Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban Institute of Technology, 2006. / Health care practitioners have known for some time that patients benefit from specific manual intervention effects, but also from the manner in which these are presented. The latter at times having as much impact on patient health as the former. Thus the purpose of this study was to determine the effect of the clinical ritual during instrument assisted adjusting whilst managing mechanical lower back pain. The study was a randomized prospective study comprising of sixty participants aged 18-59. These individuals were randomly allocated into two groups of thirty and then further stratified to control for gender. Both Groups were diagnosed according to the Activator Methods Chiropractic Technique (AMCT), however the tension was set at maximum for group A, whilst the device was set to the minimum tension for group B. Each patient received three treatments and one follow up visit over a two-week period. Subjective data was collected at the first, third and follow up visit. Subjective data was recorded using the Visual Analogue Scale, the Numerical Pain Rating Scale, the Roland Morris Questionnaire and the Short-form McGill Pain Questionnaire. Outcomes were analysed through with the SPSS statistical package at a 95% level of confidence. After analysis of the collected data it was found that there was no statistical difference between the groups, but there was a non-specific trend suggesting a better outcome in the full tension activator group (Group A). Thus, the research indicated that patients perceptions, the patient-practitioner relationship, and the assumption of an outcome of success as well as the power of placebo or non-specific effects play a large role in the managing of lower back pain in a chiropractic environment.

Dissertation submitted in partial compliance with the requirements for the MTech: Chiropractic, Durban University of Technology, 2011. / Background: In terms of kicking speed the instep kicking technique is the most effective and commonly used method. Immobilization or restricted motion within a joint segment, results in adverse changes in the surrounding ligaments, tendons and muscular tissue. To improve joint mobility and thus improving flexibility, this study focused on spinal manipulation. Objectives: The main purpose of this study was to determine the immediate effectiveness of lumbar spine and sacroiliac manipulation on the range of motion (ROM) of the lumbar spine and sacroiliac joints as well as the kicking speed of the subjects. Methods: Forty asymptomatic soccer players, playing for the regional Premier League team or higher, were divided into four groups of 10 each. Group 1 received lumbar spine manipulation, Group 2 received sacroiliac (SI) joint manipulation, Group 3 received combined lumbar spine and SI joint manipulation and Group 4 received the sham laser intervention (placebo/control). Pre and post warm-up and post intervention lumbar and SI joint ROM were measured using a digital inclinometer. Kicking speed was measured post warm-up and post intervention with a Speed Trac™ Speed Sport Radar. The subjects’ perception of a change in kicking speed post intervention was also recorded. SPSS version 15.0 was used to analyse the data. Results: Pre and post outcome measurements were compared using a p value of < 0.05 to indicate statistical significance. Statistically significant ROM increases were noticed in left and right lumbar rotation motions post lumbar manipulative intervention. Lumbar extension, left and right lumbar rotation and SI joint extension ROM increased post combination of lumbar spine and SI joint manipulation. There VI was a significant increase in kicking speed post intervention for all three manipulative intervention groups. A significant correlation was seen between subjects’ perception of change in kicking speed post intervention and the objective results obtained. Conclusions: Lumbar spine and SI joint manipulation is an effective intervention for short-term increase in kicking speed.

