Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2014. / Aim: The aim of this study was to evaluate the normal selected radiographic parameters (thoracic kyphosis (TK), anterior vertebral body height (AVBH), posterior vertebral body height (PVBH), intervertebral disc height (IVDH) and interpedicular distance (IPD)) in young to middle-aged males across the four racial groups in Durban. Participants: Eighty young to middle-aged apparently healthy males between the ages of 18-45 years from the White, Black, Indian and Coloured racial groups in Durban. Methodology: After written informed consent was acquired, all participants underwent a case history, physical examination and thoracic orthopaedic examination. An AP and lateral radiograph of the thoracic spine was then obtained. The TK, AVBH, PVBH, IVDH and IPD were assessed using methods described previously. The IBM SPSS version 20 was utilized for the data analysis. Mean, standard deviation (SD) and range are reported for the TK, AVBH, PVBH and IPD for each of the four racial groups. For the IVDH, however, the median for the respective vertebral levels is given. ANOVA testing with Bonferroni post-hoc tests were used to determine overall inter-group variations and compare each group to the other. Pearson’s correlation test was used to determine the relationship between the thoracic kyphosis and the other radiographic parameters that were assessed. Results : The mean, SD, minimum and maximum values of the thoracic kyphosis by racial group There was no significant difference in the TK among the four race groups. Significant differences (p < 0.05) were observed in the AVBH, PVBH, IVDH and IPD between the White, Black, Indian and Coloured males at various thoracic levels. Conclusion: The trends of the various radiographic parameters observed in this study support the argument that these parameters should be based on sex, age and geographic race. These values would be useful for South African spinal health care practitioners in the diagnosis and management of spinal disorders.

Dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic at the Durban University of Technology, 2009. / It has been noted that in many recent research studies mechanical neck pain is a serious problem in the world today. There are epidemiological and statistical studies documenting the high incidence and prevalence of mechanical neck pain, which effects people’s daily living (Drew, 1995; Ferrari and Russell, 2003; Cote et al., 2000, Venketsamy, 2007 and Haldeman et al., 2008). Background: Treatments for chronic neck pain, which are non-surgical, appear to be the most beneficial for patients (Haldeman, 2008). In brief, the presentation of chronic mechanical neck pain is defined as localised, asymmetrical neck pain with restricted range of motion and dysfunctional musculature (Grieve, 1988). The muscular dysfunction known as the upper cross syndrome is defined as tightness of the upper trapezius, pectoralis major and levator scapulae and weakness of rhomboids, serratus anterior, middle and lower trapezius and deep neck flexors. These muscles are responsible for stabilizing the scapula and the patient may present with rounded, elevated shoulders and anterior head carriage when diagnosed with this syndrome (Liebenson, 1996). Clinical trials conducted by Cassidy et al., (1992 a, b) concluded that spinal manipulative therapy (SMT) was highly effective in treating mechanical dysfunctions within the cervical spine. However, due to multi systemic involvement of the muscular, neural and passive systems in mechanical neck pain, the treatment may need to target all three of the subsystems of spinal stability to be most effective (Panjabi, 1992 a, b; Lee et al., 1998; Lee 2004 and Richardson et al., 2002). No research has been conducted on the effects and benefits of treatment directed on the cervical spine and upper cross syndromes. This research will compare scapula stabilization training and SMT to SMT in isolation, as a treatment for chronic mechanical neck pain. Objectives: The purpose of this study was to determine the effect that scapula stabilization had on chronic mechanical neck pain. Pilates exercises were used to strengthen and stabilize the scapula muscles (this included stretching out the hypertonic musculature of the upper cross syndrome). The aim was to improve posture as well as to decrease the mechanical stress on the neck. SMT was also concomitantly used to correct any cervical restrictions that were present. These results were then compared to the results of a group that only received spinal manipulative therapy. The null hypothesis was that the intervention group would not respond differently to the treatment protocol