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Simmonds, Marian. "The effect of neck manipulation on excitability of the motor cortex thesis submission to Auckland University of Technology in partial fulfilment of the degree of Master of Health Science, 2004." Full thesis. Abstract, 2004.
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Duffy, Margaret R. "Investigation and manipulation of adenovirus interactions with host proteins." Thesis, University of Glasgow, 2012. http://theses.gla.ac.uk/3582/.
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Adenoviruses are the most commonly used vectors for clinical gene therapy applications, accounting for 24% of all clinical trials to date, the majority of which are based on Ad serotype 5 (Ad5). However, the high prevalence of neutralising antibodies and a range of “off target” interactions result in liver sequestration, hepatic transduction and decreased circulation times. Such interactions include Kupffer cell uptake and binding to blood components such as erythrocytes, platelets, complement and coagulation factors. Recent studies have shown that hepatocyte transduction by Ad5 is mediated by a high-affinity interaction between coagulation factor X (FX) and the Ad5 major capsid protein hexon, with FX bridging the virus to heparan sulphate proteoglycans (HSPGs) on the cell surface. This thesis has focused on gaining a greater understanding of the Ad5:FX pathway and potential strategies for its manipulation. FX, a key component of the blood coagulation system, is a zymogen of a vitamin K-dependent serine protease that is primarily synthesised in the liver and circulates in the bloodstream at 8-10 μg/ml. It is composed of a light chain consisting of a domain rich in γ-carboxylated glutamic acid (Gla) residues, two epidermal growth factor-like domains and a serine protease (SP) heavy chain. The Gla domain of FX binds to the virion by docking in the cup formed by each hexon trimer, whilst the SP domain tethers the Ad5:FX complex to the hepatocyte surface through binding HSPGs. Previously, it was demonstrated that pharmacological blockade of the heparin-binding proexosite (HBPE) in the SP domain prevents FX-mediated cell binding. Here, the specific residues of FX which mediate Ad5 attachment to HSPGs were identified. Employing mutagenesis techniques each of the seven basic residues R93, K96, R125, R165, K169, K236 and R240 that were previously shown to bind heparin, were converted to alanine. This mutated FX was termed “SP mutant”. Stable cell lines were generated to constitutively produce the wild-type and SP mutant rFX protein in the presence of vitamin K. The conditioned media was affinity purified using a FX specific mouse monoclonal antibody 4G3 coupled to sepharose. The rFX proteins were quantified by ELISA, had the predicted molecular weight of 59 kDa and were biologically active, as shown by conversion to FXa in the presence of tissue factor and FVIIa. Surface plasmon resonance (SPR) analysis demonstrated the SP mutations had no effect on FX-specific binding to the Ad5 hexon. However the proexosite mutations ablated FX-mediated Ad5 cell surface binding, internalisation, cytosolic transport and gene transfer as shown by confocal microscopy, qPCR and quantification of transgene expression. Assessing the involvement of rFX with single (R125A) and double (R93A_K96A, R165A_K169A and K236A_R240A) point mutations in the SP domain, indicated the residues exhibit different levels of contribution to Ad5:FX complex binding to HSPGs. The seven SP mutations also inhibited FX-mediated Ad5 binding to mouse liver sections ex vivo. Taken together, this study uncovered that basic residues within the HBPE of FX have a fundamental role in Ad5:FX complex engagement with HSPGs at the surface of target cells. This study contributes to the existing knowledge of the FX-mediated Ad5 transduction pathway. Whilst the classical in vitro CAR-mediated Ad5 infection mechanism has been extensively studied, the post-binding events governing FX-mediated Ad5 intracellular transport and gene expression have not been fully characterised. This study employed a panel of small molecule inhibitors of cellular kinases in vitro to investigate cellular and signalling events occurring during FX-mediated Ad5 infection. Blockade of protein kinase A, p38 mitogen-activated protein kinase and phosphatidylinositol 3-kinase significantly hindered efficient Ad5 intracellular trafficking and colocalisation with the microtubule organising centres (MTOC), as shown by confocal microscopy, indicating their fundamental involvement in the pathway. Screening a library of 80 diverse kinase inhibitors for effects on FX-mediated gene transfer, highlighted the compound ER-27319 had the ability to prevent Ad5 transduction in vitro. Previous work reported that ER-27319 acts by binding to the immunoreceptor tyrosine based activation motif (ITAM) of the FcεRI receptor gamma subunit in mast cells to prevent spleen tyrosine kinase (Syk) activation. Here, this compound had no effect on FX-mediated cell binding but substantially disrupted intracellular transport at 3 h in the absence of toxicity. It was postulated that this effect may be due to ER-27319 binding to a viral or cellular ITAM-containing protein involved in viral trafficking. Sequence analysis of the Ad capsid proteome for ITAM-like motifs ((D/E)-x-x-Y-x-x-(L/I)-(xn=6-8)-Y-x-x-(L/I)) identified two motifs on the hexon. However neither followed that reported for the FcεRI gamma subunit, instead of the conventional 6-8 amino acid residues between the two Y-x-x-I/L, the hexon ITAM-like sequences expressed 17 or 22 amino acids. Alternatively the ITAM-containing cellular proteins, ezrin, radixin and moesin (ERM) were investigated. The ERM family are key regulators of the cell cortex, capable of interacting with both the plasma membrane and filamentous actin. However, in the time frame imposed by this study this hypothesis could not be studied in depth, but warrants further research to investigate whether ERM proteins have a novel role in FX-mediated Ad5 intracellular trafficking. A wide range of approaches have been investigated to detarget Ad5 from the liver. In this thesis, a pharmacological strategy to preclude FX-mediated liver gene transfer was implemented. A high throughput screening platform was developed to identify a novel small molecule(s) to manipulate the Ad5:FX infection pathway. In addition to the value of such an agent in the gene therapy setting, it may also have potential to treat life-threatening disseminated Ad infections in immunocompromised individuals. Using a fluorescence and cell-based in vitro high throughput assay 10,240 small molecules were screened using the Pharmacological Diversity Drug-like Set library. Initial screening identified 288 compounds that reduced FX-mediated Ad5 gene transfer by > 75% without causing toxicity. Upon further analysis, three compounds, T5424837, T5550585 and T5660138 were identified as consistently ablating Ad5 transduction both in the absence and presence of FX and all had IC50 values < 5.5 μM. These compounds did not directly interfere with Ad5 binding to FX, instead they primarily caused a post-binding stage block of the Ad infection pathway and all affected optimal virus trafficking to the MTOC, as demonstrated by SPR, flow cytometry and confocal microscopy. The candidate molecules have common structural features and fall into the “one pharmacophore” model. Focused mini-libraries were generated relating to these molecules and structure-activity relationship analysis was performed. In vitro screening of the analogues revealed novel hits with similar or improved activity, thereby further validating the initial hits and pharmacophore model. Six compounds, T5550585, its analogue T5572402, T5660138, its analogue T5660136, T5424837 and its analogue T5677956 were tested in vivo. 10 μM T5660138 substantially reduced Ad5 liver accumulation 48 h post-injection and, in addition to its closely related analogue T5660136, significantly reduced transgene expression at 48 h post-intravenous administration of a high viral dose (1 x 1011 vp/mouse). Therefore, this study identifies novel small molecule inhibitors of circulating Ad5 infection. Through investigation and manipulation of Ad5 interactions with host proteins the work presented here, increases the understanding of the key in vivo Ad5:FX tropism determining pathway. In summary, in this thesis the mechanism of FX-mediated Ad5 complex binding to hepatocytes was dissected and potent inhibitors of this important Ad5 infectivity pathway both in vitro and in vivo were identified. This data may contribute to the optimisation of Ad vectors for gene therapy applications and potentially the advancement of anti-adenoviral drug development.
