Theses and dissertations (Health Sciences)

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The effect of a unilateral sacroiliac joint manipulation on muscle activity and force output in the posterior oblique sling muscles
(2020-06-10) McNally, Aimee Paige; O’Connor, Laura; Abdul-Rasheed, Ashura
Objective: The effects of spinal manipulation have been well documented, however, current literature poses a gap regarding the neurophysiological mechanisms responsible for these effects. Further evidence is required in order to uncover the specific neurophysiological mechanisms of spinal manipulative therapy (SMT) and its effect on muscle activity. The study aimed to investigate the immediate effect of a unilateral sacroiliac joint (SIJ) manipulation compared to a control on muscle activity (EMG in mV) and maximum voluntary force output (dynamometer in kg) in the posterior oblique sling (POS) muscles in asymptomatic participants. Methods: A randomised, controlled, pre-test, post-test design allowed for 34 participants, aged 18-45 years old, with joint dysfunction at the SIJ to be allocated to either a manipulation or a control group. Force output and muscle activity of the gluteus maximus (GM) and latissimus dorsi (LD) muscles were measured before and after the intervention. IBM SPSS was used to analyse the data with significance set at (p=0.05). Independent samples t-tests were used to determine significance within, and between, the groups, and Pearson correlation analysis looked for correlations between the muscles in the two slings. Results: There were no significant differences observed between the control and intervention groups for age (p=0.355), gender (p=0.688), race (p=0.338), BMI (p=0.142), and the side of joint fixation (p=0.473). The intra-group analysis and intergroup analysis showed no significant differences for peak amplitude and mean muscle activity of the muscles of the POS when assessed for intra- or intergroup comparisons. A significant difference between pre and post maximum force output in the right GM for both groups (intervention: p=0.016; control: p=0.030), and in the right LD for the control group only (p=0.032), was noted. However, there was no significant difference between group results for any muscle in terms of force output when assessed for intergroup comparisons. Conclusion: The results of this study showed no treatment effect of SIJ manipulation on the muscles of the POS in asymptomatic participants. Consideration should be given to the way SMT is administered, the type of sham intervention used and the protocol followed to elicit maximum voluntary isometric contraction (MVIC).
The effect of cervical spine manipulation compared to muscle energy technique on neck muscle activity and range of motion in asymptomatic participants
(2020-06-10) King, Sasha Lee; Docrat, Aadil; Abdul-Rasheed, Ashura
Background: Clinical evidence supports the use of spinal manipulative therapy (SMT) and muscle energy technique (MET) for the treatment of cervical spine dysfunctions. However, the physiologic mechanism behind their effectiveness is not well understood. Joint dysfunctions are associated with hypertonicity of segmentally related muscles and can occur in both symptomatic and asymptomatic individuals. Neck pain (NP) has been associated with cervical muscle dysfunction, due to the presence of altered muscle activity and impaired kinematics, demonstrated in NP patients. This includes the upper trapezius and posterior cervical muscles, whose dysfunction can be a source of NP. Spinal manipulative therapy and MET are mechanical interventions, that when applied to joint dysfunctions, produce neurophysiological changes, specifically the modulation of muscle activity and improved range of motion (ROM). However, the demonstration and comparison of the neurophysiological effects of SMT and MET in the neck, and its related musculature, are unknown. Aim: The aim is to determine the effect of cervical spine manipulation compared to MET on neck muscle activity and range of motion in asymptomatic participants. Method: This is a quasi-experimental study utilising a pre-test, post-test design, which employed 50 asymptomatic participants aged between 18 – 35 years of both genders and all races. The participants were randomly allocated into one of two treatment groups. Group 1 received cervical spine manipulation (CSM) and Group 2 received MET. Before and after the respective interventions, resting upper trapezius and posterior cervical electromyographic muscle activity and the cervical spine range of motion (CROM) (lateral flexion and extension) were measured. The IBM SPSS version 24 was used to analyse the data. The intra-group changes were compared pre- and post-intervention using paired Wilcoxon signed ranks tests. Median changes between pre- and post- were compared between the two treatment groups using Mann-Whitney U tests. A p value < 0.05 was considered as statistically significant. Results: None of the demographic or background variables differed significantly between the two groups. Both treatments had an effect, although not all significant, involving mostly reductions in resting electromyographic muscle activity and improvements in CROM. This was significant for the right posterior cervical muscles in the SMT group (p = 0.012) and for ROM in both groups (p < 0.001). No evidence of a difference in treatment effect was found. Conclusion: The results of this study suggest that SMT and MET mostly decrease resting neck muscle activity and improve CROM. Muscle energy technique may possibly be equally as effective as CSM. Concurrent changes in both outcomes suggest that more than one physiologic mechanism may likely explain these effects.
