M.Tech. / This study was conducted to investigate the efficacy of Chiropractic cervicothoracic spinal adjustment therapy in the treatment of active Trapezius myofascial trigger point dysfunction. Thirty participants were recruited and placed into one of two groups. Participants were between the ages of 18 and 30 years and selected based on the inclusion criteria being met. Participants had to present with active upper Trapezius trigger points and a restriction of the cervicothoracic junction. The experimental group received a Chiropractic adjustment to the cervicothoracic junction and the control group received detuned ultrasound as their respective treatments. The participants were treated six times over a 3-week period and measurements were taken on the first, fourth and seventh visits. A case history, physical examination and cervical regional examination were conducted at the first visit. Objective measurements included pressure algometry readings of Trapezius trigger points 1 and 2 and cervical spine goniometry readings. Subjective measurements included the Vernon Mior Pain Disability Index and the Numerical Pain Rating Scale. The results were interpreted by Statcon at the University of Johannesburg. The data was analysed using the Mann Whitney test and the Friedman test. According to the tests, the experimental group improved significantly in both the objective and subjective measurements over the seven visits. The control group showed an increase in the objective measurements and a decrease in the subjective measurements over the seven visits. This was found to be statistically insignificant. This study concluded that a Chiropractic adjustment to the cervicothoracic junction is effective in the treatment of upper Trapezius trigger points

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2005. / One of the most common clinical disorders known is mechanical low back pain (Painting et al. 1998:110). A significant source of low back pain is the sacroiliac joint and therefore, according to Schwarzer et al. (1995:31), it warrants further study. With respect to treatment, Gatterman (1995) states that specific manipulative therapy is the treatment of choice for sacroiliac dysfunction. This is supported by clinical studies (Cassidy et al., 1992), which have shown significant improvement with daily manipulation over a 2-3 week period in 90% of the patients suffering from sacroiliac dysfunction. Different adjusting techniques for the sacroiliac joint include side posture adjustment and prone drop piece adjustments (Bergmann, 1993). With respect to side posture, Bergmann (1993) further states that the side posture adjustment is the most common position used. However, it has been noted that side posture can produce unwanted rotation in the lumbar spine. This may be detrimental to patients who have contra-indications to torsioning such as abdominal aortic aneurisms, nerve root entrapment or disc pathology. Patients, who experience anterior catching of the hip capsule or decreased flexibility with side posture adjustments, experience more discomfort and could therefore benefit from a different technique (Gatterman, 1995). Hence the need for an effective adjustment technique that does not rely on torsioning (e.g. drop piece technique). (White, 2003; Pooke, 2003; Hyde, 2003; Pretorius, 2003; Haldeman, 2003; Cramer, 2003; Engelbrecht, 2003). Although drop table thrusting techniques were rated as being effective for the care of patients with neuromuskuloskeletal problems (Haldeman et al., 1993) as cited by Gatterman et al., (2001), it is still unknown which specific drop piece technique is the most appropriate for sacroiliac dysfunction. Therefore this study was aimed at determining the efficacy of a toggle recoil drop piece adjustment technique. / M

A dissertation presented in partial compliance with the requirements of the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2003. / In recent years, sacroiliac syndrome has been widely accepted by many different health professions as one of the major contributors to low back pain. Manipulation to effect the relief of the condition has thus far proven to be one of the most effective methods. Comparatively little research has however been done on the different forms of physical therapy that can be used in conjunction with a manipulation so as to maximise its affect / M

A dissertation submitted in partial compliance with the requirements for a Masters Degree in Technology: Chiropractic, Durban Institute of Technology, 2003. / The purpose of this study was to determine the relative effectiveness of a home programme of ischaemie compression, sustained stretch and a combination of the two, in terms of subjective and objective clinical findings for the treatment of Myofascial Pain Syndrome. / M