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"Reflex motorneuron excitability of the musculocutaneous nerve in the biceps brachii muscle after upper cervical or cervicothoracic spinal manipulative therapy." Thesis, 2009. http://hdl.handle.net/10210/2671.
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"A treatment protocol for the treatment of cervical facet syndrome comparing the use of cryotherapy before or after the chiropractic adjustment." Thesis, 2009. http://hdl.handle.net/10210/2679.
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"The effects of chiropractic spinal manipulation on driver club head speeds of asymptomatic amateur golfers." Thesis, 2009. http://hdl.handle.net/10210/2695.
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White, Stuart J. "A study to determine the role of soft tissue therapy in the chiropractic management of cervical facet syndrome." Thesis, 2009. http://hdl.handle.net/10210/2646.
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Stacey, Leandra R. "An investigation to determine whether the combination of a hip mobilisation and sacroiliac adjustment or a hip mobilisation alone is more effective in the treatment of osteoarthritis of the hip." Thesis, 2009. http://hdl.handle.net/10210/2688.
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Swartz, Brett. "The immediate effect of cervicothoracic junction manipulation on triceps muscle strength." Thesis, 2009. http://hdl.handle.net/10210/2689.
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Sher, Gregory Colin. "The effect of sacroiliac joint manipulation on quadriceps muscle strength." Thesis, 2009. http://hdl.handle.net/10210/2694.
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Herwill, Dylan Marc. "A study of the effect of chiropractic adjustment therapy of the tibiotalar joint and strengthening of the gastrocnemius muscle." Thesis, 2010. http://hdl.handle.net/10210/3136.
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M. Tech.<br>The aim of this study was to determine whether a combination treatment of strength training of the Gastrocnemius muscle and adjusting of the Tibiotalar joint would have a greater effect and influence on the strength of the Gastrocnemius muscles when compared to either strengthening the Gastrocnemius muscles or adjusting the Tibiotalar joints alone. Thirty participants from the surrounding community of the University of Johannesburg were randomly divided into one of three groups, with an equal male to female ratio within each group. Group A received a strength training protocol directed at the Gastrocnemius muscles. Group B received Chiropractic adjustment therapy directed at the Tibiotalar joints and Group C received a combination of a strength training protocol of the Gastrocnemius muscles in addition to Chiropractic adjustment therapy directed at the Tibiotalar joints. All three groups received 6 treatments on alternate days over a two week period. Objective data was collected by means of a surface Electromyograph (sEMG) taken pre- and post-treatment on the 1st, 3rd and 6th appointments, and muscle strength testing was measured using an Isometric Dynamometer post-treatment on the 1st, 3rd and 6th appointments. Demographic data was collected and evaluated from the Case History, Pertinent Physical Examination, Demographic Data Questionnaire and Physical Assessment Form. In executing the comparison, it was anticipated that all three groups would be effective, but the group undergoing the combination treatment would have the best improvement on the Gastrocnemius strength overall, followed by the adjustment group and then the strengthening group. It could then be concluded that Chiropractic adjustment therapy would provide a safe, cost effective treatment and preventative measure of injury to the Gastrocnemius muscles. Treatment proposed in this research could thus serve as an adjunct and preventative therapy in current rehabilitation treatment protocols in athletes as well as in the general public. The results obtained from the study demonstrated that there was no statistically significant improvement in either of the groups however, there was a definite effect from the treatment protocols in each group that would warrant further investigation. There is a definite link between adjusting the Tibiotalar joint and affecting the Gastrocnemius muscle. Therefore, treating the joint can help the Gastrocnemius muscle to reach its optimal functionality. In conclusion, the study showed that Chiropractic adjustment therapy of the Tibiotalar joint and strengthening of the Gastrocnemius muscles had a combination effect on its strength and endurance that was greater than either of the treatments alone. From these results, it would be prudent to incorporate this treatment protocol to serve as an adjunctive therapy in rehabilitation and training protocols.
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Motala, Yasser. "A study on the effect of hamstring rhythmic stabilization and post-isometric relaxation stretches with adjustments on active hip flexion." Thesis, 2009. http://hdl.handle.net/10210/2837.
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Pyper, Candice Nicola. "The effects of chiropractic manipulation on electromyographic findings in patients with tension-type headache." Thesis, 2009. http://hdl.handle.net/10210/2851.
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Rolland, Patrick Christopher. "The effect of chiropractic manipulative therapy in children with attention deficit hyperactivity disorder." Thesis, 2009. http://hdl.handle.net/10210/2848.
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Orfao-Fugareu, Susana Mendes. "The effectiveness of rehabilitative exercises in combination with chiropractic manipulative therapy versus chiropractic manipulative therapy alone, in the management of iliotibial band friction syndrome in road runners." Thesis, 2009. http://hdl.handle.net/10210/2677.
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Marinus, Michael Allan. "The effects of chiropractic cervical spinal manipulation versus costal diaphragmatic release technique on dynamic lung function." Thesis, 2009. http://hdl.handle.net/10210/2663.
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Hari, Milan. "The effectiveness of spinal manipulative therapy versus manipulation of the acromioclavicular joint in the treatment of impingement syndrome of the shoulder /." 2004.
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Thesis (M. Tech.(Chiropractic))--Technikon Witwatersrand, 2004.<br>Supervisor: Malany Moodley ; Co-supervisor: Neil De Villiers. Includes abstract. Includes bibliographical references (leaves 107-114). Also available via World Wide Web.
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Morris, Cheryl Anne Veronica. "The relative effectiveness of anterior night splints and a combination of anterior night splints and manipulation of the foot and ankle joints in the treatment of plantarfasciitis." Thesis, 2000. http://hdl.handle.net/10321/2702.