The effect of lumbar spine manipulation on the muscle activity of the quadriceps femoris and hamstring muscle groups
(2020-11-30) Parkes, Jenna-Leigh; Abdul-Rasheed, Ashura
Background: The clinical use of spinal manipulative therapy is becoming increasingly evident in the treatment of musculoskeletal conditions. However, the exact neurophysiological mechanisms behind spinal manipulative therapy and its effects on muscle activity require further investigation. Fixated joints within the spine have been shown to cause changes in muscle activity in both segmentally related muscles and extremity muscles. When present in symptomatic or asymptomatic individuals, fixations in the spine may not only lead to local neurophysiological changes but may affect global neurophysiology. Chronic lower back pain has been associated with the presence of arthrogenic muscle inhibition in lower limb musculature which prevents an individual from fully activating the affected muscle. Although this form of inhibition is predominately present in symptomatic individuals, there is evidence to suggest that asymptomatic individuals undergo a similar neuromuscular change. However, further research is needed to determine if the extent of the effects of arthrogenic muscle inhibition differs between symptomatic and asymptomatic subjects. Aim: This study aims to determine and compare the effects of a lumbar spine manipulation on the muscle activity in the quadriceps femoris and hamstring muscle groups in asymptomatic and symptomatic participants. Method: This study was a randomised controlled trial which utilised a pre- and postexperimental design. A total of 48 participants between the ages of 18-45 years of both genders and all races were recruited. The sample population included a symptomatic and asymptomatic clinical group. Each clinical group had a treatment and control group. Once placed into their respective groups, individuals were randomly allocated to the intervention or control group. Muscle activity readings of the quadriceps femoris and hamstring muscles were obtained during sets of maximum voluntary contractions that occurred at the pre-intervention/control, post-intervention/control and post 10- minute intervention/control. IBM SPSS version 26 was used to analyse the data. Repeated measures ANOVA tests were used to compare each outcome between preand immediate post-treatment between the intervention and control groups for immediate effects, and pre- and 10-minute post-treatment between the intervention and control groups for short-term effects. This was initially done within the asymptomatic and symptomatic participants separately. Results: There were no statistically significant differences between the age and gender of the symptomatic and asymptomatic groups. With regards to muscle activity, no significant changes in the quadriceps femoris or hamstring muscle groups were identified in the asymptomatic group. Significant changes were detected in the right rectus femoris of the quadriceps muscle demonstrating evidence of a treatment effect (p=0.047). However, this change did not persist in the 10-minute readings. Although not statistically significant, there was clear evidence of a clinical trend that presented in the quadriceps femoris muscle (rectus femoris and vastus medialis) of the symptomatic group, as the overall muscle activity of the participants who received the intervention increased bilaterally. There were no statistically significant differences found when comparing the data between the symptomatic and asymptomatic clinical groups. Conclusion: The results showed that lumbar spine manipulation did not produce significant differences in the immediate post-readings and the 10-minute readings in the quadriceps femoris and hamstring muscles of the symptomatic and asymptomatic groups. When comparing the clinical groups, there was no significant difference between the asymptomatic and symptomatic groups in terms of the pre-intervention readings of muscle activity and the post-intervention measures immediately and at the 10-minute interval following lumbar spine manipulation.
