Thesis (M.Tech.: Chiropractic)-Durban University of Technology, 2008. xviii, 83, [29 ], 25 leaves / Golfing literature today recommends to both the amateur and professional golfers to try and achieve maximum performance with each golf club (Seaman, 1998 and Bulbulian, Ball and Seaman, 2001). This encourages golfers to use a state of maximum spinal rotation in their golf swing in order to achieve optimal performance (Seaman, 1998), thus resulting in back pain becoming endemic in the golfing population. Thus if it is considered that performance, in terms of the golf swing, is mainly influenced by; • the strength and power of the torso, i.e. the low back and abdominal muscles (Chek, 2003), • as well as muscle balance and flexibility, i.e. those muscles which are responsible for the static and dynamic postural stability of the golf swing (Chek, 2003). It then stands to reason that any decrease in the range of motion of the lumbar or thoracic spine of the amateur golfer, in terms of biomechanics, could affect their performance (Nordin and Frankel, 2001). In this regard it is hypothesised that altered biomechanics could be that of asymptomatic segmental joint dysfunction . In terms of interventions Kirkaldy-Willis and Burton (1992) explained the effect of SMT in the treatment of low back pain, similarly Bergmann et al. (1993) and Vernon and Mrozek (2005) further proposed the following effects of spinal manipulative therapy (SMT): • SMT may stretch or break intra-articular adhesions that form from immobilised facet joints due to acute synovial reactions. • SMT allows entrapped menisci to exit the facet joint in which it became entrapped. • If the capsule of the facet gets lodged between two adjacent articular surfaces, the process of SMT could allow this to be freed. • SMT re-aligns misaligned spinal segments to conform to the centre of gravity. It was thus assumed that if these mechanical and reflex mechanisms occur in the symptomatic amateur golfer, they should also occur in the asymptomatic amateur golfer. Currently however very little is known about the effects of spinal manipulative therapy (SMT) on asymptomatic segmental joint dysfunction. Objective: Therefore, the purpose of this study was to evaluate the immediate and short term effect of spinal manipulative therapy (SMT) on asymptomatic amateur golfers in terms of performance indicators. Methods: Forty three asymptomatic participants were randomized to four equal groups consisting of ten participants each (and three drop outs). Three of the groups received a single intervention, i.e. spinal manipulative therapy (SMT) while the last group acted as a placebo control group and received no intervention. Objective measurements were taken using the EDH Sports-FlightScope Pro Electronic Swing Analyser. All objective data collection took place pre and post SMT. Statistical analysis included various statistical methods and correlation analyses, by means of the latest version of SPSS. Results and conclusions: The main findings were that certain outcomes seem to be better with lumbar manipulation alone (smash, horizontal azimuth) and others better with thoracic manipulation alone (CHV, vertical azimuth, distance), but none are better with both lumbar and thoracic manipulation. Therefore in terms of future studies of this nature the treatment groups should be analysed separately and the research powered for such analyses (e.g. larger sample sizes).

Thesis (M.Tech.: Chiropractic)--Durban University of Technology, 2008 / The core stability, club head velocity and ball carry in golfers with and without low back pain – a comparative study. Objective: The aims of this study was to establish whether an observable difference exists in the abdominal core stability of two comparable groups of golfers: one asymptomatic and the other suffering from low back pain, and whether an observable reduction of performance, expressed as club head velocity and ball carry can be observed in those with low back pain. First Objective was to differentiate the groups at baseline with respect to core stability strength between asymptomatic golfers and golfers suffering from low back pain. Whereas the Second Objective was to establish whether a relationship exists between abdominal core stability, CHV and ball carry in the two population groups under study. Following the above the Third Objective was to establish which other factors besides core stability strength have an effect on CHV and ball carry. And lastly the Fourth Objective was to establish the correlation between CHV and ball carry. Design: A comparative study was carried out between the two sample groups. A sample of forty patients were selected for this study, where twenty patients were asymptomatic and had no current episode of low back pain and were able to maintain a core contraction; and the other twenty patients low back pain and could not maintain a core contraction. Because the patients presented in a random manner, the patients were matched as close as possible according to age, so as to have better comparative value between the groups (the maximum age difference of a year was instituted). This allowed for comparisons among similar ages, with the difference being their low back pain and core contraction status. Outcome Measure: Each golfer was required to hit 5 balls using a standard club (in this study, a standard driver was used), after which an average value v was calculated for CHV and ball carry. All measurements were carried out using the Flightscope Pro machine at the Durban Pro Shop. Results: Core stability and low back pain did not influence CHV. However there was a non significant trend which indicated higher ball carry in the group with better core stability and no low back pain than in the group with low back pain and poor core stability. Increasing age and handicap reduced the CHV and ball carry values significantly. Ball carry and CHV were positively correlated together in both groups.