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Dissertation submitted to the Faculty of Health in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic at Technikon Natal, 2000.<br>The purpose of this study was to test the effectiveness of anterior night splints alone compared to the combination of foot and ankle manipulation with anterior night splints, in terms of subjective and objective clinical findings, in the treatment of plantarfasciitis.<br>M
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"A pilot study on the uncovertebral joints and their degenerative changes in the aetiology of cervical spondylosis." Thesis, 2009. http://hdl.handle.net/10210/2691.
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Pronto, Pedro Jose Nunes. "The effect of cervicothoracic junction manupilation on grip strength." Thesis, 2014. http://hdl.handle.net/10210/11800.
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Scheepers, J. H. L. "The effect of chiropractic manipulation on the sacroiliac joints compared to mobilisation, on the weight distribution through the lower limbs." Thesis, 2008. http://hdl.handle.net/10210/972.
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Sacro-iliac joint (S.I joint) dysfunction can result in leg length discrepancies (LLD). LLD has been associated with many musculoskeletal problems such as osteoarthritis of the hips, knee pain and lower back pain. It has been theorised that LLD alters a persons body posture, which in turn changes the forces acting on the joints in the lower extremity and spine. These unnatural forces then create the excessive forces seen as the causative factors in the previously mentioned musculoskeletal conditions. (Murrel, Cornwall, Doucet 1991) The purpose of this pilot study was to was to compare the effect of chiropractic manipulative therapy on the S.I joints with chiropractic mobilisations of the S.I joints on the weight transfer from the spine into the lower limbs. This randomised study consisted of two groups of fifteen patients between the ages of eighteen and fifty years. All potential candidates were examined and admitted once all the inclusion and exclusion criteria had been met. Once S.I joint restrictions were detected the patient received either chiropractic manipulation or mobilisation to the restricted joint. Group A received chiropractic manipulation while group B were treated with mobilisations of the S.I joints. Patients were treated over a two week treatment period. Objective measurements were taken before the 1st treatment and after the 1st ,3rd ,5th and final consultations one month later. The measurements were taken with the Spinal Analyses Machine (S.A.M). This instrument has got two scales on a platform that determines the patients weight distribution from the spine through the left and right lower limbs. The data collected was then statistically analysed using the One Way ANOVA Test (analyses of variance) as well as the Student-Newman-Keuls Method to compare the inter-group and intra-group data. Statistically significant changes in the weight distribution between the lower limbs were seen in group A. Based on the results from the study chiropractic manipulation to the S.I joint proved to be more effective than mobilisation in the treatment of S.I joint dysfunction. This does however require further research, and a larger sample size.<br>Dr. M. Moodley Dr. J. Kotze
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Borowsky, Wayne Alan. "A comparative study of soft tissue therapy and ultrasound therapy versus Chiropractic manipulative and mobilization therapy, or a combination of both treatments in the treatment of acute Achilles Tendinitis." Thesis, 2012. http://hdl.handle.net/10210/7320.
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M.Tech.<br>This unblinded, controlled pilot study was conducted in order to compare the effectiveness of soft tissue therapy and ultrasound therapy, versus chiropractic manipulation and mobilization therapy, or a combination of the aforementioned therapeutic protocols in the treatment of acute Achilles tendinitis. In executing the comparison, it was hypothesized that both treatment protocols would be effective, but the combined therapy would be the most effective for the treatment of acute Achilles tendinitis, as this treatment protocol focused not only on the symptomatic pathological area entailing the Achilles tendon in this case, but also focused on the entire kinetic chain which perhaps was contributing to the pathomec.hanics in turn causing Achilles tendinitis. It is hoped that this combined therapy will be more effective in terms of a more speedy recovery and long term effect. This will not only benefit the patient from the point of view of health and quality of life, but financially as well, as less consultation fees will have to be paid. Patients were recruited for the study by the use of advertisements in newspapers and posters, or from patients entering the Technikon Witwatersrand Chiropractic Day Clinic complaining of Achilles pain. Only those forty-five patients who conformed to the specified delimitations and diagnostic criteria were accepted. These patients were randomly placed into three groups of fifteen patients each. Group one received chiropractic manipulative and mobilisation therapy and group two received soft tissue therapy and ultrasound therapy. Group three received a combination of the aforementioned therapies. Each patient received eight treatments over a three week period, ie. three treatments in weeks one and two, and two treatments in week three. After the treatment period there was a month break from the treatment and a follow-up consultation at the end of this 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 the McGill Pain Questionnaire. The objective data was obtained from readings on the digital inclinometer, showing the extent of the ankle range of motion in dorsiflexion and plantarflexion, as well as from muscle activity levels in the triceps surae complex, recorded with the use of electromyography. Depending on normality being reached, both parametric testing and non-parametric tests were used to analyse the data. These tests were conducted on a 95% confidence level. The results indicated that all three treatments were in treating acute Achilles tendinitis. Treatment received by group one caused a generalized increase in EMG muscle activity levels specifically in the triceps surae, where as group two and group threes' treatment protocols caused an overall decrease in EMG muscle activity levels in the triceps surae. Group one showed the greatest improvement achieved in ankle range of motion in both dorsiflexion and plantarflexion throughout the study. And group one and group three showed the most significant response to treatment in terms of 100% reduction of pain and return to activity. Overall it was deduced that chiropractic manipulative and mobilization therapy were very effective in creating an increase in range of motion of the ankle joint as well as causing a significant improvement in reduction of pain in the Achilles tendon. It was noted that soft tissue therapy was beneficial in certain cases in terms of causing a relaxation in the triceps surae, as well as clearing any scar (fibrin) tissue found in the Achilles tendon. In summary group three showed the best response to treatment carried out in the study. The therapy used in group three not only directly treats the pathological injured-,Achilles tendon and associated triceps surae, but also the kinetic chain, thereby correcting any biomechanical dysfunction that could potentially be the cause of tension overload in the Achilles tendon.
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Saayman, Lindie Cornelia. "The effect of chiropractic manipulative therapy and low level laser therapy on cervical facet syndrome." Thesis, 2014. http://hdl.handle.net/10210/10600.
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Kotze, Elize. "The effect of cervical spinal manipulative therapy on attention and higher-level cognitive functioning and processing." Thesis, 2009. http://hdl.handle.net/10210/2367.