The effect of spinal manipulative therapy and ischaemic compression versus muscle energy technique in chronic nonspecific neck pain
(2022-05-13) Dicks, Tyron D.; Varatharajullu, Desiree; Abdul-Rasheed, Ashura
Neck pain has become a problem experienced worldwide and it poses a global healthcare challenge to practising medical professions. There are numerous manual and non-manual treatments available for this frequently encountered problem. Frequently utilised and effective therapies are spinal manipulative therapy (SMT) and ischaemic compression (IC); however, these have been associated with several contraindications. An alternative form of treatment with less contraindications that may be of benefit to the patient is muscle energy technique (MET). Therefore, the aim of this study was to determine the effect of spinal manipulative therapy and ischaemic compression compared to muscle energy technique in chronic nonspecific neck pain. Methodology: This study was a quantitative randomised, single blinded clinical trial. Forty participants with nonspecific pain, aged 20-50 years, were randomly allocated into two groups using a random allocation chart provided by a statistician. Group one received SMT and IC, whereas group two received MET alone. The numerical pain rating scale (NRS) was used to determine the level of neck pain. The cervical range of motion (CROM) goniometer was used to calculate the degree of lateral flexion occurring at the neck. The pain pressure algometer was used to determine the pain pressure thresholds (PPT). The Canadian Memorial Chiropractic College (CMCC) Neck Disability Index (NDI) was used to assess the disability in activities of daily living as a consequence of neck pain. Each participant had four consultations over a two-week period, receiving treatment on the first three consultations with the fourth being purely subjective and objective measurements. Results: Repeated measures ANOVA testing was utilised to examine the changes over time in each group. Profile plots were used to visually explore the trends of each group over time. Intra-group analysis of subjective and objective measurements revealed that both groups had a beneficial response to the treatment over time. Inter-group analysis showed that there were no statistically significant differences between the two groups in terms of subjective and objective measurements. Conclusion: In conclusion, this study revealed that the use of MET is as equally effective as a combination of SMT and IC in the treatment of chronic nonspecific neck pain
The effects of an upper cervico-thoracic segment manipulation on posture and muscle activity in participants with forward head and round-shouldered posture
(2023-05-31) Petzer, Matthew; Abdul-Rasheed, Ashura
Background: Postural dysfunction in the cervico-thoracic spine often leads to segmental restrictions and hypomobility, and this is often caused by biomechanical alterations due to postural changes and over activity of skeletal muscles in that region. These muscles include the pectoralis and trapezius muscles. Postural dysfunction and joint restrictions are often treated by manual therapies, such as spinal manipulation. Previous studies have established that joint manipulation reduces postural dysfunction and improves joint mobility, which could be explained by a combination of neurophysiological,and biomechanical effects.In literature, the immediate benefitsof acervico-thoracicmanipulation on muscleactivityandposture are not well understood and, therefore, an investigation into the immediate effects of manipulation on muscle activity and posture was implemented in this study. Aim: This study aimed to observe the immediate effect of an uppercervico-thoracic segment manipulation on posture and muscle activity in participants with forward head and round-shouldered posture. Methods: This study was a quantitative, observational study with a pre-test posttest design. Surface electromyography was used to measure the muscle activity of the pectoralis major, upper and middle trapezius muscles prior to and after the cervico-thoracic intervention. A sample size of 40 asymptomatic participants were recruited to participate. The participants were randomly divided into two groups: group A, which was the control group, and group B, which was the intervention group. The intervention group received a cervico-thoracic manipulation, but the control group received no intervention and remained prone for 3 minutes between the pre-test and post-test readings. The within-group comparisons of pre- and postmuscleactivity were achieved usingpairedT-tests. Within groupandbetween group comparisonsof the change between pre- andpost-intervention wereachieved using repeated ANOVA testing. A p-value below 0.05 was statistically significant. IBM Statistical Package for Social Sciences (SPSS) version 26 software was used to process the data. Results: There was no statistically significant treatment effect of cervico-thoracic spinal manipulation in the effects on muscle activity. Although there was not a statistically significant change in muscle activity, there was a positive change in pectoralis major compared to the upper or middle trapezius. The upper and middle trapezius muscles decrease activity followed an evident trend between the participants who received the intervention compared to the control group. Postural results were not statistically significant but positive correlations to treatment were found. The craniovertebral angle was seen to decrease at a higher rate compared to the control group. Additionally, the study provided evidence of a treatment effect on the acromiovertebral angle, decreasing overall in severity. Conclusion: The results of this study do not provide conclusive evidence that the intervention has any immediate statistical effect on the three muscle activity measurements outcomes observed. In terms of the Posture Pro Analysis System measurements, changes (decrease in angles) between the pre- and postintervention were mostly significant in both groups, but statistically there was no difference between the control and intervention groups. Posture Pro ratings did not provide evidence of changes in categories within the groups. Therefore, the null hypothesis was retained.
