Dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic, Technikon Natal, 1998. / Mechanical neck pain is an extremely common condition. At any specific time, as many as 12% of the adult female population and 9% of the adult male population experience pain in the neck, with or without associated arm pain, and 35% of people can recall an episode of previous neck pain (Bland 1994:3). However, to date little research has been conducted to investigate which treatment protocolIs may be the most effective in the management of mechanical neck pain syndromes. The aim of this study was to investigate whether the combination of chiropractic manipulative therapy and intermittent, mechanical cervical traction would be more effective in the treatment of mechanical neck pain than chiropractic manipulative therapy alone. It was hypothesized that chiropractic cervical manipulative therapy and the combination of chiropractic cervical manipulative therapy and intermittent, mechanical cervical traction would both be effective in the treatment of mechanical neck pain. Moreover, with reference to objective and subjective clinical findings, it was hypothesized that the combination of chiropractic cervical manipulative therapy and intermittent, mechanical cervical traction would be more effective in the treatment of mechanical neck pain than chiropracic manipulative therapy alone. / M

Dissertation submitted in partial compliance with the requirements for a Masters Degree in Technology: Chiropractic, Technikon Natal, 2002. / The purpose of this study was to determine the efficacy of a conservative chiropractic management approach in the treatment of symptomatic hallux abductovalgus (bunions). The study was a prospective, randomised clinical trial involving sixty subjects, thirty in each group, which were selected from the general population. Group A received a conservative chiropractic management approach, encompassing progressive mobilization of the first metatarsophalangeal joint, used in conjunction with cryotherapy and adjustment of all other fixations found in the foot and ankle. Group B received a placebo treatment by means of de-tuned Action Potential Therapy administered to the involved foot. Each group received six treatments over a two-week period and attended a one-week follow up consultation for data collection. Objective assessment was performed by measuring the pressure pain threshold using a digital algometer. Subjective assessment was by means of the Numerical Rating Scale-101 (NRS-101) and the Foot Function Index (FFI). The Hallux-metatarsophalangeal-interphalangeal Scale (HAL) incorporated assessment of both objective and subjective measurements. Assessments were taken at the first, third, sixth and one week follow-up consultations, for all the subjective and objective data. Statistical analysis was completed under the supervision of Mr K. Thomas at . the Technikon Natal, at a 95% confidence interval. The parametric two-sampled paired t-test, the Friedman's test and the Dunn's post test were used to analyse the data within each group (intra-group analysis), whilst the parametric two-sampled unpaired t-test and the non-parametric Mann Whitney unpaired U-test were used to analyse the data between the two groups (inter-group analysis). / M

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 1998. / Purpose: The purpose of this study was to determine the relative effectiveness of two seemingly different approaches to manipulation of the cervical spine in the treatment of cervical spine dysfunction. The researcher postulated that a manual manipulation would have a greater effect in reducing pain and increasing range of motion that accompanies cervical dysfunction than an instrumental, low force, high velocity thrust delivered by means of an Activator Adjusting Instrument. The reason for this is that it provides greater joint movement. Methods This randomised controlled trial consisted of two treatment groups. Each group consisted of 15 subjects, between the ages of 16 and 65 years, selected from the general population and randomly allocated to treatment group A or B. Group A received instrumental thrusts delivered by an Activator Adjusting Instrument (AAI), while group B received standard diversified manual manipulations to the dysfunctional joints in the cervical spine. Each subject was assessed by using subjective measures of the CMCC Neck Disability Index, Numerical Pain Rating Scale and McGill Short- Form questionnaire; and the objective measure of degrees of cervical range of motion obtained using a cervical goniometer (CROM). Two tailed statistical analysis was conducted at a = 0.05, using the non-parametric Wilcoxin Signed Rank Test and the Mann-Whitney U Test comparing intra-group and inter-group data respectively. Further assessment of the data was conducted using power analysis. This data as well as the descriptive statistics were presented in tables and bar charts. / M

A dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic at Technikon Natal, 1999. / The purpose of this study was to determine the efficacy of patella mobilization in patients suffering from patellofemoral pain syndrome, This was a prospective, randomized, placebo controlled, pilot study, Group A received patella mobilization, while Group B, the placebo group, received detuned ultrasound, The study involved 30 subjects, 15 in each group selected from the general population, Each subject was treated eight times within a four week period, however if they became asymptomatic prior to their eighth treatment the subjective and objective data normally collected on the eighth treatment was collected on their last consultation, patients were required to return for a one month follow-up from the date of their last consultation, Each subject was assessed by means of the short-form Mc Gill Pain Questionnaire, Numerical Pain Questionnaire and the Patient-Specific Functional Scale, Objectively their pressure-pain threshold and tolerance was assessed by means of an algometer, Assessments were taken at the first, eighth, and follow-up consultation for all the subjective and objective measurements, Algometer readings were also obtained at the fourth consultation, the pressure was applied at approximately one kilogram per centimeter squared per second, Excessively high or low readings were retaken, Statistical analysis was completed under the guidance of the statistician at Technikon, Natal, using the non-parametric Wilcoxon sign-rank test and the Mann- Whitney unpaired test comparing intra-group and inter-group data respectfully, / M