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M.Tech.<br>Terrett (1994) has a theory that diminished blood flow to the brain causes some areas to ‘hibernate’ that is, remain alive, but not function, resulting in diminished mental capacity. He also states that he is sure this is exactly what happens to many people every day, and that it could be the reason they suffer from problems such as tiredness, headache, depression, irritability, difficulty concentrating, poor attention span, visual difficulty, and so forth (Terrett, 1994). Brain function can be detrimentally affected by occipito-atlanto-axial subluxations (Eriksen, 2004). Research showed an improved brain stem evoked response after patients were adjusted. This indicated that the neural messages were going through their brain stems more quickly or with less delay (Shambaugh, Pearlman & Hauck, 1991). The aim of this study was to determine whether spinal manipulative therapy of the cervical spinal segments have any influence on the attention and higherlevel cognitive functioning and processing of an individual who has not received any chiropractic treatment to his/her cervical spine three months prior to the study. Any patient presenting to the University of Johannesburg Chiropractic Day Clinic was considered a potential candidate for the study. The patients were briefly screened through a case history, pertinent physical examination, cervical spine examination and soap note (Appendix E, F, G and H) that were performed at the initial consultation to determine the patients’ suitability for the study. The participants were invited to sign a consent form. In total forty participants were invited to take part in the study. Participants were put into either the adjusting group, or the control group, according to their gender and age. Participants received spinal manipulative therapy to all restricted segments in their cervical spines. Participants in the PDF created with pdfFactory Pro trial version www.pdffactory.com iv control group received detuned ultrasound therapy over the posterior aspect of their cervical spines. Both groups performed the coding test (Appendix D) before their first treatment and after their third treatment, as well as a questionnaire to obtain some personal information and to indicate their present feelings and emotions (Appendix C). The results indicate that there was a statistical difference at the ten percent level of significance in terms of the average number of blocks completed and the average number of blocks filled in correctly for the adjusting group. There was also a statistical difference at the ten percent level of significance in terms of the average number of blocks / symbols changed for the control group. The adjusting group worked more effectively and made fewer mistakes than the control group after the treatment trial was completed. For the chiropractic profession this opens huge potential with regards to the chiropractic benefits and improving the functioning of the society.
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Van, Den Berg Christine Dominique. "The reliability of the tuning fork and therapeutic ultrasound to determine the most reliable methods of fracture diagnosis." Thesis, 2009. http://hdl.handle.net/10210/2672.
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Segeel, Moira. "The effect of chiropractic adjustive therapy and dry needle therapy in the treatment of inter-scapular pain due to active rhomboid minor and major trigger points." Thesis, 2010. http://hdl.handle.net/10210/3123.
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M. Tech.<br>The Rhomboideus muscle is made up of the Rhomboid minor and Rhomboid major muscles. The collective term for theses two separate muscles is commonly referred to as the Rhomboid muscle (Moore, 1999). For the purpose of this study the term Rhomboid muscle will also be referring to the two separate muscles as one, namely the Rhomboid muscle or the Rhomboids. Rhomboid trigger points are one of the main causes of inter-scapular pain because the referral pattern of this muscle is on the medial border of the scapula (Smith, Padgett and Kaufmann, Harrington, An and Irby, 2004). Articular dysfunction associated with Rhomboid trigger points can involve any of the spinal segments from C7 to T5 usually two or three segments are involved. It is therefore, evident that Rhomboid trigger points in conjunction with articular dysfunction can thus be the primary cause of inter-scapular pain (Travell and Simons, 1999).
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Rosenberg, Marie Jane. "A study to determine the effectiveness of chiropractic manipulative therapy of the sacroiliac joint and pelvic stabilisation exercises in the management of post-partum lower back pain." Thesis, 2008. http://hdl.handle.net/10210/978.
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This study compared the effectiveness of three different Chiropractic treatment protocols in the treatment of post-partum low back pain. This was done in order to establish whether or not a combined treatment of Chiropractic Manipulative Therapy (CMT) of the sacroiliac joint combined with slow dynamic strengthening exercises to strengthen and stabilise the pelvis is a more effective treatment than CMT of the sacroiliac joint alone, or slow dynamic strengthening exercises in isolation. Thirty participants were used for this study. They were randomly placed into one of three groups namely; group 1, group 2 and group 3. Group 1 received CMT solely to the involved sacroiliac joint. Group 2 received slow dynamic strengthening exercises of gluteus medius, piriformis and psoas muscles. These exercises were designed to strengthen and stabilise the pelvis. Group 3 received a combination of the above two treatments. Six treatments were administered over a period of three weeks with each participant receiving two treatments per week. Prior to the commencement of treatments one, three and six; each participant was objectively measured for forward flexion range of motion using the Modified Schober’s test. The subjective measurements used in this study were the Numerical Pain Rating Scale and the Oswestry Lower Back Pain and Disability Questionnaire, these were also completed prior to first, third and sixth treatments. All the collected data was statistically analysed using the one-way Anova test, the Scheffe Multiple Comparisons test and the Paired-t test. This statistical analysis revealed statistical differences on intra-group analysis, for all the three groups involved, mostly between treatment three and treatment six for both the objective and subjective measurements. On inter-group analysis no statistical differences were found although group three subjective and objective measurements improved by a larger percentage than both group one and group two. It was thus concluded that a combined treatment of CMT and slow dynamic strengthening exercises of gluteus medius, piriformis and psoas muscles was the most effective protocol to use on women with post-partum low back pain.<br>Dr. C.D. Losco Dr. B. Losco
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Frese, Monica. "A study to determine the prevalence of low back pain in registered pharmacists in Johannesburg and the individual and work-related risk factors involved." Thesis, 2014. http://hdl.handle.net/10210/10986.
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M.Tech. (Chiropractic)<br>The purpose of this study was to assess the prevalence of lower back pain in registered pharmacists in Johannesburg, in terms of workplace and individual factors, in order to establish under which circumstances workplace and individual factors could influence the prevalence of lower back pain in pharmacists. The sample population of registered pharmacists in Johannesburg (N=300) was selected from the register of pharmacists of Gauteng and a questionnaire was sent to the relevant pharmacists. A total of 92 questionnaires were returned and represented a 30,7% response rate. The questionnaire consisted of questions regarding : The prevalences of previous and current lower back pain; the intensities and frequencies of previous and current lower back pain; the location of previous and current lower back pain; the radiation of pain occurring in the lower extremities during previous and current lower back pain; the weakness or numbness perceived in the lower extremities during previous and current lower back pain; the professionals consulted for previous and current lower back pain; the medication administered for previous and current lower back pain. The questions asked regarding individual factors included : age; gender; anthropometry; exercise and smoking; the workplace factors included : number of years in practice; number of hours and days worked per week; bending, twisting and lifting; static work postures and repetitive work. The results were statistically analysed using frequency distributions, cross-tabulations and the Kruskal-Wallis.Chi-squared approximation test. The results were represented by pie charts, frequency tables and cross-tabulations, and descriptively analysed. The overall prevalence of lower back pain in registered pharmacists in Johannesburg was 41,3%. Among other findings, the weight and build were found to be significantly associated with the respondents increased lower back pain. Other significant findings were that respondents who worked more days per week as well as those who had an increased frequency of reaching above shoulder height at work, had an increased incidence of lower back pain. It must be emphasised that great caution should be exercised in attempting to generalise the findings of this survey, 'since workplace and individual factors associated with the lower back pain were based on the respondent's subjective evaluations. This study was not designed to establish cause and effect relationships between individual and workplace factors, and prevalence of lower back pain among pharmacists.