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 1999. / Impingement syndrome of the shoulder is a very common problem, yet the diagnosis and management of it is still not completely understood. The purpose of this investigation was to investigate the effectiveness of the chiropractic adjustment in order to determine whether or not it is an effective approach in the treatment of impingement syndrome / M

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2017. / Background: Acute ankle sprains and chronic ankle instability syndrome (CAIS) may be managed effectively through conservative management approaches such as strapping. There are two main types of strapping viz. rigid tape which is used to stabilise the joint and limit joint motion and elastic tape which permits joint motion but provides dynamic support. Kinesio™ tape is becoming increasingly popular in the management of various conditions. It is reportedly beneficial in reducing pain, improving circulation, increasing proprioception and correcting muscle function. Due to claimed benefits of Kinesio™ tape, it should, in theory, be beneficial in the management of individuals with CAIS particularly in terms of reducing pain and improving proprioception. AIM: To investigate the effect of three types of strapping applied in the method described for the application of Kinesio™ tape in the management of CAIS. METHODS This study consisted of three groups of 15 participants (recruited through convenience sampling) with each group receiving a different tape (i.e. rigid, elastic or Kinesio™ tape), all three groups, however, received the same taping method which was the Kinesio™ tape functional correction application. After obtaining informed consent each participant underwent a case history, physical examination and a foot an ankle orthopaedic examination. Thereafter, baseline measurements of subjective pain rating (NRS-101), pain threshold (analogue algometer), ankle dorsiflexion, plantarflexion and inversion (analogue goniometer) and proprioception (Biodex Biosway portable balance system) were documented. Depending on the group, the particular tape was then applied and a follow up consultation was made for two to three days later where the tape was removed, measurements were reassessed and the tape was reapplied. At the final consultation three to four days later, the tape was removed and final measurements were assessed and documented. Statistical intra- (using Wilcoxon Signed Ranks Test) and inter-group (using the Mann-Whitney U-test) analyses of the data were performed due to a skewed distribution of the variables. Data was analysed using SPSS version 21.0 with the level of significance set at 0.05. RESULTS The mean (± SD) age of the participants was 24.8 (4.7) and there were 23 male participants in total. Intra-group analyses of subjective outcome measurements showed significant increases (p < 0.05) in subjective pain rating in all three groups across all consultations. Similarly, intra-group analyses of objective outcome measurements found significant increases (p < 0.05) in pain threshold and dorsiflexion range of motion in all three groups across all consultations. Plantarflexion and inversion range of motion also showed significant increases (p < 0.05) but these were not consistent across all consultations. Intra-group analyses of the sway index showed no significant improvements (p > 0.05) in Groups Two and Three across the three consultations. Only Group One showed significant increases during the eyes open foam surface (EOFoS) (p = 0.013) and eyes closed foam surface (ECFoS) (p = 0.047) test conditions between Consultations One and Two. Inter-group analyses of subjective outcome measurements showed no significant increases (p > 0.05) in subjective pain rating across each of the three consults in all three groups. Inter-group analyses of objective outcome measurements revealed a significant increase in pain threshold (p = 0.040) between Groups Two and Three at Consultation One. There was a significant increase in plantarflexion between Groups One and Three at Consultation Two (p = 0.021) and Consultation Three (p = 0.030). There were no other significant results amongst the three groups. CONCLUSION The results suggest that pain rating, pain threshold and ankle dorsiflexion would improve if taping is applied in the manner described for Kinesio™ tape irrespective of the type of taping used in the management of CAIS. The taping method did not result in a significant difference in proprioception. Further studies, with larger sample sizes are required to confirm the findings of this study and to determine the role of taping in the management of CAIS. / M