in terms of the subjective and objectives measurements. iv Method: This clinical trial was conducted on a sample population of 30 patients with chronic mechanical neck pain. Each patient was assigned to one of two groups (n=15) according to convenience sampling. Both groups received SMT to the cervical spine, while group B (intervention group) also received pilates classes twice weekly for four weeks, which retrained the scapula stabilization muscles to function optimally. The patients each underwent six spinal manipulative treatments over four weeks and a seventh consultation in the fifth week for data collection. Both groups were evaluated in terms of subjective and objective clinical findings. Subjectively the assessment included 2 questionnaires (Numerical Pain Rating Scale and Canadian Memorial Chiropractic College [CMCC] neck disability index). Objective assessment included cervical motion palpation, Cervical Range Of Motion goniometer (CROM) measurements, scapula stabilization tests and a postural analysis with the use of digital photography. The statistics were completed under the guidance of a biostatistician, from the College of Health Science, University of KwaZulu – Natal, (Esterhuizen, 2008) who analyzed the captured data with the use of SPSS version 15. All outcome measures were quantitative. Repeated measures ANOVA testing was used to assess the presence of a different effect for each outcome measure over time between the two treatment groups. A statistically significant time by group effect would indicate a significant treatment effect. The minimum significance level was 0.05. The trends and direction of the effect were assessed via profile plots. Result: According to the statistical analysis, both groups showed improvements - subjectively and objectively - with regards to chronic mechanical neck pain, which is in keeping with the literature. In terms of the inter-group comparison the SMT group (Group A) showed a more constant improvement in range of motion, pain and disability indexes with the SMT only group while the SMT and pilates group (Group B) showed a greater effect in stabilizing the scapula and increasing the functionality of the surrounding musculature. Conclusions and Recommendations: The intervention treatment (Group B) did not have a greater effect on the short-term treatment of chronic mechanical neck pain than the reference group (Group A). It was also evident that the intervention group (Group B) often continued to improve when the SMT (Group A) only group often regressed at the follow up sessions. This improvement was either not significant enough or v the follow up session did not allow for enough time for a true reflection to be noted. It is recommended that more research be carried out to gain conclusive results indicating whether there is a more beneficial long term result to this treatment protocol.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2011. / Introduction: Radiographic parameters of the cervical spine are utilized by chiropractors and spinal surgeons for making diagnoses and determining management protocols. However several researchers have reported discrepancies in these parameters which need to be investigated across ethnic groups and gender. Aim: To evaluate the normal selected cervical spine radiographic parameters i.e. the cervical lordosis (CL), sagittal canal diameter (SCD), interpedicular distance (IPD), and the cervical gravity line (CGL) in apparently healthy young to middle-aged males across four ethnic groups in Durban, KwaZulu Natal. Participants: Eighty healthy male participants between 18 and 45 years of age of White, Black, Indian and Coloured ethnicity. Methodology: A case history, physical examination and an orthopedic assessment of the cervical spine was conducted for each participant. Study-specific data such as age, ethnicity, weight and height were recorded. A lateral and an A-P radiograph of the cervical spine was taken of each participant. Selected radiographic parameters viz. SCD, IPD, CL, CGL were assessed and recorded. SPSS version 15.0 (SPSS Inc., Chicago, Illinois, USA) was used for data analysis. Results: The mean (± SD) values of the CL, SCD and IPD are shown in the table below for the respective ethnic groups Parameter Ethnic Group Black (Mean (± SD)) White(Mean (± SD)) Indian(Mean (± SD)) Coloured (Mean (± SD)) CL° (C1-C7 method) 42.6° (± 9.6°) 46.2° (± 11.0°) 46.5° (± 11.3°) 47.7° (± 9.1°) CL° (C2-C7 method) 15.1° (± 6.4°) 17.4° (± 9.3°) 13.1° (± 10.2°) 18.1° (± 10.4°) SCD (mm) C2 22.1mm (± 1.6) 24.1mm (± 1.4) 22.8mm (± 1.7) 22.9mm (± 1.5) C3 19.5mm (± 1.6) 20.6mm (± 1.4) 19.7mm (± 1.6) 20.0mm (± 1.5) C4 18.6mm (± 1.9) 19.9mm (± 1.3) 19.1mm (± 1.6) 19.5mm (± 