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Dell, Charmaine. "The effects of diversified chiropractic manipulation versus sacro-occipital technique in chiropractic management of sacroiliac syndrome." Thesis, 2008. http://hdl.handle.net/10210/959.
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Purpose: The purpose of this pilot study was to assess the effects of Diversified Manipulation versus Sacro-Occipital Technique in the management and treatment of Sacroiliac Syndrome. Method: This study consisted of two groups, a Diversified group consisting of 15 subjects with Sacroiliac Syndrome and a Sacro-Occipital Technique group consisting of 15 subjects with Sacroiliac Syndrome. The subjects were between the ages of 18 and 55 years. Potential candidates were examined and accepted based on the inclusion and exclusion criteria. The Diversified group received Diversified Manipulative therapy to the sacroiliac joint, while the Sacro-Occipital group received SOT Category 2 blocking, from which the subjective and objective findings were based. Procedure: Each successful candidate was treated six times over a two-week period. Before the commencement of the treatment one, three and six, the candidate completed the Oswestry Back Pain and Disability Index questionnaire and the Numerical Pain Rating Scale. Digital Inclinometer readings were taken of the thoracolumbar and lumbosacral regions of the spine. Sacroiliac Manipulation was then administered to the Diversified group based on the restrictions obtained during motion palpation. Category 2 blocking was administered to the Sacro-Occipital Technique group based on the SOT Category 2 categorization test findings. The same treatment was administered at each of the six treatment sessions. Results: Objective statistically significant differences were noted on lateral flexion range of motion, in favour of the Sacro-Occipital Technique group. Subjective readings also showed statistically significant differences with regards to Oswestry Back Pain and Disability Index and Numerical Pain Rating Scale in favour of both the Diversified group and the Sacro-Occipital Technique group. Conclusion: The results of the study indicate that both Sacro-Occipital Technique and Diversified have a positive effect on patients suffering from Sacroiliac Syndrome. However, Sacro-Occipital Technique proved to have a greater overall benefit compared to Diversified manipulation in the treatment and management of Sacroiliac Syndrome. It should be emphasized that the present study was a pilot study to determine the effects of Diversified manipulation versus Sacro-Occipital Technique in the management of Sacroiliac Syndrome. Accurate conclusions could not be formulated due to the remainder non-significant statistical findings obtained from the study; therefore further research needs to be conducted on this comparative study.<br>Dr. B. Losco Dr. C. D. Losco
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Phillips, Clinton Glen. "The efficacy of low back strengthening with and without Chiropractic adjustment in the treatment of chronic mechanical low back pain." Thesis, 2008. http://hdl.handle.net/10210/962.
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Objectives: To determine the efficacy of chiropractic spinal manipulative therapy (CSMT) in the resolution of the persistent or chronic middle ear effusion that is associated with otitis media. This treatment was compared to the insertion of tympanostomy tubes with regards to parent perception and satisfaction. Methods: Thirty patients under the age of seven that were diagnosed as having persistent or chronic middle ear effusion were assigned to receive either tympanostomy tubes or chiropractic treatment according to parental choice. Results: After chiropractic treatment, an objective improvement in the middle ear status was noted by serial tympanography, demonstrating resolution of middle ear effusion. This was noted in 64.3% in the right ear, where a type B tympanogram improved to a type A or type C tympanogram, and in 58.3% in the left ear, where a type B improved to a type A or C tympanogram, or a type C improved to a type A tympanogram. After chiropractic treatment, subjective improvements were noted in the patient’s health, hearing, speech and language, behaviour and social skills, balance, gross and fine motor skills, otalgia and the amount of disturbed nights. Additional benefits from chiropractic treatment were noted in 93.3% of cases. Conclusions: The manner in which the middle ear effusion was resolved by chiropractic manipulation is by normalising the function of the eustachian tube. Eustachian tube dysfunction is a commonly reported aetiological factor in the development of otitis media with effusion, yet previously there was no treatment type to address this problem. Improvement of middle ear effusion occurred in 58.3-64.3% of cases, indicating that chiropractic spinal manipulative therapy could be a viable treatment option to correct the eustachian tube dysfunction.<br>Dr. Harold Humphries Dr. Chris Yelverton
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Lyons, Craig. "The efficacy of soft tissue therapy in the chiropractic management of subacute and chronic Grade I and Grade II ankle inversion sprains." Thesis, 2009. http://hdl.handle.net/10210/2637.
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Phillips, Clinton Glen. "The efficacy of low back strengthening with and without Chiropractic adjustment in the treatment of chronic mechanical low back pain /." 2002.
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Bornman, Jaco Casper. "The effect of cervical spine adjustments on low back pain in the workforce of the corporate environment /." 2004.
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Du, Plessis Juan. "The relative effectiveness of pulsed ultrasound as an adjunct to foot manipulation in the treatment of plantar fasciitis." Thesis, 2002. http://hdl.handle.net/10321/1981.
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A dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2002.<br>Plantar fasciitis (PF) is a syndrome that causes pain at the insertion of the plantar fascia to the medial calcaneal tubercle of the calcaneaus. This syndrome has been described as an overuse injury with subsequent inflammation at the insertion of the plantar fascia to the bone. The literature describes inflammatory changes that occur within the body and attachment of the plantar fascia, together with biomechanical aberrances that may be the result of the PF. The purpose of this study was to determine the relative effectiveness of pulsed ultrasound as an adjunct to foot manipulation in the treatment of plantar fasciitis. The foot manipulations are used to correct the biomechanical abnormalities, while the pulsed ultrasound is used for its anti-inflammatory properties. The combination of pulsed ultrasound and foot manipulation was compared to foot manipulation alone to determine if this ultrasound manipulation combination had any beneficial effect over and above foot manipulation alone. Thus determining whether it is of importance to o approach and treat both aspects of the syndrome described. This was a prospective, randomised, comparative controlled trial. Forty subjects were diagnosed with plantar fasciitis and chosen to participate in the study. They were subsequently divided into two groups (Group A and Group B) of twenty. Group A was the experimental group receiving foot manipulation and ultrasound as treatment, and Group B, the control group received foot manipulation alone as treatment. Each subject received six treatments within a period of three weeks, with a seventh follow-up within one week of the sixth treatment. There was no treatment at the seventh consultation; this was used for obtaining subjective and objective readings. Subjective assessment was by means of the Foot Function Index, and objective was by means of the manual algometer. Both the subjective. and objective readings were taken prior to the first, sixth and at the seventh (final) consultations.<br>M
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Harpham, Graeme John. "The relative effectiveness of manipulation versus a combination of manipulation and oral Traumeel S in the treatment of mechanical neck pain." Thesis, 2005. http://hdl.handle.net/10321/282.