M.Tech. / This study was conducted to determine whether Chiropractic treatment was beneficial in improving a male tennis player’s serve speed. Thirty participants were recruited and placed into a single group. Participants were between the ages of 18 and 40 years and selected based on the inclusion criteria being met. Participants had to be injury-free at the time of the research study and fall within a specified skill level (Provincial colours must have been attained at some stage in the participants tennis career). The participants were treated six times over a 3-week period and fifteen serve speed measurements were taken before the first consultation, and following the third and six consultations. A full case history, full physical examination, cervical spine regional examination and shoulder regional examination were conducted at the first consultation to locate joint restrictions and myofascial trigger points in the associated musculature of these areas. Diversified Chiropractic techniques were employed in the treatment of any restrictions found and trigger points were treated using either dry needling or ischaemic compression techniques. The results were interpreted by an outsourced statistician and the data was analysed using the ANOVA model and a Box Cox transformation was applied to transform the scale to normality. This yielded data onto which a parametric approach could be applied. According to the analysis, the treatment applied to the participants produced significant increases in their serve speed over the three sessions, although some increases were more prominent than others. This study concluded that Chiropractic treatment was effective in increasing the serve speed of a male tennis player and the study provides evidence that the effects of Chiropractic treatment could enhance performance in a sporting environment, perhaps even on a sustainable timeline with maintenance treatment.

M.Tech. / Purpose: Acupuncture has been a controversial issue in the medical world for many years before the sceptic western medicine slowly adopted its idea. Some mechanisms for pain relief were clinically researched and proven to be valid as well as effective in treating tension-type headaches (Stux, Berman and Pomerantz, 2003) The purpose of this study was to assess and compare the effects of cervical spine manipulation and needling of acupuncture points in those patients with tension-type headache and suggest another complimentary treatment to the chiropractic manipulation, especially in those patients where manipulation is contraindicated to manipulation. If found to be effective, various mechanisms have been suggested in the formation of tension headache episodes. Those mechanisms may be alterations within the spinal cord and/or brainstem gating mechanisms as a result of facet joint dysfunction, sensitization of nociceptors in the peripheral structures of the body and psychological factors. Method: This study consisted of two groups, consisting of 16 subjects in each group. All participants were screened for tension-type headaches and accepted based on the inclusion and exclusion criteria. The subjects were between the ages of eighteen and thirty-five. Group 1 received chiropractic manipulation treatment to the most restricted levels in their cervical spine. Group 2 received treatment consisting of needling of acupuncture points to specific predetermined points. Procedure: Each successful candidate was treated six times over a 3 week period which included a total of seven sessions. Before the beginning of the treatment, the successful candidate completed the Vernon-Mior Neck Pain and Disability Index Questionnaire and the Numerical Pain Rating Scale. Readings for cervical spine ranges of motion were then taken with a CROM device. In group 1, chiropractic manipulation was then delivered to the most restricted segments in the cervical spine. In group 2, needling of six predetermined acupuncture points for relieving tension-type headache was performed bilaterally. The same treatment procedure was administered at sessions one through six, the CROM readings and questionnaires were taken in sessions one, three, five and seven. Results: The results were obtained by using the Mann-Whitney U and t-test. No statistically significant differences were identified between the groups, when comparing the 2 treatment methods at the visits. However, both groups showed a statistically significant improvement over time within each group individually for subjective measurements and for right lateral flexion in the objective measurements. Conclusion: The results were inconclusive with regards to the prolonged effects of chiropractic manipulation and needling of acupuncture points on cervical spine range of motion in patients with tension-type headache. However, it was concluded that both methods of treatment had beneficial effects on how the participants perceived their pain and disability. Due to the small group of subjects and relatively short duration of the study, accurate conclusions could not be formulated. The findings obtained were insignificant and further research needs to be performed on the effects of cervical spine manipulation and needling of acupuncture points on those suffering with tension-type headache.