1.3) C5 18.9mm (± 1.8) 20.0mm (± 1.5) 19.3mm (± 1.7) 19.8mm (± 1.6) C6 18.8mm (± 1.7) 20.4mm (± 1.5) 19.5mm (± 1.6) 20.0mm (± 1.8) iv C7 18.5mm (± 1.7) 20.3mm (± 1.5) 19.4mm (± 1.6) 19.7mm (± 1.9) IPD (mm) C3 28.2mm (± 1.2) 28.9mm (± 1.8) 27.8mm (± 1.1) 29.1mm (± 1.4) C4 28.6mm (± 1.4) 29.6mm (± 1.8) 28.5mm (± 1.4) 29.5mm (± 1.6) C5 29.4mm (± 1.2) 30.0mm (± 1.7) 28.8mm (± 1.2) 30.1mm (± 1.5) C6 29.3mm (± 1.6) 30.7mm (± 1.6) 30.0mm (± 1.6) 30.1mm (± 1.5) C7 29.3mm (± 1.2) 30.1mm (± 1.5) 29.6mm (± 1.6) 30.3mm (± 1.9) There was anterior placement of the CGL in 60% of the Black ethnic group, 45% of the White ethnic group, 55.6% of the Indian ethnic group and 52.6% of the Coloured ethnic group. No significant differences in mean CL was observed across the four ethnic groups for both methods utilized (p > 0.05). The significant differences in SCD lay between the White and Black ethnic groups at C2, C6 and C7 (p = 0.002, 0.030 and 0.017, respectively, ANOVA). The C3 and C5 IPD varied significantly between the Coloured and Indian ethnic group (p = 0.048 and 0.027, respectively, ANOVA). The CGL was not influenced by the CL in all the ethnic groups. Conclusion: Significant differences were observed between ethnic groups for the SCD and IPD. These will assist South African health care practitioners with patient management within these ethnic groups when diagnosing spinal stenosis and tumors. A larger South African based population should be evaluated to confirm the trends observed utilizing digitized diagnostic imaging modalities including radiographs, CT and MRI scans as errors may occur during manual assessment of conventional radiographs.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2012. / Aim: To evaluate the normal selected cervical spine radiographic parameters i.e. the cervical lordosis (CL), sagittal canal diameter (SCD), interpedicular distance (IPD) and cervical gravity line (CGL) in asymptomatic young to middle-aged females across four ethnic groups (Black, White, Indian and Coloured) in Durban, KwaZulu Natal, South Africa. Participants: Eighty apparently healthy females between the ages of 18 and 45 years from the Black, Indian, Coloured and White ethnic groups in Durban, KwaZulu Natal. Methodology: Written informed consent was obtained from each participant. A case history, physical examination and an orthopaedic assessment of the cervical spine was conducted for each participant. Study specific data such as ethnicity, age, height and weight was recorded. A lateral and an A-P radiograph of the cervical spine were taken for each participant. The selected radiographic parameters viz. cervical lordosis (CL), sagittal canal diameter (SCD), interpedicular distance (IPD) and cervical gravity line (CGL) were evaluated according to methods described previously. SPSS version 15.0 (SPSS Inc., Chicago, Illinois, USA) was used for data analysis. Coefficients of variation were calculated within ethnic groups to assess intra-group variation. Inter-group variation was assessed using ANOVA testing with Bonferroni-adjusted post-hoc tests in the case of a significant ANOVA test. Pearson’s chi square test was used to assess the association between ethnic groups and position of the CGL. T-tests were used to compare mean CL between those with anterior and normally placed CGL within each ethnic group. Results: The mean ± SD of the CL in South African females by ethnic group using the C1-C7 and C2- C7 methods CERVICAL LORDOSIS (mean ± SD) (°) ETHNICITY C1-C7 C2-C7 Black 42.1° (±13.4) 16.3° (±8.3) White 37.4° (±10.3) 9.9° (±4.8) Indian 33.7° (±9.7) 6.9° (±4.8) Coloured 42.5°(±10.9) 12.1° (±9.5) The mean ± SD of the SCD in South African females by ethnic group SAGITTAL CANAL DIAMETER (mean ±SD)(mm) ETHNICITY Black White Indian Coloured SCDC2 SCDC3 SCDC4 SCDC5 SCDC6 SCDC7 20.2 (±1.7) 17.4 (±1.4) 17.2 (±1.4) 17.0 (±1.4) 17.6 (±1.3) 17.5 (±1.4) 20.8 (± 2.2) 17.9 (±1.6) 17.6 (±1.6) 17.4 (±1.6) 17.6 (±1.4) 21.0 (±2.0) 18.2 (±1.7) 17.5 (±1.5) 17.4 (±1.7) 17.6 (±1.6) 17.1 (±1.5) 20.3 (±1.6) 17.5 (±1.8) 17.4 (±1.5) 17.7 (±1.2) 17.6 (±1.3) 16.9 (±1.2) 16.9 (±1.4) The mean ± SD of the IPD in South African females by ethnic group INTERPEDICULAR DISTANCE (mean ±SD)(mm) ETHNICITY IPDC3 IPDC4 IPDC5 IPDC6 IPDC7 Black 27.0 (±2.8) 27.6 (±3.2) 28.2 (±4.0) 28.9 (±4.2) 27.5 (±3.5) White 28.4 (±2.6) 28.8 (±2.2) 29.5 (±2.3) 29.3 (±2.5) 28.2 (±2.9) Indian 27.2 (±1.8) 27.5 (±1.8) 27.9 (±1.6) 27.9 (±1.6) 27.5 (±2.0) Coloured 27.9 (±2.3) 27.8 (±2.3) 28.3 (±2.2) 28.4 (±1.8) 28.2 (±1.7) The placement of the CGL in South African females in each ethnic group CERVICAL GRAVITY LINE ETHNICITY PLACEMENT OF CGL Black 70% anterior placement White 70% anterior placement Indian 60% anterior placement