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Thesis (M.Tech.: Chiropractic) -Dept. of Chiropractic, Durban Institute of Technology, 2005. xii, 51 leaves : ill. (some col.) ; 30 cm<br>According to the recent literature the application of non-steroidal anti-inflammatory drugs (NSAIDS) is the mainstay and first line of conventional treatment for many types of pain, including that of spinal origin (DiPalma and DiGregorio 1994; Dabbs and Lauretti 1995; Koes et al. 1997). NSAID therapy has inherent side effects (Goodman and Simon 1994), however, given the risks involved, they are still of value as an adjunct to spinal manipulation (Crawford 1988), which has been shown to have less side effects and be more effective than conventional NSAIDS (Dabbs and Lauretti 1995; Giles and Müller 1999). A homeopathic alternative to NSAIDS is Traumeel S, it fulfils all the criteria for a locally acting therapeutic medication, with promotion of the natural healing process, and minimum side effects (Zell et al. 1989). A study by Hepburn (2000) compared the relative efficacy of Traumeel S against NSAIDS in the treatment of cervical facet syndrome. Hepburn concluded that there was statistically no difference between the two therapies. It could therefore be inferred that Traumeel S may be a valid alternative to NSAID therapy in the treatment of cervical facet syndrome. This study tested this hypothesis by comparing the effectiveness of spinal manipulation with the concurrent administration of oral Traumeel S against spinal manipulation alone in order to assess the potential benefit of combining Traumeel S with manipulation.
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"A comparison of sacroiliac joint manipulation versus piriformis muscle ice-and-stretch combined with sacroiliac joint manipulation on post-partum females suffering from sacroiliac syndrome." Thesis, 2009. http://hdl.handle.net/10210/2664.
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Seedat, Mihaad. "The effects of manipulation versus manipulation combined with dynamic stabilization of the sacroiliac joint in chronic lower back pain." Thesis, 2009. http://hdl.handle.net/10210/2687.
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"A study on the effect of cervical spine adjustments on sub-acute or chronic low back pain." Thesis, 2009. http://hdl.handle.net/10210/2692.
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"A comparative study to determine the efficacy of chiropractic spinal manipulative therapy and allopathic medication in the treatment of infantile colic." Thesis, 2009. http://hdl.handle.net/10210/2640.
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"A treatment protocol for lumbar facet syndrome, comparing diversified chiropractic manipulative therapy and Traumeel S®." Thesis, 2009. http://hdl.handle.net/10210/2680.
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Govender, Neetu. "The efficacy of manipulation and mobilization in the treatment of Morton's neuroma." Thesis, 2002. http://hdl.handle.net/10321/2037.
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Final submission of a dissertation in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, Technikon Natal, 2002.<br>The purpose of this randomised, placebo-controlled clinical trial was to investigate the efficacy of foot and ankle manipulation and mobilization as opposed to a placebo treatment (de-tuned ultrasound), in terms of objective and subjective findings in the treatment of Morton's neuroma. This clinical trial consisted of two groups, each with twenty patients. Patients who were diagnosed by the researcher as suffering from Morton's neuroma were included in the study. The patients were randomly allocated into the respective groups. The ages of the patients ranged from 23 to 79 years old. Group A received the de-tuned ultrasound as the placebo treatment and Group B received foot and ankle manipulation and mobilization as well as the de-tuned ultrasound to eliminate any massage effect that may have been incurred. It was hypothesised that foot and ankle manipulation and mobilization would be effective in the treatment of Morton's neuroma. The treatment protocol consisted of a course of six treatments over a treatment period of three weeks. Subjective and objective measurements were taken at the initial, third and final consultations. Subjective data was obtained via the use of the Numerical Rating Scale 101, the Short-form McGill Pain Questionnaire and the Foot Function Index. Objective data was obtained by means of digital algometer measurements<br>M
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Tomas, Wendy Vilaca. "The effects of chiropractic spinal manipulation and ergonomic advice for the treatment of cervical and thoracic pain and discomfort in those working in a deskbound environment." Thesis, 2012. http://hdl.handle.net/10210/4603.
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M.Tech.<br>This study aimed to compare either separately or in combination the effects of chiropractic manipulation and ergonomic advice on cervical and thoracic pain and discomfort in those working at computer workstations or in desk bound professions. Three groups were chosen. Group A was treated with chiropractic manipulation only. Group B received ergonomic advice only, which they were required to adhere to for the duration of the study. Group C received a combination of chiropractic manipulation and ergonomic advice. Subjects within each group were attended to over a period of three weeks. It was anticipated that a combination of the therapies would yield the most favorable results in comparison to either of the therapies alone. The study was a clinical trial involving three groups of ten subjects of women only. Volunteers responded to posters placed throughout the University of Johannesburg, Doornfontein campus and at companies in and around Johannesburg. Objective data was collected using the Cervical Range of Motion (CROM) Instrument and the Digital Inclinometer to measure cervical and thoracic spine range of motion. Subjective data was obtained by participants recording their progress on the Vernon Mior Neck Pain and Disability Index and the Numerical Pain Rating Scale. Both the objective and subjective data was collected prior to the commencement of the first, third and sixth treatments for Groups A and C and at the first, second and third consultations for Group B. All the collected data was statistically analyzed using the One Way and the Repeated Analysis of Variance tests. Data obtained from cervical and thoracic ranges of motion testing showed some significant differences for the three groups throughout the treatment however no consistent pattern was revealed to determine which treatment group was favored. Statistical analysis of the data obtained from the questionnaires indicated that all three groups responded with statistical significance to the treatments. All three groups responded with a reduction in the subject‟s perceived pain and disability and the Combination group responded most favorably followed by the Advice/Ergonomics group and then lastly the Adjustment group. This study concluded that a combination of the therapies resulted in a quicker response to treatment with regards to the subject‟s pain and disability. All of the three treatments however provided some improvement therefore also reiterating the effects of ergonomic advice and chiropractic treatment alone.
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Goosen, Nico. "The effect of cervico-thoracic adjustments on the activity of the lattisimus dorsi muscle and its trigger points using electromyography and algometer readings respectively." Thesis, 2012. http://hdl.handle.net/10210/6716.