The epidemiology of musculoskeletal injuries in trail runners in the eThekwini Municipality of KwaZulu-Natal
(2019) Millar, Maxine-Lee; Varatharajullu, Desiree; Abdul-Rasheed, Ashura
AIM: The aim of this study was to determine the point and period prevalence of musculoskeletal injuries, the injury profile, associated risk factors and the impact of musculoskeletal injuries on trail runners who participated in selected trail races in the eThekwini municipality of KwaZulu-Natal. SUBJECTS: Participants from various trail running races volunteered to participate in the study after the completion of a trail race. METHODOLOGY: Participants were approached individually following the completion of a minimum of a 10 kilometre trail race. Each participant read a letter of information and signed an informed consent form before completing the questionnaire. A total of 197 completed informed consent and post-pilot questionnaires were collected and placed in separate sealed ballot boxes. A code was allocated to each questionnaire before data was captured on a spreadsheet for statistical analysis. RESULTS: In total, 145 questionnaires were statistically analysed. The results revealed that only ethnicity and how often the participant's trail ran per month were significant predictors of developing an injury. White participants were five times more likely to be injured compared to African participants and those who ran more than 10 times a month were 4.65 times more likely to be injured than those who ran less than five times a month. The most common past injuries sustained by trail runners was shown to be predominantly due to trauma, and were located in the knee, ankles and ITB regions. Current injuries were shown to be equally due to trauma and overuse, with predominant location being in the same anatomical regions as past injuries. CONCLUSION: The majority of the data collected was in line with the literature on running; however, most of those studies were done on road runners. The findings of this study were unique to trail runners in KwaZulu-Natal. Further studies are required on trail runners in other regions of South Africa to determine a clearer injury profile.
The epidemiology of work-related neck pain in diagnostic radiographers working in the eThekwini Municipality
(2023-05-31) Devnarain, Akshoy; Abdul-Rasheed, Ashura
Diagnostic radiography is a branch of radiography that is primarily involved with the diagnosis of disease through diagnostic imaging. Additionally, diagnostic radiographers are predisposed to work-related risk factors due to the work that they perform daily and, as result, they are at risk of developing work-related neck pain (WRNP). Investigating the prevalence and work-related risk factors associated among diagnostic radiographers will create awareness amongst diagnostic radiographers and healthcare providers. Furthermore, in a South African context, this will add updated knowledge to the current literature that exists. AIM The aim of the study was to determine the epidemiology of work-related neck pain in diagnostic radiographers working within the eThekwini municipality. METHODOLOGY The study used a quantitative approach and a descriptive cross sectional survey design. A total 130 participants were recruited for this study. The population sample included qualified diagnostic radiographers who were employed within the eThekwini municipality in the public and private sectors. The questionnaire was distributed and answered either via Hardcopies or QUESTIOPRO® link. All the data were then imported into SPSS version 26 for analysis RESULTS A total of 61 participants had reported WRNP and hence the prevalence rate was 65.6%. The study also reported that females are more likely to have WRNP. Furthermore, the selected risk factors showed that more than 50% of radiographers with WRNP had worked over-time shifts, 75.4% of radiographers experienced neck pain from wearing lead protective gear, 78.7% of radiographers from the study had neck pain from lifting and positioning heavy equipment and machinery, and 47.5% of the participants who had WRNP had a history of a previously diagnosed neck condition. Additionally, 59% of participants had taken leave from work because of WRNP. CONCLUSION This study revealed a high WRNP prevalence rate among diagnostic radiographers working within the eThekwini municipality. The results found in this study shared similar findings from various local and international studies. Due to the high prevalence of WRNP, it is highly recommended that management protocols at work should be investigated to aid diagnostic radiographers.