M.Tech. (Chiropractic) / Aim: The aim of this study was to determine if a chiropractic adjustment had an effect on muscle strength. The study then aimed to compare the effects a resistance training protocol, to a chiropractic adjustment, to a combination of these two treatments on the neck strength of individuals with cervical facet syndrome. Method: This study consisted of three groups of 10 participants each. The participants were grouped by stratified sampling to balance the groups in terms of age and gender. The participants ranged in age from 22 to 28 years. There were 18 male and 12 female participants. Participants were examined and accepted into the trail according to inclusion and exclusion criteria. Treatment was allocated according to groupings. Group 1 received a resistance training protocol, group 2 received chiropractic adjustment only and group 3 received a combination of both treatments. Procedure: Treatment consisted of 6 treatment sessions and a 7th follow up session, over a three week period. Participants in group 1 and 3 were instructed to perform the demonstrated resistance training protocol 3 times a week for 3 weeks. Participants in group 2 and 3 received chiropractic adjustments to hypomobile cervical spine segments, twice a week for three weeks. Cervical range of motion (CROM) was mesured using a CROM device and strength readings were measured using a hand held isometric dynamometer. Measurements were recorded on the 1st, 4th and 7th visits. All participants were required to fill in a Vernon-Mior Neck Disability Index (NDI) on the 1st and 7th visits. The data collected was analysed by a statistician. Results: Analysis of the Vernon-Mior NDI intra-group results showed that all three groups were effective in reducing cervical pain and disability. There was no statistical difference in improvement between the groups. CROM results indicated that all three groups successfully increased cervical range of motion. The combination group had the greatestimprovement, followed by the adjustment group and lastly the resistance training group. The combination group showed statistical improvements in all ranges of motion at visit 4 while this was only achieved by the resistance training group at visit 7. In the adjustment group statistical changes in flexion, extension and lateral flexion were only noted at visit 7, however in rotation, statistical improvements were noted at visit 4. Isometric dynamometer analysis showed that all 3 groups did show a statistically significant increase in cervical muscle strength. The combination group provided the greatest gains, followed by the adjustment group. The smallest gains were seen in the resistance training group. Statistical changes in the resistance training group were only measured at visit 7, while in the combination and adjustment group, these changes were noted by visit 4. Conclusion: Chiropractic adjustment was effective in increasing neck strength. Of the 3 groups, the combination treatment proved to be the most effective method of improving neck strength in individuals with cervical facet syndrome. Of the two individual treatments, chiropractic adjustment was more effective in terms of both strength gains and time taken to achieve these results, than the resistance training protocol.

M.Tech. / Problem Statement: Myofascial Pain Syndrome (MPS) is a painful and prevalent muscular condition that is characterized by the development of myofascial trigger points (TrP’s). These are locally tender when active and are able to refer pain through specific patterns to other areas of the body distal from the trigger point (Manga, 2008). Myofascial trigger points are a frequently overlooked and misunderstood source of the distressingly ever-present musculoskeletal aches and pains of mankind and many authors have found that the trapezius muscle is most often the muscle that has frequent myofascial trigger points (Travell and Simons, 1999). Much debate and discussion has arisen on the merits of the fanning dry needling technique compared to that of the static dry needling technique, but research evidence is very limited. Some practitioners prefer the static technique over the fanning technique as it reduces the presence and amount of post-needling soreness, as well as reduces the possibility of penetrating a blood vessel resulting in hemorrhaging. Other practitioners prefer the fanning technique as it increases the chances of locating the loci of the TrP, as well as increasing the chances of eliciting a local twitch response and possibly making this method more effective in deactivating a TrP than the static technique. Aim of Study: The aim of this study was to compare the effects of static myofascial dry needling to the effects of fanning myofascial dry needling of an active trigger point (TrP1) in the upper trapezius muscle in order to determine which of the two treatments is more effective with regards to decreasing neck pain and disability as well as increasing pressure pain threshold in patients with neck pain due to Trapezius Myofascial Pain Syndrome. Method: Forty participants underwent a general screening to determine whether they had active myofascial trigger points in the upper fibers of the trapezius muscle.