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M.Tech.<br>OBJECTIVE: To determine and compare the effect of Spinal Manipulative Therapy (SMT) to the cervico-thoracic junction on the activity of the ipsilateral latissimus dorsi with regards to muscle activity measured by electromyography and activity of the trigger points measured by the algometer. STUDY DESIGN: Fourty subjects with lower cervical spine pain and dysfunction underwent six spinal manipulative treatments on alternative days over a 3 week period (excluding weekends) to test the changes in activity of the ipsi-lateral Latissimus Dorsi muscle. SETTING: Chiropractic Day Clinic at the University of Johannesburg, Johannesburg, South Africa. SUBJECTS: Forty subjects with lower cervical spine pain participated in this study. Each of the subjects was randomly assigned to one of two groups. Group A consisted of 20 subjects receiving SMT to the cervico thoracic junction. Group B consisted of 20 subjects receiving de-tuned ultra-sound to the area of cervical spine pain. METHODS: Latissimus Dorsi muscle activity and its trigger point activity were tested before and after the first consultation using electromyography and the algometer respectively. After consultations two, four and six readings were taken. For the electromyography readings subjects were asked to lie down in a prone position with their arms next to their sides. They were then instructed to lie as still as possible for three minutes. The mean, peak and minimum values from the surface electromyographic meter were recorded, analysed and compared for reference. For the algometer readings, the researcher grasped the Latissimus Dorsi muscle along the free border at the posterior axillary fold of the midscapular level. The algometer was then pushed into this point and candidates had to indicate when they started to feel pain. This measurement was then recorded. RESULTS: Data was analysed using the T-test for independent samples to compare the two individual groups. Repeated measures ANOVA was useful to investigate changes over time. If one considers Group A as the superior group, no statistical significant difference were noted between Group A and Group B regarding the electromyographic readings. With regards to the algometer readings no statistically significant differences were identified between the two groups except for the last consultation (treatment 4) of Group A where the p-value = 0.035<0.05. CONCLUSION: In light of these findings, it can be concluded that there were no statistically significant differences between Group A and Group B, regarding the electromyographic readings. Group A showed the most favourable treatment efficacy in terms of the algometer readings. The trends shown in this study should be used and tested in future similar research studies incorporating larger sample groups.
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Trope, Daniel. "Study to ascertain beneficial effects of static magnetic fields to trigger points associated with lower back pain in conjuction with spinal manipulative therapy as opposed to isolated spinal manipulative therapy." Thesis, 2009. http://hdl.handle.net/10210/2673.
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Lötter, Ingrid. "The efficacy of the homeopathic remedy Discus Compositum® in the treatment of lumbar facet syndrome." Thesis, 2010. http://hdl.handle.net/10210/3160.
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M. Tech.<br>Low back pain is experienced by approximately 60-90% of the population and is one of the most expensive public health problems today (Shin and Slipman, 2005). Lumbar facet joint syndrome is a common condition, involving about 79% of patients suffering from low back pain (Schleifer, et al., 1994). The aim of this study was to determine the effectiveness of treatment for lumbar facet syndrome with the homeopathic injectable Discus compositum® by using the pressure algometer, Helbig and Lee scorecard system and the Oswestry low back pain questionnaire. This double-blind placebo-control trial, with matched pairs, was conducted at the University of Johannesburg and participants were recruited with posters and by word of mouth. Thirty-two participants that met the inclusion criteria, and were not outside of treatment parameters, were included in the study. These participants were then randomly divided into two groups: Group A was treated with Discus compositum® injectables and Group B was treated with placebo injectables. In addition, participants were matched according to activity levels of more than 3 times per week and activity levels of less than 3 times per week. Participants in both groups were treated four times over a period of two weeks; two treatments per week. A one month post-injection follow-up consultation was carried out in order to determine if the treatment had a lasting effect. The subjective and objective data was analysed by using non-parametric tests in order to establish statistical significance between visits and between groups. The subjective data was obtained by using the Oswestry low back pain and disability questionnaire. The objective data was gathered by using the Helbig and Lee scorecard system as well as the algometer readings. The two sample groups did exhibit statistical differences. The results showed that there was a significant decrease in the pain experienced by the participants, as well as a significant change in the participant’s pain pressure threshold, for both groups. With regards to the diagnostic criteria a higher percentage of participants that were treated with Discus compositum® injections were no longer diagnosed with lumbar facet syndrome according to the Helbig and Lee scorecard system, than those participants that were treated with the placebo injections. In addition, it was determined that a combination of Discus compositum® injections and activity levels of more than 3 times per week proved to be beneficial. Based on the results of this study, one can determine that Discus compositum® is effective in the treatment of lumbar facet syndrome.
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Le, Roux Matthys Christiaan. "The effects of spinal manipulative therapy on reaction and response time of cricket players." Thesis, 2010. http://hdl.handle.net/10210/3159.
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M. Tech.<br>Method The purpose of this study was to determine whether spinal manipulative therapy (SMT) of the cervical spinal segments would have any influence on the reaction and response time of a cricket player. It has been suggested that a dysfunctional vertebral subluxation complex can cause a decrease in visual performance. The decreased visual performance may be due to decreased blood flow to the visual centers of the brain. Thirty six participants (3 cricket teams) participated in this study. They were divided into two groups. Group A consisted of eighteen subjects who received spinal manipulative therapy (SMT) of the cervical spine. The eighteen subjects in Group B received detuned ultrasound to the cervical spine The inclusion criteria required the participant to be a male cricket player who was asymptomatic, without any history of cervical spine surgery and without any current injuries (e.g. hand or wrist fractures). The participant had to be between the ages of sixteen and twenty one and have no contra-indications to spinal manipulative therapy. Measure Objective data was obtained by the Wayne’s Saccadic Fixator ® which determined the patients’ visual reaction time. After testing the participants’ visual reaction time, the one group received SMT and the other group received detuned ultrasound. After which all participants’ reaction and response time were retested. vii Results Although there was a decrease in the reaction and response time of the players after spinal manipulative therapy, the objective results showed that due to the small sample size and different baseline values of the participants in this study there was no statistical proof that Chiropractic treatment had a positive influence on the reaction and response time of the participants.
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Sharp, Angela Jane. "The release of B-endorphins during adjustment and mobilisation of cervical spine." Thesis, 2014. http://hdl.handle.net/10210/11538.
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M.Tech. (Chiropractic)<br>The study evaluated any changes in serum p-endorphin levels before and after a chiropractic adjustment and mobilisation ofthe cervical spine. Three groups of male and female subjects were randomly assigned; the chiropractic group, mobilisation group and detuned ultrasound (control group). Each group consisted of 10 subjects, aged between 18 to 35 with equal numbers of males and females. All subjects were mentally and physically healthy, and were instructed to refrain from nicotine and caffeine intake at least one hour prior to the experiment, as these substances are stimulants and may influence the results. The research protocol involved having blood taken five minutes before the treatment, and repeated five minutes after the treatment. The experimental group received bilateral cervical spine adjustments. The mobilisation group under-went cervical spine mobilisation with oscillatory motion, but no thrust was included. The control group had detuned ultrasound applied to their posterior cervical and trapezius muscles. Blood samples were taken by venipuncture and the p-endorphin levels were analysed using immunoenzymometric assay technique. The results of this study demonstrated that a decrease in p-endorphin levels occurred post intervention in the spinal adjustment group. The mobilisation and detuned ultrasound groups both experienced an increase in p-endorphin levels, but the increase was not statistically significant. This finding allows us to hypothesize that the pain-relieving effects of the chiropractic adjustment, may not be due to a release of p-endorphins, but may be due to the analgesic effect of another system that is not opiate mediated.