Dissertation submitted to the Faculty of Health in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic, at the Durban University Of Technology, 2008. / Objectives: To determine a profile of soccer injuries prevalent in amateur Indoor and Outdoor soccer players in the greater Durban areas. Methods: This study used the Outdoor Supersport corporate league and the Kwa-Zulu Natal (KZN) Indoor soccer league. A total of 103 out of a possible 147 players participated in the study which included 41 Outdoor and 62 Indoor players. The Indoor soccer players were contacted to complete the questionnaire at their match days at the Gale street Indoor soccer arena and the Outdoor players were contacted during their training sessions and/or match days. The researcher was present to answer any questions posed by the participants. In the case of participants having difficulty in understanding English, a bilingual Zulu translator accompanied the researcher in every interaction with the participants. Results: Out of a total of 103 participants, the foot/ankle (62.1%) was the most frequently injured site. This was followed closely by the knee (55.3%). The rest of the sites in descending order were wrist, back, head, elbow, shoulder, chest, genital and abdomen. All participants reported a first injury, 69 participants reported a second injury and 27 participants reported a third injury. Outdoor soccer players reported the knee as being the most affected area, while Indoor soccer players injured the foot/ankle frequently. Furthermore, age was stated as a significant positive correlation when compared with number of sessions missed, meaning the older the participants, the more sessions they missed. The findings suggest that the use of protective equipment can decrease injury rates due to the use of ankle guards decreasing missed sessions. Conclusion: The profile of soccer injuries in selected amateur league Indoor and Outdoor soccer players in the greater Durban area has been described in this study. In terms of number of injuries, there seems to be no significant differences iv between Indoor and Outdoor soccer players. With regard to site of injuries, the lower limb was affected more than any other body part. The Outdoor players showed more knee injuries than the Indoor players who showed higher incidences of foot/ankle injuries.

Dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Durban University of Technology, 2010. / Motion palpation is used to assess the functional status of a joint and is defined as “The manual palpation of bony structures and soft tissues, through pressure applied in various directions of joint motion to ascertain areas of joint hypomobility and hypermobility.” Motion palpation is a collection of manual examination procedures, used to identify the site and characteristics of altered joint motion and which has been an important part of chiropractic since its inception. One of the most important goals for any clinical instrument is for it to have good reliability and reproducibility, this is because the clinical value of a test must be demonstrated before the results are considered valid. The extent to which a repeated test will produce the same result when evaluating an unchanged characteristic is its reliability. Reliability is evaluated by multiple blinded measurements performed on a sample of subjects. Inter-examiner reliability evaluates the consistency of different examiners and is determined through repeated assessment by two or more raters. Objective The aim of this study was to determine the inter-examiner reliability of motion palpation of knee joints with patellofemoral pain syndrome and asymptomatic knee joints, and to compare the inter-examiner reliability of motion palpation between the two groups. Method This quantitative, inter-examiner, clinical reliability study, included 30 patients each with one knee with patellofemoral pain syndrome and one asymptomatic knee. Each patient had both of their knees motion palpated by three independent examiners blinded to which was the symptomatic knee. The examiners were senior student interns at the DUT Chiropractic Clinic. The motion palpation findings were recorded and statistically analyzed through the SPSS statistical package. Fleiss Kappa statistic was used to give a Kappa score for each direction of motion palpation and these scores evaluated the inter-examiner reliability of motion palpation in the symptomatic and the asymptomatic knee. A comparison of the inter-examiner reliability of motion palpation between the two groups was performed using a paired Wilcoxin signed ranks test. Results The Kappa scores for motion palpation ranged from -0.2081 to 0.1802 for the symptomatic knee joint and -0.2836 to 0.0339 for the asymptomatic knee. This shows poor agreement in both cases. There was no significant difference in Kappa values (p= 0.609) for the two groups for the Wilcoxin signed ranks test and the number of positive and negative ranks were similar. This indicates that the reliability of motion palpation in both groups was similar. Conclusion It was concluded that inter-examiner reliability of motion palpation of the knee joint was poor in knees with patellofemoral pain syndrome and in knees that were asymptomatic. Motion palpation was found to be equally reliable in both groups, indicating that motion palpation of a symptomatic joint does not improve its reliability. This research suggests that motion palpation should be used together with other diagnostic tests to identify patellofemoral pain syndrome as it is not a reliable tool when used in isolation.

Submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban University of Technology, 2013. / Background: A triathlon comprises of a combination of swimming, cycling and running. Triathlons are usually classified as sprint distance, Olympic distance, and Ironman or ultra-distance. Triathlon was popularized in the 2000 Summer Olympic Games and, despite this, there is insufficient data relating to injuries in the South African context. This study aimed to determine the injury profile of amateur and semi-professional Kwa-Zulu Natal triathletes. Methods: This Institutional Research Board approved, cross sectional study, included 80 active members of the Kwa-Zulu Natal Triathlon Association. All triathletes completed a questionnaire on training and injury profiles; with only those having had a musculoskeletal complaint additionally completing a clinical consultation. In order to assess associations between presence of injury and explanatory variables, binary logistic regression using backward selection based on likelihood ratios was used. Data was described using frequency tables for categorical data and summary statistics for continuous data. Odds ratios was reported and a p value <0.05 was considered statistically significant. For triathletes reporting injuries, linear regression was used for factors associated with injury severity. Results: Fifty seven triathletes responded giving a response rate of 71% (68% male, 32% female). The point and period (year) prevalence of triathlon-related musculoskeletal pain was 17.5% and 68.4% respectively. The ranking of the most common site of injury in the last 12 months included the knee (64%), low back (21%) and thigh (18%); with females having had a significantly higher risk of injury than males (p=.019). Additionally, injury risk also increased with weight (p=.055), number of triathlons undertaken in the previous year (p=.031), number of triathlons in the last 4 months (p=.009) and running distance during competition times (p=.011). Injury risk decreased with increasing distance of cycling (p=.061) and swimming (p=.030) in a competition, and length of training in- and off-season (p=.105 and p=.043 respectively). Strong trends were demonstrated between injury severity and long-slow training distance (p=.006) and weight (p=.006). By contrast to risk of injury, injury severity was negatively associated with weight, while a long-slow distance was positively associated with the severity of the injury. Of all the health professions, chiropractic was the most utilized health profession. Conclusion and recommendations: The results concur with previous research, but add insights into factors predisposing triathletes to injury. The most common injuries require investigation to develop preventative interventions to reduce injuries in triathletes. Health professionals require education about triathlon-related injuries to improve preventative and curative interventions.

No description available.

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2016. / Background: Running injuries are increasingly common as participation in this sport increases. Health care providers need to be better able to treat and manage these injuries and prevent their recurrence. Thus, there is a need for profiles of different population groups to enable the development of health promotion and injury prevention strategies. This research study profiled and tracked runners over seven marathons held in the eThekwini and uMgungundlovu Municipalities during the first quarter of 2014. Methods: This Durban University of Technology, Institutional Research and Ethics Committee approved retrospective Chiropractic Treatment Facility record analysis, analysed 741 recorded marathon visits. The records were based on a previously validated data collection tool (CSSA questionnaire) that allowed clinical data to be captured relating to patient demographics, anatomical site of the complaint, clinical impression, diagnosis and treatment. These fields were analysed for each visit, and then captured in SPSS version 22 with records only being excluded because they were unsigned. Descriptive and inferential statistics (McNemar’s tests) were compiled and a p-value of 0.05 was used. Results: The majority of the runners were Black males of approximately 40 years of age. A total of 95.6% of runners presented with overuse injuries, of which 73.6% and 89.3% had no history of previous injury or trauma respectively, and with 94.7% being able to continue participation. The shin and calf (21.7%), thigh (21.6%) and lumbar regions (16.1%) were most commonly affected by injuries which were predominantly muscle strains (23.2%) and SI syndrome (21.4%). These injuries were treated by manipulation (82.8%), massage (57.2%) and PNF stretching (33.6%). With runners that presented at subsequent marathons, a significant difference (McNemar’s p=0.013) in history of previous injury between the first and second marathon was found, with the runner being more likely to report a history of previous injury at their second marathon visit. Specific trends, although not significant, were found for specific subgroups (defined by age, gender, ethnicity, history of previous injury / trauma and chronicity of the diagnoses). Conclusion: The data is not dissimilar to the literature on running injuries, although specific trends in terms of sub categories were noted. These trends require further investigation through prospective, longitudinal studies. / M