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 1997. / This study was done in order to compare the effectiveness of chiropractic treatment in association with a wellness approach, to chiropractic treatment without a wellness approach in the management of Mechanical Low Back Pain. Low back pain is an enormous problem in today's society. Vast amounts of money are spent annually on the investigation into and treatment of low back pain, and numerous work days are lost due to absenteeism. Chronic low back pain also affects the individual's life\xB7style, and can lead to psychological problems. Thousands of low back operations are done yearly, with a significantly high failure rate. (Frymoyer et al. 1980.) In this study factors such as cost, recovery tine and incidence of reoccurrence were used as criteria to determine the effectiveness of chiropractic treatment applied to the two groups of patients. The concept of holise was applied to one group, whereas the other group was treated without this approach. The study was conducted as a clinical trial, with two experimental groups. Thirty patients who had responded to an advertiselOent were selected and randomly divided into two groups. The patients were selected fro~ the general population on the grounds of their signs and sylllptoos. Group A received chiropractic treatment in association with the wellness approach. This comprised patient education in the form of guidance towards life-style changes and exercises. Patients were also given a detailed explanation of their problems, leading to an understanding of their conditions. Group B received chiropractic treatment only. Their condition was not explained, and they did not receive any of the holistic aspectts mentioned for group A. / M

A dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Technikon Natal,1997. / Asthma, one of the most frustrating medical conditions known to man, has been a thorn in the side of physicians world wide. A condition that seems to consist of all exceptions and no rules has resulted in endless debates regarding the correct treatment protocol for its management, which at present only seem to subdue the patient's symptomatology rather than eliminate them. The ever increasing number of asthmatic sufferers and the increasing number of deaths related to asthma are both reflections of the inadequacy of present treatment protocols and therefore demonstrate the need for their revision. It is thus the aim of this study to ascertain the therapeutic efficacy of spinal adjustive procedures a n the management of asthma. Patients were obtained for this study by consecutive sampling, whereby any patients presenting to the Chiropractic Clinic at Technikon Natal, as a response to the newspaper adverts and pamphlets placed ln the greater Durban area, were considered for the study. Of these patients, only those who conformed to the specified delimitations and diagnostic criteria were accepted. The study was divided into 3 distinct periods. The first, called the baseline study, required the entire sample of 30 patients to undergo subjective and objective tests, whilst receiving no chiropractic treatment, in order to establish the patients' astrunatic condition. The second period, called the initial treatment period, required the entire sample to undergo further subjective and objective testing while receiving chiropractic treatment, which comprised soft tissue therapy and adjustments of fixations in the CO-C2 and T2-T7 areas. / M

A dissertation proposal presented in partial fulfilment of the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 2002. / Lateral epicondylitis is a relatively common disorder affecting approximately one third of the nearly thirty-two million tennis players worldwide. It usually presents as a chronic disorder that follows a remitting relapsing course, and as such represents a challenge to manage. At present the scientific literature does not favour any particular treatment modality and as such well designed placebo studies are required to assess the efficacy of the various modalities of treatment, with a long term view of establishing an effective treatment protocol to manage lateral epicondylitis. The purpose of this study was to determine the efficacy of dry needling the posterior distal muscles of the upper extremity as a treatment for lateral epicondylitis. Sixty patients were included in the study. They all under went a case history, physical examination and an elbow regional examination. They were then randomly allocated into the experimental or control groups. The thirty patients in the experimental group received dry needling while the thirty included in the control group received placebo or 'sham' needling. All participants in the study received three treatments over a nine-day period with subjective and objective measurements being taken before the 1st. 2nd, and 3rd treatments, with a 4th being taken after the third treatment. Examination of the statistical data revealed that a significant improvement in the experimental group versus the control group in terms of both subjective / M

A dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2006. / This research study was designed in the form of a quantitative, non-experimental, empirical clinical survey. Objectives: 1) To determine the period prevalence (1 January 1997 – 31 December 2004) of congenital cervical spine anomalies. 2) To determine if there is any association between the presenting clinical features and the congenital cervical spine anomalies in general. 3) To determine if there is any association between the presenting clinical features and individual congenital cervical spine anomalies. 4) To compare subjects presenting clinical features with reported clinical features from literature. / M

M.Tech. (Chiropractic) / Lateral elbow tendinopathy is the most frequent periarticular lesion which affects 1% to 3% of the general population and is a difficult condition to manage with a wide range of procedures and management protocols advocated (Abrahamson and Comfort, 2010). This study aimed to assess the efficacy of managing lateral elbow tendinopathy using therapeutic ultrasound (U/S), interferential current (IFC) or alternatively a combination of IFC and therapeutic U/S in addition to chiropractic manipulative therapy of the cervical spine and elbow. This study was a comparative study consisting of three groups of ten participants each with an equal gender ratio. Prior to becoming a participant in this study individuals were assessed according to the inclusion and exclusion criteria. Group A received therapeutic U/S; Group B received IFC and Group C received combination therapy of IFC and therapeutic U/S. All three groups received chiropractic manipulative therapy to the cervical spine and joints of the elbow complex. Subjective data was obtained using the Numerical Pain Rating Scale (NPRS). Objective data was obtained using the pressure algometer (pain pressure threshold) and the Jamar grip strength dynamometer (pain-free grip strength) on the affected side. The study was conducted over a course of three weeks for a total of seven visits per participant. Subjective and objective data was collected pre-intervention on the first and fourth visits and on the seventh evaluation only visit. Analysis of the data collected was performed by a statistician. All three groups showed statistically significant clinical improvements in all measures. The only group not exhibiting a statistical significance was the therapeutic U/S group in the initial pain pressure threshold results. In the objective measures of all intervals none of the groups showed statistical superiority over one another. However, the final NPRS results showed statistically significant improvement in therapeutic U/S and combination therapy groups over IFC alone. From the results it can be concluded that all groups were effective for lateral elbow tendinopathy in conjunction with chiropractic manipulative therapy. With respects to subjective pain therapeutic U/S and combination therapy appeared to have a greater efficacy than IFC, but no superior modality was identified with respects to objective measures.

M.Tech.