M.Tech. (Chiropractic) / Introduction The aim of this study is to determine whether standard leg rubs and reassurance combined with lumbosacral manipulations have an effect on growing pain symptoms by comparing it to standard leg rubs and reassurance only. The study can possibly serve as a platform for further research. Furthermore, this will be one of the first chiropractic studies done in this field and may provide the chiropractic profession with a proven treatment for growing pains. Methodology Thirty participants with growing pains between the ages of 4 and 12 years were recruited. The participants were placed into two groups of fifteen participants each on a first come first serve basis. The two groups received different treatment protocols according to their group allocation. Group One received chiropractic manipulative therapy to the lumbar spine and sacroiliac joint restrictions combined with legs rubs and reassurance administered by the parent(s)/guardian(s). Group Two received only legs rubs and reassurance administered by the parent(s)/guardian(s). The participants completed the study over a period of three weeks. Subjective and objective readings were taken. Subjective readings from each participant were taken using the Oucher self-rating pain scale (OSRPS) and a pain diary completed by the parent(s)/guardian(s). Objective readings were taken using a pressure algometer over the anterior tibial muscles bilaterally. A six-week post study follow up was done via email. Results The statistical data was analyzed using the Friedman test, Mann-Whitney test and the Wilcoxon Signed-Rank test. The results demonstrated that both groups responded favourably to their specific treatment over time. However, Group One proved to show a quicker response to treatment over time; and the post study follow up of Group One proved to be significantly more positive than Group Two. These results highlight the positive effects of the chiropractic manipulation. Discussion The fact that the participants of Group One have improved in subjective and objective measurements and the parent(s)/guardian(s) of the participants have responded very positively to the post study follow up, one has to consider that the anatomical theory proposed by Evans and Scutter (2007), the pain referral theory supported by Cookson (2003) and the activation of pain inhibitory systems supported by Wright (1995) and Sterling et al. (2001) might all be a likely aetiologies for growing pains. However, one has to consider that the participants from Group Two, who received no spinal manipulation, have also improved in subjective and objective readings. Therefore it is possible, and cannot be excluded, that the leg rubs administered to both groups could also have played a role in relieving the growing pains. Conclusion The results of the data collected from this study, the pressure algometer and OSRPS readings, showed that spinal manipulation did not have much of a benefit. However, the pain diaries and feedback from the parent(s)/guardian(s), which are probably more reliable for growing pains, indicates that spinal manipulation does show to be beneficial.

M.Tech. (Chiropractic) / PURPOSE: Shoulder pain has been identified to be one of the most common musculoskeletal problems found in a variety of different countries, showing characteristics of chronicity and recurrence. It is considered to be a main contributor towards nontraumatic upper limb pain. One of the identifiable causes of chronic or reoccuring shoulder pain may be attributed to myofascial pain syndrome which is caused by MTrP’s and produces symptoms that are similar to that of other shoulder pain syndromes. The infraspinatus muscle as an integral component of the rotator cuff complex is subject to high tension biomechanical strain as well as neuromuscular tension. While therapeutic interventions have been devised to treat varying degrees of biomechanical and neuomuscular tension, little evidence exists establishing which of these treatment regimes is most effective in treating myofascial trigger points. The purpose of this study was to compare different regional chiropractic adjustments relative to the attachment site and the innervation segment of the infraspinatus muscle and to identify the most effective treatment protocol with regard to chronic, active infraspinatus myofascial trigger point dysfunction. DESIGN: A selection of thirty participants were recruited for this study. The participants were divided into two groups of fifteen participants each. Group A received a chiropractic adjustment to the glenohumeral joint, the attachment site for infraspinatus muscle. Group B received a chiropractic adjustment to the cervical spine segments associated with the innervation to the infraspinatus muscle. Cervical spine restrictions specific to levels C4/C5 and/or C5/C6, and glenohumeral joint restrictions were determined using motion palpation techniques. All participants received a total of six treatments over a three-four week period. MEASUREMENTS: Subjective measurements were obtained by the Functional Rating Index Questionnaire and the Numerical Pain Rating Scale. Objective measurements were obtained using the hand-held pressure algometer and counting the number of active infrapsinatus myofascial trigger points. The data was collected on the first, fourth and seventh consultations. OUTCOME: With regards to the subjective readings, the results from the Functional Rating Index Questionnaire for the intragroup analysis indicated that the glenohumeral joint adjustment group showed the greatest improvement over time (15.5%). No statistically significant differences were noted for the intergroup analysis. The intragroup analysis of the Numerical Pain Rating Scale indicated that the glenohumeral joint adjustment group showed the greatest improvement over time (68.8%). The intergroup analysis indicated that there were no statistically significant differences. vii With regard to the objective measurements, the intragroup analysis of the pressure algometer readings indicated that the glenohumeral joint adjustment group showed the greatest improvement over time (21.7%). There were no statistically significant differences with the intergroup analysis. The intragroup and intergroup analysis of the number of active infraspinatus myofascial trigger point dysfunction showed no statistically significant differences between the groups or within each of the groups over time. CONCLUSION: The results showed that both treatment groups protocols were effective in reducing chronic, active infraspinatus myofascial trigger point dysfunction. Small differences were noted between the two treatment groups with regards to the subjective and objective findings. The glenohumeral joint adjustment group showed the greatest clinical and statistical improvements over the three-four week trial period.

