Repetitive movements of the arm in or above the horizontal plane, can initiate the development of impingement syndrome of the shoulder (Wolin and Tarbet, 1997:56, 59). Impingement syndrome of the shoulder is a common problem, yet the diagnosis and management of it is still not completely understood. The purpose of this pilot study was to determine the most effective treatment protocol in the management of impingement syndrome of the shoulder due to supraspinatus tendonitis. This randomised study consisted of three groups of ten patients, between the ages of eighteen and forty-five. All potential candidates for the trial were examined and admitted once all the exclusion and inclusion criteria had been met. Once joint restrictions were found in the cervical and/ or thoracic spine and the acromioclavicular joint, diversified chiropractic manipulative therapy was administered to all the patients. Group A received cervical and/ or thoracic spine manipulations, Group B received acromioclavicular joint manipulations, and Group C received a combination of spinal manipulations (cervical and/ or thoracic) and acromioclavicular joint manipulations. Patients were treated over a two-week treatment period. Measurements were recorded on the first, third and sixth treatments. The objective data consisted of pain free shoulder abduction range of motion, the presence of a painful arc of the shoulder, a positive supraspinatus test and/or Neers and/or Hawkins impingement test. The subjective data included the numerical pain rating scale 101 questionnaire. The statistical analysis that was conducted included the One Way ANOVA (analysis of variance) as well as the Student-Newman-Keuls Method to compare intra-group and inter-group data. Statistically significant changes were seen in all three groups. However, group A (cervical and/ or thoracic spinal manipulations) and group B (acromioclavicular joint manipulations) showed to be the most effective in treating impingement syndrome of the shoulder. This does however require further research, and a larger sample size. / Dr. M. Moodley Dr. G. Sher

M.Tech. (Chiropractic) / The aim of this study was to determine the most effective treatment protocol for cervical spine facet syndrome, with regards to treatment frequency. Group one was treated three times weekly, and group two was treated once weekly. Both groups were treated with chiropractic manipulation of the cervical spine over a period of six treatments with a two week follow-up consultation. It was hypothesised that the group treated three times weekly would respond better compared to the once weekly treatment group. The study was a clinical trial involving two experimental groups of fifteen patients each (n=15), total sample size N=30. Volunteers responded to advertisements placed in the local press. Those who met the criteria, in other words suffered from cervical spine facet syndrome, were included in the study. Objective data was acquired using a goniometer to measure cervical spine range of motion. Subjective data was obtained by participants recording their progress on the Vemon-Miorneck pain and disability index and the Numerical pain rating scale. Data obtained from the range of motion testing showed that both groups responded with statistical significance to the treatment, but no statistically significant difference was obtained when the two respective groups were compared to each other. It was also noted that specifically rotation bilaterally for both groups, and left lateral flexion for group 1 (treated three times weekly), showed no statistically significant improvement at all. Statistical analysis of the data obtained from the questionnaires indicated that both groups responded with statistical significance to the treatment, but when group was compared to group 2, no statistically significant difference was noted between the two groups. This rejects the hypothesis that three times weekly chiropractic treatment is more beneficial to the patient, than once weekly chiropractic treatment. This study concluded that there was no statistical difference between the two above mentioned groups and no difference in response to different treatment frequencies. Therefore it shows that less frequent treatment is not to the detriment of the patients' progress and might be of benefit for achieving cost effectiveness.

M.Tech. (Chiropractic) / Cervicogenic Headache is a common musculoskeletal disorder afflicting people worldwide. It causes decreased productivity and mild to severe disability and thus has a large socio-economic impact on society. Much research is needed to improve the successful management of patients afflicted with this disorder. The aim of this study is to compare the effectiveness of spinal manipulation alone and spinal manipulation in conjunction with cervical stabilization exercises in the treatment of cervicogenic headache. Thirty eligible participants conforming to the North American Cervicogenic Headache Society classification of cervicogenic headache were solicited and randomly assigned to two groups of fifteen. Group 1 received spinal manipulative therapy to the full spine. Group 2 received spinal manipulative therapy to the full spine as well as cervical stabilization exercises. Patients were treated eight times over a four-week period with a six-week follow-up consultation thereafter. Objective and subjective measurements were taken at. the first, fourth, eighth and six-week follow-up consultations. Objective measurements consisted of cervical spine range of motion measurements. Subjective measures consisted of the Vernon-Mior neck pain and disability index and the numerical pain rating scale. Both groups displayed numerical improvements in all cervical spine ranges of motion. Both groups had statistically significant improvements in cervical spine right lateral flexion, while group 1 only had a statistically significant improvement in cervical spine left lateral flexion. Both groups displayed statistically significant improvements in the subjective measures. However, neither group had a statistically significant improvement over the other. It can be concluded that neither spinal manipulative therapy nor spinal manipulative therapy in conjunction with cervical stabilization exercises is more effective than the other. Thus rehabilitation of the cervicogenic headache patient yielded no measurable added benefit to spinal manipulative therapy only. However, results indicate that if more rigid or complex application of cervical spine stability training is incorporated, superior results may be achieved.