Coloured 60% anterior placement The C1-C7 measurements and the C2-C7 CL measurements were significantly different amongst the ethnic groups. For the C2-C7 method, Blacks differed significantly from both Whites (p = 0.037) and Indians (p = 0.001; Bonferroni adjusted post-hoc test); with the values for the Blacks being higher than both Whites and Indians. There was no correlation between CL and BMI amongst any of the selected ethnic groups. There were no significant differences in the mean SCD and IPD amongst the ethnic groups (p > 0.05; ANOVA test). There was no significant association between any ethnic group and the position of the CGL (p = 0.830; Pearson’s chi square test). In Black females, those with a normally positioned CGL had significantly higher C2-C7 CL measurements (p = 0.008; T- tests). There was no correlation between the CL and anterior placing of the CGL in any of the ethnic groups. Conclusion: No individual differences were observed in the CL amongst the ethnic groups when using the C1-C7 method. However, significant differences were observed when the C2-C7 method was used. There were no significant differences observed in the mean SCD and IPD amongst the ethnic groups. In Black females, those with a normally positioned CGL had significantly higher C2-C7 CL measurements. The trends observed in this research study and the differences in the findings to those of previous studies lay the platform for a larger population-based study across South Africa to establish normative reference values for each radiographic parameter specific for gender and ethnicity.

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic Durban University of Technology, 2013. / Background : Chronic non-specific neck pain is a common condition that negatively affects cervical muscle functioning and activities of daily living. Combined exercise and mobilisation are currently recommended as the most effective treatment for this condition. Mobilisation, such as mobilisation of the cervical spine, provides short-term pain relief and affects neural activity, while the craniocervical flexion exercise provides immediate pain relief and activates the deep cervical flexors. The short-term effect of mobilisation and the craniocervical flexion exercise have not been compared. Objectives : This study aimed to compare mobilisation and craniocervical flexion exercise in terms of subjective and objective outcome measures at a short-term follow-up consultation for the treatment of chronic non-specific neck pain. The null-hypothesis was that the mobilisation group would not respond differently to the craniocervical flexion exercise group. Method : A group of thirty females between the ages of 20 and 35 complaining of non-specific neck pain for more than three months were randomly allocated into either the mobilisation or craniocervical flexion exercise groups. During the first two consultations, a mobilisation was administered to the mobilisation group. Whereas the craniocervical flexion exercise and a posture correcting exercise were taught to the participants of the craniocervical flexion exercise group. The Numerical Pain Rating Scale, Neck Disability Index, Neck Bournemouth Questionnaire, cervical range of motion and algometer readings were taken at each of the three consultations. The Patient Global Impression of Change Scale was administered at the last consultation one week after the first consultation. Results : Both the mobilisation and craniocervical flexion exercise groups showed significant improvements in all of the subjective outcomes. The Neck Disability Index score of the craniocervical flexion exercise group was the only subjective outcome that did not decrease enough to be considered clinically significant. The PGIC score of the mobilisation group was slightly higher than that of the craniocervical flexion exercise group. There was no statistically significant improvement in the objective outcomes of either group. All ranges of motion decreased in both groups, while pain pressure threshold improved in both groups. There was no significant difference between the results of the subjective and objective outcomes of the mobilisation and craniocervical flexion exercise groups. Conclusions and recommendations : The two interventions were found to have a similar effect in the treatment of chronic non-specific neck pain in terms of subjective and objective outcome measures. Participants of both groups indicated on the subjective scales that their conditions improved, even though objective outcomes showed no significant change. In future studies, a larger sample size should be used and the sample should be stratified for ethnicity to increase validity of the results.