M.Tech. / This research study was conducted as an unblinded controlled pilot study. The aim of this research was to investigate the effects of Chiropractic adjustive therapy on lower back pain in South African Police Service (SAPS) operational mounted policemen in Gauteng. The participants for this research where obtained from the Johannesburg, East Rand, Vaal Rand and Pretoria SAPS Mounted units. Only male participants were recruited and placed into one group where they received Chiropractic adjustive therapy to the restricted Lumbar and Sacroiliac joints. Thirty participants were treated 6 times over a 3-week period, which translated to 2 treatments per week. A two day follow-up visit (visit 7) was conducted to obtain only subjective and objective data, no treatment was administered. An important part of this study was that the duties of the participants continued as usual and were not stopped during this trial. Subjective data was collected using the Oswestry Pain and Disability Questionnaire. Objective data was collected using lumbar range of motion (with a Digital Inclinometer) in flexion, extension, lateral flexion and rotation. All data was collected during the 1st, 4th and 7th visits. Additional data was collected by enquiring about the saddle type and stirrup length that the participants used. The data collected was analysed using Maunchly and Greenhouse Tests for parametric tests and the Friedman and Wilcoxon Signed Rank Tests for the non-parametric tests. The results of this study concluded that Chiropractic adjustive therapy was effective in relieving or completely eliminating the lower back pain of the participants as well as increasing there lumbar spine range of motion.

M.Tech. (Chiropractic) / Purpose: The pelvis, femur, tibia, fibula, ankle and foot form a closed kinematic chain during gait. According to biomechanical principles any restriction or tension in one part of the kinematic chain will create increased load on the other parts of the same chain (Comerford and Mottram, 2001; Sahrmann, 2000). This increased load can lead to dysfunction and compensation along the chain and also lead to gait anomalies. A chiropractic adjustment is utilised for the treatment of sacroiliac joint restrictions. There has not been research conducted to establish the effects that a chiropractic adjustment has on lower limb biomechanics and gait. The purpose of this study was to determine whether a sacroiliac adjustment had an effect on gait by looking at the gait parameters. Method: Sixty participants who were between the ages of 18 and 40 years were recruited. The participants were asked to sign a consent form and then a thorough history and physical examination was performed to ensure that participants did not have any disease or pathology that may have excluded them from the study. These included foot pathologies, knee pathologies, hip pathologies, structural leg length discrepancies, or any contraindications to chiropractic adjustment. A lumbar spine regional examination as well as motion palpation of the sacroiliac joints was performed to determine which joints were restricted. Each participant then underwent a gait assessment before and after they received a chiropractic adjustment to the restricted sacroiliac joint. Procedure: Participants only received one adjustment. Objective measurements were obtained using the Zebris FDM gait analysis system. This system uses high-quality capacitive force sensors that are arranged in matrix form. As a result, each sensor produces its own calibration curve. The measuring plates enable the static and dynamic force distribution to be analysed under the feet while standing and walking. The measuring plate is integrated in a level walking area. The measuring parameters are automatically calculated in the WinFDM program and a printable, easy to read report of the measuring results is then available (Zebris Medical GmbH, Germany). Each participant walked over the measuring plate for 4 times. This was done before and after the adjustment.Results: Statistically significant changes were seen between the pre and post treatment measurements of foot rotation on the treatment side, the step length on the treatment side, the stride length, the stance phase on both the treatment and non-treatment sides, the swing phase on the treatment and non-treatment side and the total double support. Conclusion: This study shows that a chiropractic adjustment to the sacroiliac joint does change certain gait parameters and it should therefore be part of any treatment regime for gait abnormalities. Podiatrists, biokineticists and chiropractors should work together when treating patients with gait abnormalities. As the study only recruited asymptomatic participants, further studies are necessary to determine the effect a chiropractic adjustment has on the gait of symptomatic patients.