M.Tech. / Osteoarthritis (OA) is a common and severely disabling disease (I). Chiropractic mobilisation functions well to improve mobility, relieve pain and promote healing (2). Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used for the treatment of OA. Their role in OA, however, is not clearly understood (3). Adverse side effects and the cost of NSAIDs also remain a problem (4). Seatone is a health supplement that has therapeutic properties that provides symptomatic relief of OA by means of its anti-inflammatory action (5,6). Seatone produces a slow, but progressive relief from pain and stiffness and improves quality of life (7' 8). The purpose of this study was to determine the effect of Seatone on the treatment of OA. This was achieved by comparing Chiropractic mobilisation (in preference to Chiropractic manipulation) in conjunction with oral administration of Seatone to Chiropractic mobilisation or oral administration of Seatone alone, by means of subjective and objective measurements. The study required forty-five subjects, above the age of thirty-eight years, suffering from OA of the knee joint, according to the classification criteria (Appendix A). The subjects were screened according to the exclusion and inclusion criteria and all the relevant forms, questionnaires and clinical examinations were completed. The subjects were randomly assigned to one of three treatment groups. Treatment was conducted over a period of eight weeks. Objective or goniometer readings and subjective measurements were done prior to and following treatment to determine the effect of the therapies. The subjective measurements were taken from the Numerical Rating Scale (NRS), the Visual Analogue Scale (VAS) and the McGill Pain Questionnaire. The Cincinnati Knee Rating System, a comprehensive knee questionnaire, was completed at the initial and final consultation. A combined treatment of Chiropractic mobilisation and oral administration of Seatone or oral administration of Seatone alone showed a greater mean improvement than Chiropractic mobilisation alone, in mobility. There was no significant difference in the assessment of pain between the three groups. However, results show that Seatone has a positive effect in the treatment of OA of the knee, for improving mobility.

No description available.

Dissertation submitted in partial compliance with the requirements for the Master's Diploma in Technology: Chiropractic at Technikon Natal, 1995. / The efficacy of chiropractic spinal manipulation on its own versus chiropractic spinal manipulation combined with other treatment modalities used in a chiropractic practice was evaluated in a single blind, randomised, controlled trial using a patient population of thirty nurses who were experiencing mechanical low back pain / M

Submitted in compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2017. / Background Performance of the golf swing is mainly influenced by the strength and power of the torso i.e. the low back and abdominal muscles (Gluck, Bendo and Spivak 2008). As rotary velocities increase, muscle force is absorbed by deforming connective tissue, allowing for increased rotation (Gluck et al. 2008). Therefore any decrease in range of motion of the spine in the golfer, could affect performance (Nordin and Frankel 2001). The cause of poor range of motion is often a result of a physical restriction or mechanical dysfunction within the joints (Blanchard 2004). Spinal manipulative therapy (SMT) has been found to bring about biomechanical effects such as an increase in range of motion (ROM) (Millan et al. 2012) by releasing trapped meniscoids and connective tissue adhesions (Pickar 2002). A lack of core muscle strength is also thought to result in an inefficient technique, which predisposes individuals to poor performance (Asplund and Ross 2010). According to Kibler (2006) core muscle strengthening (CMS) is essential for efficient biomechanical function, to maximise force generation and minimise joint loads in all types of activities. The effects of SMT on golfing performance are well documented (Jermyn 2004; Delgado 2006) however, the effects of CMS on golfing performance are unknown. By improving physiological and biomechanical function through CMS, performance indicators maybe maximised (Pickar 2002; Kibler 2006). Aim Therefore, the purpose of this study was to determine the effectiveness ofSMT compared to CMS on performance indicators club head velocity (CHV) and ball carry (BC) in asymptomatic amateur male golfers. Methods Fifty-two asymptomatic amateur male golfers were recruited for this study, but seven withdrew leaving a final sample size of forty-five. Participants were randomly allocated to either the Core Muscle Strengthening (CMS, n=20) or the spinal manipulative group (SMT, n=25). The SMT (n=25) group received a single session of SMT while CMS (n=20) underwent a four week CMS exercise program. Core muscle strength and indicators of performance were taken before and after the intervention using the Bio-pressure feedback unit (BPU) and GC2 Foresight (swing analyser) respectively. Statistical analysis included paired t-tests to assess change in duration of contraction in the CMS group, Pearsons correlation analysis was used to assess the correlation between changes in CHV and BC intra-group and profile plots were used to show direction and trend of the effect by means of the latest version of SPSS software. Results The main findings show that CMS will improve following a four week CMS program (p= <0,001).When compared over time both SMT and CMS have the same effect on CHV (p= 0.127), whereas CMS has a more profound effect over time compared to SMT on BC (p=<0.001). Conclusion Core muscle strengthening appears to have a positive influence on CHV and BC in asymptomatic amateur male golfers, however it is still uncertain which intervention is more effective. Therefore future studies of this nature should look to increasing the duration of the study or the sample size. / M