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Department of Chiropractic, Durban University of Technology, Durban, South Africa, 2016. / Background: Tennis is one of the most popular sports globally with over 75 million players around the world. Most studies have focused on junior or elite level players although the majority of players around the world are presumed to be recreational/non-professional players. To date, limited research is available pertaining to the epidemiology of tennis related musculoskeletal in non-professional league tennis players in South Africa. This study aimed to determine the profile of musculoskeletal injuries amongst league tennis players in the northern eThekwini region. Methods: This was a quantitative, cross-sectional, descriptive study utilizing a self-administered questionnaire, developed specifically for this research utilizing an expert group and pilot study. The questionnaire contained sections on demographics, tennis history, training and nutrition, court surface and equipment as well as a section on tennis related musculoskeletal injuries. Risk factors for injury were first tested using chi square tests in the case of categorical variables, and t-tests in the case of continuous variables. In order to assess the relationship between injury and potential risk factors for injury, a binary logistic regression using backward selection based on likelihood ratios was used. Odds ratios and 95% confidence intervals of the variables remaining in the model at the end were reported. A p value <0.05 was used to indicate statistical significance. Results: Eighty league tennis players responded giving a response rate of 70.16%. The period prevalence, and the point prevalence of tennis related musculoskeletal injury was 68.75% and 36.25% respectively. A predominance of injuries to the upper extremity were recorded (49%) compared to the lower extremity (27.5%) and the back and trunk (23.5%). The elbow was the most common anatomical site of injury (21.4%) followed by the shoulder (19.4%), the lumbar spine (17.3%) and the knee (8.2%). Age was considered to be a risk factor for injury (p=0.049) as older players in the study (49.32 (17.547) years of age) were less likely to contract an injury than younger players (48.38 (13.210) years of age). The likelihood of injury decreased with a higher Body Mass Index (p=0.042). The relationship between consumption of spirit alcohol and injury was significant (p=0.043). Ex-smokers had a higher chance of contracting an injury (p=0.013). It was also found that those who cycled weekly were less likely to contract an injury (p=0.040). Conclusion: The results concur with other studies on recreational/non-professional tennis players and add insight into risk factors predisposing this population to injury. Health care practitioners need to understand the risk factors for injury in this population so that players can be better managed. Using the results of the study, an injury prevention strategy such as a strength and conditioning program, needs to be implemented with the goal to reduce or prevent common injuries in this population of players. / M

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Department of Chiropractic, Durban University of Technology, Durban, South Africa, 2016. / Background There has been a remarkable increase in the participation of sport for athletes with disabilities. Consequently, there have been many international studies on injuries in athletes which have shown a high prevalence in wheelchair basketball, largely attributed to the fast-paced, high intensity nature of the sport. This sport has grown worldwide including South Africa, however, very little research has been published on South African wheelchair basketball players and more research is, therefore, needed. Aim To determine the prevalence and profile of musculoskeletal pain in elite wheelchair basketball players of different point classifications in South Africa. Hypothesis 1: Upper extremity (including neck and back) pain is experienced more commonly in lower point classified wheelchair basketball players than in higher point classified players. Hypothesis 2: Lower extremity pain is experienced more commonly in higher point classified players than in lower point classified players Method This study was a quantitative, cross-sectional, questionnaire-based study. The questionnaire comprised of sub-sections on demographics and disability characteristics; activity levels pertaining to wheelchair basketball and other sport/physical activity; the prevalence of pain and the impact thereof on wheelchair basketball and/or activities of daily living. This questionnaire was administered to 48 wheelchair basketball players who were competing in the 2015 Supersport League. A response rate of 70% was decided as the lower limit cut-off for statistical power. Results Fourty-three participants responded yielding an 89.58% response rate. The mean age of participants was 33.3 (SD:9.5) years and the majority of participants (n=35) were male and African (n=29). Out of the 43 participants, 79.1% (n=34) used mobility devices, the majority (n=20) used wheelchairs. Most of the participants (n=41) played wheelchair basketball for more than five years and 32 participants did not participate in other sport. Almost half of the participants (n=25) experienced musculoskeletal pain in the last twelve months or at present, 75% of whom (n=12) visited a Physiotherapist for the pain. More than half of these participants (n=15; 60%) reported that the pain negatively affected their basketball performance. It was established that arm pain occurred frequently in lower point classified players (1.0-2.5 point players) and that hand and wrist pain was also more prevalent in lower point players than in higher point players. The prevalence of lower extremity pain was low and there was no statistically significant difference between higher and lower point classified players. Conclusions and Recommendations The finding that upper extremity pain occurred more frequently in lower point classified players was in keeping with the first hypothesis (the null hypothesis was, therefore, rejected). The second hypothesis was, however, rejected (and the null hypothesis was, therefore, accepted) as lower extremity pain did not occur more frequently in higher point classified players than in lower point classified players. The Eta scores may have been higher and may have shown a much larger than typical relationship between point classification and the prevalence of musculoskeletal pain had there been a larger sample size. Notwithstanding this limitation, it is a challenge to obtain a significantly larger sample size due to the nature and limited number of participants in this sport. More studies are warranted on this group of individuals, as a large number experienced pain which affected more than half of the participants’ performance in wheelchair basketball. These studies are important for the future success of the South African players and the sport in South Africa. / M

published_or_final_version / Psychology / Doctoral / Doctor of Philosophy