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic at Durban Institute of Technology, 2007. / Objectives The objectives were to compare the relative effect of manipulation and core rehabilitation in the treatment of acute mechanical lower back pain in athletes. Project Design: The study design was a randomized controlled parallel group trial. A quantitative study was performed, by making use of a pre à à à ¢ and post experimental investigation (Nansel et al. 1993 and Naidoo, 2002). Setting: Participants presenting with acute low back pain with an onset of 7 days or less, to the Chiropractic Day Clinic at the Durban University of Technology. Subjects: Thirty athletic participants, either male or female, between the ages of 18 and 45 years presented at the initial consultation which included participant screening and establishment of their suitability for the study. These were then divided into either group A (which received a manipulation) or group B (which received core exercises). Outcome measure: A correct contraction of the core stability muscles was maintained, with a decrease in pressure (in mm Hg) on a Pressure Biofeedback Unit, and an increase in length of time (in seconds). Results: It was found that there was no significant difference between the manipulation and the core rehabilitation groups. Although both groups showed v improvement with regards to their acute mechanical low back pain, the core rehabilitation group improved at a significantly faster rate than the manipulation group with regards to endurance on the stabilizer. Conclusions: Both treatments were equally beneficial for most of the quantitative outcomes measured in this study. However, for the outcome of time on the stabilizer, the core rehabilitation group improved at a significantly faster rate than the manipulation group (p=0.006).

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 2001. / Neck pain is a common condition that has become a serious health concern. Since there is controversy regarding the most effective management of this condition, further research needs to be executed. The purpose of this investigation was to compare manipulation combined with a cervical pillow to manipulation alone in the management of mechanical neck pain. The rationale behind this, was that manipulation is one of the most common treatments for spinal conditions and has shown significant results in alleviating mechanical neck pain. Cervical pillows have been investigated by various researchers. They have concluded that cervical pillows are effective in treating mechanical neck pain. Thus, using the pillow as an adjunct to manipulation should attain superior results to manipulation alone. This study consisted of 40 patients who were randomly divided into 2 equal groups. The average age of the patients was 34 years old and the average duration of neck pain was pain of greater than 6 months. The patients received 6 treatments over a 4 week period. Group1 were manipulated and given a cervical pillow to sleep on, while group 2 received manipulation alone. / M

M.Tech. / The primary aim of this investigation was to evaluate the possible effectiveness of a cervical support pillow in combination with cervical spine manipulation versus cervical spine manipulation alone, in the management of cervicogenic headache. The secondary aim of this study was to compare the efficacy of a cervical support pillow (Top Pillow) to the efficacy of the cervical support pillow used by Ross (2002) in the management of cervicogenic headache. During this study, thirty participants were recruited. The participants were divided into three groups of ten each. The three groups received the following treatments over a 3 week period: • Group one only received chiropractic cervical adjustments • Group two received a cervical support pillow and chiropractic cervical adjustments • Group three received only a cervical support pillow. After the treatment was concluded the recorded data was submitted to the staff at STATKON where the data was analysed using the Statistical Package for Social Sciences. The results of the clinical trial revealed that the group that received chiropractic manipulation and the cervical support pillow showed the most significant changes of all three the groups in all planes of cervical range of motion, with all the results being statistically significant. The group that only received chiropractic manipulation also exhibited a significant increase in all planes of cervical range of motion, with only extension not being statistically significant. The group that only received a cervical support pillow, revealed a statistically significant increase in almost all planes of cervical range of motion except for flexion where no increase was noted the increases were, however, still markedly less than those of the former two groups that received chiropractic adjustments to specific restricted motion segments. With regard to perceived pain measured on the Numerical Pain Rating Scale, the two groups that received chiropractic adjustments improved to a much greater degree than the group that only received a cervical support pillow. With regard to Vernon-Mior Neck Pain and Disability Index all three groups had a statistically significant decrease in the perception of disability although the adjustment groups once again showed a much greater decrease in disability than the pillow only group. The already proven benefits that patients with cervicogenic headache receive from chiropractic spinal manipulation, can be successfully supplemented by the use of a cervical support pillow and the top pillow performed better than the pillow used by Ross et al. (2002) in the treatment of cervicogenic headache.

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Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic at Durban Institute of Technology, 2007. / Objectives The objectives were to compare the relative effect of manipulation and core rehabilitation in the treatment of acute mechanical lower back pain in athletes. Project Design: The study design was a randomized controlled parallel group trial. A quantitative study was performed, by making use of a pre à à à ¢ and post experimental investigation (Nansel et al. 1993 and Naidoo, 2002). Setting: Participants presenting with acute low back pain with an onset of 7 days or less, to the Chiropractic Day Clinic at the Durban University of Technology. Subjects: Thirty athletic participants, either male or female, between the ages of 18 and 45 years presented at the initial consultation which included participant screening and establishment of their suitability for the study. These were then divided into either group A (which received a manipulation) or group B (which received core exercises). Outcome measure: A correct contraction of the core stability muscles was maintained, with a decrease in pressure (in mm Hg) on a Pressure Biofeedback Unit, and an increase in length of time (in seconds). Results: It was found that there was no significant difference between the manipulation and the core rehabilitation groups. Although both groups showed v improvement with regards to their acute mechanical low back pain, the core rehabilitation group improved at a significantly faster rate than the manipulation group with regards to endurance on the stabilizer. Conclusions: Both treatments were equally beneficial for most of the quantitative outcomes measured in this study. However, for the outcome of time on the stabilizer, the core rehabilitation group improved at a significantly faster rate than the manipulation group (p=0.006).