Submitted in partial compliance with the requirements for the Masters’ Degree in Technology: Chiropractic, Department of Chiropractic, Durban University of Technology, Durban, South Africa, 2014. / Background: Spinal manipulation has been shown to result in neurophysiological changes, most often noted in the paraspinal muscles. These effects have been associated with an increase in paraspinal muscle contractibility; it is unclear if this leads to an increase in paraspinal muscle endurance. Objectives: To determine the effect of sacroiliac joint (SIJ) manipulation compared to a placebo treatment of the SIJ on lumbar extensor muscle endurance time. Method: A randomised, placebo-controlled pre-test post-test experimental trial, involving 40 asymptomatic male participants divided into an intervention group receiving SIJ manipulation using an impulse adjusting instrument and a placebo group receiving a pre-load force without the delivery of an impulse thrust. Outcome measures were lumbar extensor muscle endurance time, surface electromyographic (SEMG) readings, lumbar spinal range of motion, paraspinal muscle length assessment and a subjective pain measurement. Results: There was a significant difference between the groups (p=0.004) with the SIJ manipulation group showing an increase in endurance time compared to the placebo group which showed a decrease. SEMG readings increased for both groups with no statistically significant difference between the groups (p>0.05). Only extension lumbar spinal range of motion significantly improved in both groups (p=˂0.001) with no significant differences between groups (p=0.876). Only one participant reported pain during the research procedure. Conclusions: SIJ manipulation may enhance the endurance of the paraspinal muscles. This study should be conducted in a larger sample to validate the findings.

Dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic at the Durban University of Technology, 2009. / It has been noted that in many recent research studies mechanical neck pain is a serious problem in the world today. There are epidemiological and statistical studies documenting the high incidence and prevalence of mechanical neck pain, which effects people’s daily living (Drew, 1995; Ferrari and Russell, 2003; Cote et al., 2000, Venketsamy, 2007 and Haldeman et al., 2008). Background: Treatments for chronic neck pain, which are non-surgical, appear to be the most beneficial for patients (Haldeman, 2008). In brief, the presentation of chronic mechanical neck pain is defined as localised, asymmetrical neck pain with restricted range of motion and dysfunctional musculature (Grieve, 1988). The muscular dysfunction known as the upper cross syndrome is defined as tightness of the upper trapezius, pectoralis major and levator scapulae and weakness of rhomboids, serratus anterior, middle and lower trapezius and deep neck flexors. These muscles are responsible for stabilizing the scapula and the patient may present with rounded, elevated shoulders and anterior head carriage when diagnosed with this syndrome (Liebenson, 1996). Clinical trials conducted by Cassidy et al., (1992 a, b) concluded that spinal manipulative therapy (SMT) was highly effective in treating mechanical dysfunctions within the cervical spine. However, due to multi systemic involvement of the muscular, neural and passive systems in mechanical neck pain, the treatment may need to target all three of the subsystems of spinal stability to be most effective (Panjabi, 1992 a, b; Lee et al., 1998; Lee 2004 and Richardson et al., 2002). No research has been conducted on the effects and benefits of treatment directed on the cervical spine and upper cross syndromes. This research will compare scapula stabilization training and SMT to SMT in isolation, as a treatment for chronic mechanical neck pain. Objectives: The purpose of this study was to determine the effect that scapula stabilization had on chronic mechanical neck pain. Pilates exercises were used to strengthen and stabilize the scapula muscles (this included stretching out the hypertonic musculature of the upper cross syndrome). The aim was to improve posture as well as to decrease the mechanical stress on the neck. SMT was also concomitantly used to correct any cervical restrictions that were present. These results were then compared to the results of a group that only received spinal manipulative therapy. The null hypothesis was that the intervention group would not respond differently to the treatment protocol in terms of the subjective and objectives measurements. iv Method: This clinical trial was conducted on a sample population of 30 patients with chronic mechanical neck pain. Each patient was assigned to one of two groups (n=15) according to convenience sampling. Both groups received SMT to the cervical spine, while group B (intervention group) also received pilates classes twice weekly for four weeks, which retrained the scapula stabilization muscles to function optimally. The patients each underwent six spinal manipulative treatments over four weeks and a seventh consultation in the