M.Tech. / This unblinded, randomised pilot study was performed to determine and compare the effect of innervation specific lumbar spine adjustments and stretching on the flexibility of the rectus femoris muscles in asymptomatic subjects. Twelve asymptomatic subjects between the ages of 20 and 30 years were recruited by the use of advertisements placed around the University of Johannesburg, Doornfontein Campus. The inclusion criteria required that the patient had decreased rectus femoris muscle flexibility (testing positive on the rectus femoris contracture test) and no history of, or any current osteoarthritis or pathology of the hips or knees. The patients were randomly placed into one of three groups by drawing a group number from a closed bag. Group 1 consisted of four subjects receiving a single lumbar spine adjustment per treatment relating to the most restricted segment in the L2-L4 area as well as bilateral proprioceptive neuromuscular facilitation (PNF) of the rectus femoris muscles; Group 2 consisted of four subjects receiving bilateral rectus femoris muscle stretches (PNF); and Group 3 consisted of four subjects who received a single lumbar spine adjustment at the L2-L4 area to the most restricted segment found. One adjustment per treatment was performed. With the subject in the rectus femoris contracture test position, a goniometer was used to measure the knee range of motion bilaterally before and after treatments. These measurements were used as objective data. Each subject was treated twelve times over a four to six week period. The objective results indicated that there was a statistically significant improvement in rectus femoris muscle flexibility in both Group 1 and Group 3. In conclusion, it was shown that specific adjustments at the spinal level of the nerve innervation for the rectus femoris muscle resulted in an improvement of the flexibility of the rectus femoris muscle and with a greater effect on the leg ipsilateral to the side of the spinal adjustment. This gives support for the effectiveness of innervation specific spinal adjustments.

M.Tech. (Chiropractic) / This unblinded, controlled pilot study was conducted in order to compare the effectiveness of chiropractic manipulative therapy with that of a combined therapy involving chiropractic manipulative therapy and myofascial trigger point therapy (dry needling technique and passive stretching), in the treatment of chronic mechanical posterior cervical spine pain. In executing the comparison, it was hypothesised that both treatment protocols would be effective, but that the combined therapy would be the most effective for the treatment of chronic mechanical posterior cervical spine pain, as this treatment protocol has equal emphasis on both the osseous and soft tissue structures. It was hoped that this combined therapy would be more effective in terms of a more speedy recovery and long term effect. This would not only benefit the patient from the point of view of health and quality of life, but financially as well, as less consultation fees would have to be paid. Patients wererecruited into the study by the use of advertisements in newspapers and posters, or from patients entering the Technikon Witwatersrand Chiropractic Day Clinic complaining of posterior cervical spine pain. Only those thirty patients who conformed to the specified delimitations and diagnostic criteria were accepted. These patients were randomly placed into two groups of fifteen patients each. One group received chiropractic manipulative therapy and the other group received the combined therapy. Each patient received twelve treatments over a one month period, ie. three treatments per week. After the treatment period there was a month break from treatment and a follow-up consultation at the end ofthis month. This follow-up period was used to determine the lasting effects of the treatment protocol. The subjective data was collected with the use of two questionnaires, the Neck Pain and Disability Index (Vemon Mior) and the McGill Pain Questionnaire. Further subjective data was collected, in the form of the number of fixations found in the cervical spine by the use of motion palpation and active myofascial trigger points found in the specified areas of the Trapezius and Levator Scapulae muscles. The objective data was obtained from the...

M.Tech. (Chiropractic) / This study was undertaken to evaluate the effectiveness of chiropractic treatment of chronic lower back pain in conjunction with the use of the Cory knee cushion during sleep as compared with chiropractic treatment alone. The cushion is used in an attempt to improve sleeping posture. It was proposed that both treatment protocols would be effective, but that the combined therapy would show better results. An unblinded, controlled pilot study was conducted. Patients responding to advertisements were recruited from the general population. Thirty patients who conformed to the specified criteria and delimitations were accepted into the study and placed randomly in one of two possible treatment groups. One group received chiropractic adjustments in conjunction with the use of the Cory knee cushion during sleep, the other received chiropractic adjustments alone. Comparisons were performed by means of objective (lumbar spine range of motion) and subjective (Oswestry Pain and Disability Questionnaire, MCGiIl Pain Questionnaire and Visual Analogue Scale) assessments over the eight-week treatment period, with comparisons made at treatments one, four, seven, nine and ten. The results were recorded and the data was statistically analysed using two-sample ttests, paired t-tests, sign rank tests and Mann-Whitney tests. The results indicated that there was a generalised improvement in both of the treatment groups in terms of lumbar spine range of motion and pain relief. While group one attained a better range for rotation after the month break, this was an isolated improvement. Under the circumstances of the research, neither group showed considerably superior results over the other, as there was no statistically significant difference between the groups. Thus, the full benefit of sleeping with a cushion between the knees in an attempt to improve sleeping posture will need additional investigation in order to be of-use as an adjunct to chiropractic treatment.