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Deverneuil, Victoria. "A study to determine the effectiveness of spinal manipulative therapy versus manipulative therapy of the Glenohumeral joint treatment of impingement syndrome." Thesis, 2012. http://hdl.handle.net/10210/5930.
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M.Tech.<br>PURPOSE: Impingement syndrome of the shoulder is a very 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 chiropractic treatment protocol in the management of impingement syndrome due to supraspinatus tendonitis. This was done by comparing objective and subjective measures gained during a treatment protocol consisting either of administering corrective chiropractic manipulative therapy to the cervical spine and/or the thoracic spine, to the glenohumeral joint or to both of these areas. METHODS: This randomised controlled trial consisted of three groups of fifteen patients, each between the ages of eighteen and forty-five years old. All potential candidates were examined and cleared for participation in the clinical trials subsequent to a selection process and X-ray examination if necessary. Diversified chiropractic manipulative techniques were used for all patients provided joint restrictions were detected. Group A received glenohumeral joint manipulations, Group B received spinal manipulations and Group C received a combination of spinal and glenohumeral joint manipulations. PROCEDURE: Patients were treated for six consultations over a two-week period. A follow-up appointment was scheduled for four weeks after that in order to determine the lasting effects of the treatment protocol. At the first, third, sixth and follow-up visit, measurements were recorded. Objective data included pain free shoulder abduction range of motion, the presence of a painful arc of the shoulder and the presence of a positive supraspinatus test. Subjective data included the numerical pain rating scale-101 scores. RESULTS: statistical analysis was conducted using the parametric One Way ANOVA (analysis of variance) and unpaired t-tests as well as the non-parametric Kruskal-Wallis One Way ANOVA on Ranks and Mann-Whitney Rank Sum tests to compare intragroup and intergroup data. III CONCLUSIONS: Although all three groups showed numerical improvements throughout the treatment period, only group A showed statistically significant improvements. This study therefore suggests that manipulation of the glenohumeral joint is more effective in the treatment of impingement syndrome of the shoulder with regard to short-term as well as long-term symptomatic relief. This however requires further research, as a larger sample size is required
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Ross, Claire Ann. "The effectiveness of a cervical support pillow in combination with cervical manipulation versus cervical manipulation alone in the management of cervicogenic headache." Thesis, 2014. http://hdl.handle.net/10210/11536.
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M.Tech. (Chiropractic)<br>The purpose of the study was to compare the effectiveness of a cervical support pillow in conjunction with correcting abnormal cervical spine biomechanical function (by intervention of high-speed, low-amplitude spinal manipulation in the cervical spine) versus correcting abnormal cervical spine biomechanical function alone, to determine which is the most effective treatment protocol for cervicogenic headache. Thirty-two subjects suffering from frequent, chronic headaches who fulfilled the International Headache Society criteria for cervicogenic headache participated in the investigation. These subjects were recruited from 70 headache sufferers who responded to newspaper and poster advertisements. Patients were randomly assigned to one of two groups as they enrolled for participation. The sixteen patients in group one received cervical spine manipulation twice a week for three weeks. The other sixteen patients received cervical spine manipulation twice a week for three weeks and used a cervical support pillow for sleeping over the three-week period. The main outcome measures included the following: Patients completed a daily headache diary. This monitored the change from week one to week three in analgesic use per day, headache intensity per episode, headache frequency per week and number of headache hours experienced per day. Cervical active range of motion readings were taken at all consultations prior to treatment, using a goniometer. A Neck Pain and Disability Index (Vernon- Mior) Questionnaire and a Numerical Pain Rating Scale 101 were completed by each patient at the initial, second, fourth and sixth visits. In conclusion, it cannot be denied that the combination of a cervical support pillow and correction of cervical spine joint complex dysfunction using standard chiropractic manipulative techniques is a more effective treatment protocol for the management of cervicogenic headache, as it has a far greater benefit with regard to improving the ranges of motion of the cervical spine and a similar effect in improving patient's perception of pain intensity, headache frequency, headache duration and level of functional disability as related to cervicogenic headache, than manipulation of joint complex dysfunction in the cervical spine alone. The short-term symptomatic relief and long-term goals of chiropractic management for cervicogenic headache with specific chiropractic spinal manipulative therapy may be improved by combining the use of a cervical support pillow to this already beneficial and effective protocol.
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Shearar, Kirstin Anne. "The relative effectiveness of manual manipulation versus manipulation using the activator adjusting instrument in the management of acute on chronic sacroiliac syndrome." Thesis, 2003. http://hdl.handle.net/10321/165.
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Thesis (M.Tech.:Chiropractic)- Dept. of Chiropractic, Durban Institute of Technology, 2003<br>Low back pain is a significant health problem that has had a major impact on quality of life and on health care costs (Weiner, et al. 2000:450). Schwarzer, et al. (1995) established the sacroiliac joint to be a significant source of pain in patients with chronic low back pain. Bernard and Kirkaldy-Willis (1987:2107-2130) established the sacroiliac joint to be the primary source of low back pain in 22.5% of 1293 patients presenting with back pain.
According to a review article by Hendler, et al. (1995:169), “manipulation provides dramatic relief” in cases of sacroiliac syndrome. Little research, however, has been done regarding instrument manipulation and it’s effect on acute, chronic or acute on chronic sacroiliac syndrome. Osterbauer and De Boer, et al. (1993) found a significant decrease in Visual Analogue Scale and
Oswestry scores following treatment using instrument manipulation for sacroiliac joint syndrome. They also noted a reduction in the number of pain provocation tests applied to the research subjects.
“Unless reliability and validity of assessments and effectiveness of treatment
procedures can be demonstrated, clinicians should temper their claims of measurement of, and direct effects on, the sacroiliac joint” (Walker 1992:914).
The study design was a randomised, omparative clinical trial. Sixty voluntary subjects were accepted onto the trial; each diagnosed as having acute on chronic sacroiliac joint syndrome, and divided into two groups of thirty subjects. Each subject received five treatments within a three-week period.
The subjects in group one received manipulation using the Diversified Technique of manipulation and those in group two received instrument manipulation using the “Activator Adjusting Instrument”.
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Hari, Milan. "The effectiveness of spinal manipulative therapy versus manipulation of the acromioclavicular joint in the treatment of impingement syndrome of the shoulder." Thesis, 2008. http://hdl.handle.net/10210/977.
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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.<br>Dr. M. Moodley Dr. G. Sher