Only a small amount of the available literature is concerned with venous control in lower vertebrates, such as fish. It has even been suggested that veins in fish are not important factors in active regulation of venous return. Preliminary work carried out for this thesis strongly refuted this assumption, highlighting gaps in the existing literature. As a result of the lack of information pertaining to the physiology of the central venous compartment of the circulation, my objective has been to investigate various aspects of this in the hagfish Eptatretus cirrhatus. Hagfishes, with the lowest arterial blood pressures and highest blood volumes amongst the chordates, are the earliest surviving group to separate off from the chordate lineage. They provide a unique opportunity to investigate likely physiological mechanisms in ancestral chordates. The data presented in this thesis suggest thtat 1) E. cirhatus exhibit some cardiovascular compensation during volume manipulation, however this only occurs with volume loading and not during volume depletion, 2) Veins from E. cirrhatus can respond vasoactively to adrenergic stimulation in vitro and 3) Plasma catecholamines in E. cirrhatus also respond to volume manipulation and provide a potential in vivo mechanism for the control of changes in cardiovascular parameters that were observed during volume loading.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban Institute of Technology, 2006. / Health care practitioners have known for some time that patients benefit from specific manual intervention effects, but also from the manner in which these are presented. The latter at times having as much impact on patient health as the former. Thus the purpose of this study was to determine the effect of the clinical ritual during instrument assisted adjusting whilst managing mechanical lower back pain. The study was a randomized prospective study comprising of sixty participants aged 18-59. These individuals were randomly allocated into two groups of thirty and then further stratified to control for gender. Both Groups were diagnosed according to the Activator Methods Chiropractic Technique (AMCT), however the tension was set at maximum for group A, whilst the device was set to the minimum tension for group B. Each patient received three treatments and one follow up visit over a two-week period. Subjective data was collected at the first, third and follow up visit. Subjective data was recorded using the Visual Analogue Scale, the Numerical Pain Rating Scale, the Roland Morris Questionnaire and the Short-form McGill Pain Questionnaire. Outcomes were analysed through with the SPSS statistical package at a 95% level of confidence. After analysis of the collected data it was found that there was no statistical difference between the groups, but there was a non-specific trend suggesting a better outcome in the full tension activator group (Group A). Thus, the research indicated that patients perceptions, the patient-practitioner relationship, and the assumption of an outcome of success as well as the power of placebo or non-specific effects play a large role in the managing of lower back pain in a chiropractic environment. / M

A dissertation presented in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2005. / Research indicates the sacroiliac joint (prevalence of sacroiliac syndrome ranges from 19.3% and 47.9% (Toussaint et al., 1999)) as being the primary source of low-back pain in 22.5% of patients with back pain (Bernard et al., 1987:2107-2130). Treatment options that are available for the treatment of low-back pain include allopathic (Hellman and Stone, 2000), and manual therapies such as hydrotherapy and traction (Cull and Will, 1995). It has been found that allopathic interventions have been less effective than spinal manipulative therapy, even with spinal manipulative therapy having various modes of application (e.g. side posture and drop piece manipulations) (Gatterman et al., 2001). Drop table thrusting techniques were found to be effective for patients with neuromuskuloskeletal problems such as facet syndrome (Haldeman et al., 1993), however, it is still not known which specific drop piece technique is the most appropriate for sacroiliac syndrome. Thus it is important to ascertain the clinical effectiveness of the technique as certain conditions prevent the patient from being positioned in the conventional side posture for treatment of sacroiliac syndrome (White, 2003; Pooke, 2003; Hyde, 2003; Pretorius, 2003; Haldeman, 2003; Cramer, 2003; Engelbrecht, 2003). Therefore this study aims at determining the efficacy of a maintained contact drop piece manipulation technique. / M

A dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Durban Institute of Technology. Thesis, 2005. / In symptomatic sacroiliac syndrome, nociceptors located within the capsule and ligaments of the sacroiliac joint are said to be activated which in turn act on inhibitory interneurons that synapse with the motor neuron pool of the muscles of that joint (muscles responsible for hip flexion, extension, abduction and adduction fall within the sacroiliac motor neuron pool). These inhibitory interneurons relay information that decreases the recruitment ability of that motor neuron pool. This is termed Arthrogenic muscle inhibition (AMI) and it has been stated that the number of motor units innervating a muscle relates positively to the strength of that muscle and hence may have an effect on the functional ability of that muscle. However, it has been proposed that spinal manipulation activates mechanoreceptors (Wyke receptors) from structures in and around the manipulated joint causing changes in motor neuron excitability through the altered afferent input and thereby causing an increase in motor neuron recruitment and a decrease in AMI. Furthermore, it has been found that sacroiliac joint problems have often been related to reduced or asymmetric range of motion (ROM) of the hip and / or lack of proprioceptive ability in the ipsilateral limb. In light of the above, manipulation has been found to cause a re-establishment of normal muscle tone and joint kinematics, therefore relaxing the muscles in that area and restoring normal ROM of the involved joint. This study presents the results of sacroiliac manipulation on objective hip measures (including peak torques, ROM and proprioception). / M

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 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

M.Tech.

A dissertation presented in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2003. / The purpose of this study was to evaluate the efficacy of Chiropractic Manipulative Therapy in the management of Attention Deficit Hyperactivity Disorder in children. / M