fifth week for data collection. Both groups were evaluated in terms of subjective and objective clinical findings. Subjectively the assessment included 2 questionnaires (Numerical Pain Rating Scale and Canadian Memorial Chiropractic College [CMCC] neck disability index). Objective assessment included cervical motion palpation, Cervical Range Of Motion goniometer (CROM) measurements, scapula stabilization tests and a postural analysis with the use of digital photography. The statistics were completed under the guidance of a biostatistician, from the College of Health Science, University of KwaZulu – Natal, (Esterhuizen, 2008) who analyzed the captured data with the use of SPSS version 15. All outcome measures were quantitative. Repeated measures ANOVA testing was used to assess the presence of a different effect for each outcome measure over time between the two treatment groups. A statistically significant time by group effect would indicate a significant treatment effect. The minimum significance level was 0.05. The trends and direction of the effect were assessed via profile plots. Result: According to the statistical analysis, both groups showed improvements - subjectively and objectively - with regards to chronic mechanical neck pain, which is in keeping with the literature. In terms of the inter-group comparison the SMT group (Group A) showed a more constant improvement in range of motion, pain and disability indexes with the SMT only group while the SMT and pilates group (Group B) showed a greater effect in stabilizing the scapula and increasing the functionality of the surrounding musculature. Conclusions and Recommendations: The intervention treatment (Group B) did not have a greater effect on the short-term treatment of chronic mechanical neck pain than the reference group (Group A). It was also evident that the intervention group (Group B) often continued to improve when the SMT (Group A) only group often regressed at the follow up sessions. This improvement was either not significant enough or v the follow up session did not allow for enough time for a true reflection to be noted. It is recommended that more research be carried out to gain conclusive results indicating whether there is a more beneficial long term result to this treatment protocol.

M.Tech. (Chiropractic) / Brain hibernation or cerebral dysfunction theory is the diminishing of brain function due to poor blood flow as a result of compression of the vertebral, basilar, internal carotid and subclavian arteries (Buchanan, 2004). Compression is usually due to skeletal malalignment, ligamentous or muscular in origin and correction of this by cervical spine manipulation suggests that the above difficulties may be improved with manipulative and manual techniques (Buchanan, 2005). Thomas and Wood (1992), suggest that there is a correlation between upper cervical adjustments and improved mental function. This has been shown by Shambaugh, Pearlman and Hauck (1991), who showed that after an adjustment, there was an improved brain stem evoked response which indicated that neural messages were travelling through the brain stem quicker or with less delay. Terrett (1993), has proposed that cervical manipulative therapy results in augmented cerebral blood flow, which culminates in hibernating areas of the brain becoming functional again. The higher cognitive skills tend to be affected by the decrease in blood flow. Cognitive skills are vital to the process of learning, spelling and reading. Edublox is a company that has special training programmes to develop these skills to maximise a childs potential. The aim of this study is to determine the effects of cervical manipulations combined with Edublox training versus Edublox training alone on visual spatial memory. The focus of the study would be to determine whether chiropractic cervical manipulation has a significant effect on mental function and visual memory when combined with Edublox training. The study will include a total of 34 participants split into two groups, one receiving Edublox training and the other receiving Edublox training combined with cervical spine manipulations. Participants approximately between the ages of ten and thirteen years of age will be included in this study. The manipulation group will receive spinal manipulative therapy followed by both groups receiving the same Edublox training session to limit variation. The participants shall receive an intense program of Edublox training, every day for the duration of five days and the combined group will receive adjustment every other day. The research will be conducted at the premises of Confidence College. Subjective and objective measurements will be taken at the beginning and at the end of the five days. The subjective measurement will include an Observer Memory Questionnaire – Parent Form that will be completed by the parent of the child based on their view of their child’s memory. The objective measurement will include two sub-tests from the Visual Perceptual Skills Test 3, namely the visual memory (VM) and visual sequential memory (VSM) components.

A dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Durban University of Technology, 2007. / The increasing contribution of chiropractors in health care has generated greater interest in understanding the characteristics of chiropractic practice patterns and treatments (Mootz et al., 2005). However, despite the rapid growth and extensive use of chiropractic, good descriptive data on chiropractors and their patients remains limited (Coulter and Shekelle, 2005). Even fewer studies have been reported which deal specifically with patients attending chiropractic-teaching clinics (Nyiendo and Olsen, 1988). According to Nyiendo and Haldeman (1986), there remains a paucity of empirical data regarding the type of patients seeking care at a chiropractic-teaching clinic and the types of treatments provided at these clinics. According to Till and Till (2000), South Africa is largely a developing country with scattered developed communities. Its requirements and opportunities as they relate to chiropractic may differ significantly from those in other developed countries. It was also estimated that in South Africa only a fraction of the country’s population have any notion of what chiropractic is, thus the largest challenge lies with educating the public about chiropractic (http://www.chiroweb.com, 2005). The lack of attention given to the chiropractic management of extremity conditions has contributed to a perception that chiropractic is unable to manage extremity conditions proficiently (Hoskins et al., 2006). There is a noted lack of research on the management of extremity conditions within chiropractic (Hoskins et al., 2006); therefore the current study focused on all components of the extremity system. Objectives: The purpose of this research is to conduct a descriptive study of extremity cases on record at the Durban University of Technology Chiropractic Day Clinic from 1995 to 2005 and the objectives are as follows: •To determine the prevalence of extremity complaints over the past decade at the Durban University of Technology Chiropractic Day Clinic. •To identify the demographics of patients that visited the Durban University of Technology Chiropractic Day Clinic. •To identify the most common presenting region and complaints of the extremity system as well as the aetiology and associated signs and symptoms of these complaints at the Durban University of Technology Chiropractic Day Clinic. •To identify the nature of the interventions and methods most commonly used in the management of patients at the initial consult and where possible contra-indications to any treatment modality / M

M.Tech. (Chiropractic) / Purpose: The aim of this study was to look at the effectiveness of massage with MYO₂ gel in conjunction with Spinal Manipulative Therapy (SMT) for the treatment of patients with posterior mechanical neck pain, with regards to pain, disability and cervical spine range of motion. The effect of these treatments was evaluated using a questionnaire consisting of Visual Analogue Scale (VAS) and a Vernon-Mior Neck Pain and Disability Index Questionnaire, and by measuring cervical spine range of motion using a cervical range of motion (CROM) measuring device. Method: 30 participants with posterior mechanical neck pain were randomly divided into two groups based on the order they start the study in. Group A – control group, received SMT to the cervical spine, followed by massage with ultrasound gel over the upper trapezius muscle and the area of the posterior neck musculature. Group B – experimental group, received SMT of the cervical spine, followed by massage with MYO₂ gel over the upper trapezius muscle and the area of the posterior neck musculature. Participants were treated six times out of a total of seven sessions, over a maximum three week period. Procedure: Subjective data was collected at the beginning of the first and fourth and seventh consultations. This was done by means of a Visual Analogue Scale (VAS) and a Vernon- Mior Neck Pain and Disability Index Questionnaire in order to assess pain and disability levels. Objective data was collected at the beginning of the first, fourth session, and seventh consultation by means of measuring cervical spine range of motion using a cervical range of motion (CROM) measuring device. Analysis of collected data was performed by a statistician from STATKON; a department of the University of Johannesburg. Results: When comparing the VAS of the initial with the final consultation it showed a statistically significant difference in both groups. This indicated that both interventions were effective in decreasing the perceived level of neck pain (VAS score). When comparing the Neck Pain and Disability Index of the initial with the final consultation it showed a statistically significant difference in both groups. This indicated that both interventions were effective in decreasing neck pain and disability of the cervical spine. When comparing the Cervical Range of Motion (CROM) of the initial consultation with the final consultation it showed a statistically significant improvement in both groups in all directions of motion. Both groups resulted in an increase in range of motion over time. Group B had a greater average CROM percentage increase of 28.60% average compared to Group A which had an average percentage increase of 22.25%.