M.Tech. / The primary focus of this study was to compare different treatment protocols namely Chiropractic Adjustive Therapy of the Sacroiliac Joint, lschaemic Compression of Trigger Points within the Piriformis muscle and Chiropractic Adjustive Therapy of the Sacroiliac Joint combined with lschaemic Compression of Piriformis Trigger Points in the treatment of a dysfunctional Piriformis muscle, to see which of the chosen treatment protocols would be the superior choice in treating the dysfunctional muscle. It was hypothesised that all the chosen treatment protocols would be effective in treating a dysfunctional Piriformis muscle, while it was hoped that the Chiropractic Manipulative Therapy of the Sacroiliac Joint would be the superior choice in treating a dysfunctional Piriformis muscle. Participants were recruited via posters and flyers in and around the University of Johannesburg Campuses. Forty five participants were recruited and randomly divided into three groups (Groupl received Chiropractic Manipulation of the Sacroiliac joint, Group 2 received Chiropractic Manipulation of the Sacroiliac joint combined with lschemic compression of the Piriformis muscle and Group 3 received only lschemic compression of the Piriformis muscle) by drawing a number from a box marked one, two and three for the different treatment protocols. The participants were given a consent and information leaflet which they had to sign and any questions they had were answered to the best of the researcher's ability. All the participants received five treatments and Algometer measurements were taken before and after every treatment and Numerical Pain Rating Scale forms were completed by the participant before treatment one and after treatment five. The results showed a significant decrease in pain perceived by the participants in all the different groups on the Numerical Pain Rating Scale and on the Algometer measurements. When looking at the Numerical Pain Rating Scale Scores the group that received ischaemic compression (Group 2) had the most improvement and when comparing the Algometer Measurements between the groups, the group that received only the Chiropractic Adjustive Therapy of the Sacro-iliac Joints (Group 1) had the best improvement.

M.Tech. (Chiropractic) / To compare the effectiveness of biomechanical pelvic blocking to segmental drop piece adjustments in the treatment of sacroiliac joint dysfunction. Method: Thirty participants were randomly divided in two equal groups. Group A (n = 15) received biomechanical pelvic blocking and Group B (n = 15) received segmental drop piece adjustments. The trial consisted of seven treatment visits over a period of three weeks, of which the first six were treatment sessions, with the final seventh session serving the purpose of obtaining final post-treatment data. Data was obtained only at the first, fourth, and seventh visits. Subjective data was obtained by having each participant complete a numerical pain rating scale and the oswestry low back pain and disability questionnaire. Objective data consisted of pain pressure threshold over the posterior superior iliac spine by using a pressure algometer. Results: The subjective results showed that there was a decrease in the numerical pain rating scale (NPRS) reading scores over the treatment visits for both groups. Group A had a statistically significant decrease (p = 0.000) in the NPRS reading scores between visit 1 and 4, and a statistically significant decrease (p = 0.000) between visit 4 and 7. Group B showed that there was a statistically significant decrease (p = 0.001) from visit 1 to 4, and a statistically significant decrease (p = 0.002) between visit 4 and 7. According to the Mann-Whitney test both groups showed a statistically significant decrease in their NPRS readings over the treatment period (p = 009), however Group A had a greater decrease in pain than Group B when looking at the mean score values. This indicates that both biomechanical pelvic blocking and segmental drop piece adjustments delivered to the dysfunctional sacroiliac joints are effective in decreasing pain. Over time, statistical analysis showed that there was a decrease in oswestry pain and disability for both groups A and B when looking at the Friedmann and Wilcoxon-signed rank test. Group A showed a statistically significant decrease (p = 0.012) from visit 1 to 4, and a statistically significant decrease (p = 0.002) for visit 4 to 7. Group B also showed that from visit 1 to 4, there was a statistically significant decrease (p = 0.001), and from visit 4 to 7 there was a statistically...

Dissertation submitted in partial compliance with the requirements for the Master's Diploma in Technology: Chiropractic, Natal Technikon, 1997. / The purpose of this study is to evaluate the usefulness of the Gonstead Listing System as a reliable indicator of the direction in which to adjust the sacroiliac joint in subjects with sacroiliac joint dysfunction, in terms of their subjective and objective clinical findings. The hypothesis is that the direction of manipulation is clinically insignificant in causing a decrease in the subject's clinical findings. This information is necessary in order for chiropractors to formulate a more cost-effective treatment protocol for their patients. / M

A dissertation presented in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 2001. / The purpose of this study was to determine the relative efficacy of chiropractic manipulation used in conjunction with detuned ultrasound over the gluteal muscles compared to manipulation used in conjunction with proprioceptive neuromuscular facilitation stretching of the gluteal muscle group in the treatment of sacroiliac syndrome. It was hypothesised that both treatment groups would be effective in the treatment of sacroiliac syndrome but that manipulation used in conjunction with proprioceptive neuromuscular facilitation of the gluteal musculature would be more effective than manipulation used in conjunction with detuned ultrasound, in terms of subjective and objective clinical findings. / M

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Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 97 leaves ; 30 cm / 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).

Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2003 1 v. (various pagings) / Mechanical low back pain is one of the most common clinical disorders that most people seek help for (Painting et al. 1998:110). Epidemiological studies indicate a lifetime prevalence of low back pain ranging from 60 to 80% with an annual incidence of approximately 30% (Mosheni-Bandepi et al., 1998). The Sacroiliac (S.I.) joint is a significant source of pain in patients with chronic low back pain and it therefore warrants further study (Schwarzer et al. 1995:31). S.I. syndrome is defined as pain over the S.I. joint in the region of the posterior superior iliac spine, which may be accompanied by referred pain over the buttock, greater trochanter, groin, posterior thigh, knee, and occasionally to the postero-lateral calf, ankle and foot (Kirkaldy-Willis, 1992:123). Research indicates that there seems to be a correlation between low back pain, more specifically S.I. pain and hip rotation (Ellison et al. 1990, Cibulka et al. 1999, Fairbank et al. 1984). Cibulka et al. (1998) found that patients with lower back pain who were classified as having signs suggestive of S.I. regional pain had significantly more external rotation than internal rotation on the posterior innominate side i.e. side of S.I. dysfunction (approximately a 20 difference). Manipulation is recognised as an effective means of treating mechanical low back pain, with respect to both Lumbar Facet Joint Syndrome and S.I. Joint Syndrome (Assendelft et al. 1992 and Koes et al. 1996). Kirkaldy- Willis (1992:123) states that manipulation is the most certain way of relieving the symptoms of S.I. syndrome. This investigation aimed to determine the effect of a sacroiliac joint manipulation on hip rotation ranges of motion (active and passive motion) in patients with chronic sacroiliac syndrome in terms of objective measures.

Thesis (M.Tech.: Chiropractic) -Dept. of Chiropractic, Durban Institute of Technology, 2002 1 v. (various pagings) / In recent years, sacroiliac syndrome has been widely accepted by many different health professions as one of the major contributors to mechanical low back pain. Manipulation to effect the relief of the condition has thus far proven to be one of the most effective methods. However, comparatively little research has been done on the different forms of physical therapy that can be used in conjunction with a manipulation so as to maximise its effect. This study focussed on the use of ischaemic compression (a well-accepted technique for the treatment of myofascial trigger points) of the gluteus medius muscle.

Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005. xiii, 115 leaves / One of the most common clinical disorders known is mechanical low back pain (Painting et al. 1998:110). A significant source of low back pain is the sacroiliac joint and therefore, according to Schwarzer et al. (1995:31), it warrants further study. With respect to treatment, Gatterman (1995) states that specific manipulative therapy is the treatment of choice for sacroiliac dysfunction. This is supported by clinical studies (Cassidy et al., 1992), which have shown significant improvement with daily manipulation over a 2-3 week period in 90% of the patients suffering from sacroiliac dysfunction. Different adjusting techniques for the sacroiliac joint include side posture adjustment and prone drop piece adjustments (Bergmann, 1993). With respect to side posture, Bergmann (1993) further states that the side posture adjustment is the most common position used. However, it has been noted that side posture can produce unwanted rotation in the lumbar spine. This may be detrimental to patients who have contra-indications to torsioning such as abdominal aortic aneurisms, nerve root entrapment or disc pathology. Patients, who experience anterior catching of the hip capsule or decreased flexibility with side posture adjustments, experience more discomfort and could therefore benefit from a different technique (Gatterman, 1995). Hence the need for an effective adjustment technique that does not rely on torsioning (e.g. drop piece technique). (White, 2003; Pooke, 2003; Hyde, 2003; Pretorius, 2003; Haldeman, 2003; Cramer, 2003; Engelbrecht, 2003). Although drop table thrusting techniques were rated as being effective for the care of patients with neuromuskuloskeletal problems (Haldeman et al., 1993) as cited by Gatterman et al., (2001), it is still unknown which specific drop piece technique is the most appropriate for sacroiliac dysfunction. Therefore this study was aimed at determining the efficacy of a toggle recoil drop piece adjustment technique.