / Purpose: This study aims to compare the effects of spinal manipulative therapy to the lumbar spine and/or pelvis, and spinal manipulative therapy to the lumbar spine and/or pelvis in conjunction with the application of transcutaneous flurbiprofen patches in the treatment of sub-acute/chronic mechanical low back pain with regards to pain, disability and lumbar spine and pelvic range of motion. These effects were based on a questionnaire consisting of a Numerical Pain Rating Scale, and an Oswestry Low Back Pain and Disability Questionnaire, and on lumbar spine range of motion (ROM) readings taken using a digital inclinometer. The questionnaire was completed and the ROM readings taken prior to treatment on the first, fourth and seventh consultations.

M.Tech.