An exploration into factors resulting in career change by qualified chiropractors within the eThekwini Municipality
(2019-09-05) Perumall, Joanna; Sibiya, Nokuthula M.; Abdul-Rasheed, Ashura
Chiropractic in South Africa faces different and greater challenges when compared to chiropractic in other parts of the world because chiropractic is a form of complementary and alternative medicine which is isolated within the healthcare system of South Africa. Chiropractors are burdened by the lack of acceptance and recognition both publicly and professionally. This results in financial challenges thereby impacting negatively on income and the ability to maintain a practice. Furthermore, the perceptions of chiropractors’ are altered after failing to find success in active practice. These factors result in career dissatisfaction. Consequently, they pursue alternate careers to satisfy their personal and professional needs. While many studies have explored career satisfaction among practicing chiropractors, the factors influencing career change by qualified chiropractors have been minimally explored. Aim of the study The aim of the research study was to explore and discuss the factors resulting in career change by qualified chiropractors within the eThekwini municipality. Methodology A qualitative, explorative, descriptive and contextual design was employed to guide the study. A structured interview guide was used to conduct in-depth interviews with 10 non-practicing chiropractors within the eThekwini municipality. The main research questions for this study were “Why are you not a practicing chiropractor?”, “Do you have other professional qualifications?”, “What do you think are the benefits of being in this career as opposed to practicing as a chiropractor?” and “Do you wish to practice as a chiropractor in the future?” Thematic analysis was used to analyse the data of this study The main themes that emerged from the study were the challenges of private practice, perceptions of the chiropractic programme and choosing alternate careers over chiropractic. The participants of this study expressed financial challenges in private practice, a lack of recognition of the profession and the time invested into private practice left no time for family responsibilities. The participants explained that the chiropractic programme and research component is a tedious process with minimal rewards post-qualification. Furthermore, the participants experienced greater benefits and rewards in alternate careers. Conclusion The findings that emerged from this study indicate that chiropractors are faced with numerous challenges post-qualification. Therefore, it is necessary for the DUT chiropractic faculty and staff to actively engage with chiropractic candidates and chiropractic students and vice versa (Leach 2004). Such engagement will adequately equip the students with a better understanding and knowledge of the programme to assist in their success post-qualification.
An exploration into the knowledge, understanding and management of the female athlete triad and the triad risk factors among elite swimmers in KwaZulu-Natal (KZN)
(2022-09-29) Seals, Erin; Abdul-Rasheed, Ashura
The Female Athlete Triad (FAT) includes a spectrum of dysfunction referring specifically to three health complications, which primarily are energy deficiency, menstrual disturbances, and low bone mineral density. Women’s participation in sport has drastically increased over the last four decades but women are still facing stereotyping and are often expected to look a certain way, on and off the sporting grounds. The female athlete triad is common and is widely researched in land sports, such as athletics and endurance running, but the majority of the studies focus on the prevalence of the condition, instead of its knowledge and/or management. Despite FAT being widely researched in various sporting disciplines, there was an apparent gap in the literature, and especially under investigated in elite swimmers. Despite swimming being a popular endurance-type discipline, with similar outcomes to land sporting disciplines, there is paucity in the current literature on FAT in swimmers in South Africa. The benefits of understanding the knowledge of FAT in an elite swimmer includes optimizing energy availability by ensuring adequate caloric intake whilst exercising, encouraging regular weight bearing exercise, improving the triad’s identification, and preventing its occurrence. Aim of the study The aim of this study was to explore the knowledge, understanding and management of FAT and the triad risk factors among elite swimmers in KwaZuluNatal (KZN). Methodology A qualitative, exploratory, descriptive approach was used to guide the study. A semistructured interview guide was used to conduct in-depth interviews with nine elite female swimmers in KwaZulu-Natal (KZN). The main research questions for this study were “Describe your understanding of the female athlete triad”, “Can you expand/elaborate on what makes an individual at risk for the triad?” and “Describe the management options that you, or someone that you know that has had FAT used”. The data were analysed using Tesch’s (Creswell 2007) method to identify themes and sub-themes. Results The main themes that emerged from the study were the lack of knowledge on the female athlete triad, the understanding of the female athlete triad risk factors, the understanding of the impact of fat on health and performance, the lack of education surrounding the management of FAT and the lack in choice of healthcare. The participants had poor knowledge of the term the Female Athlete Triad however, the understanding of the triad risk factors was well understood. Participants in this study lacked appropriate choices in healthcare, if they were to have been presented with components of the triad. Conclusion The findings that emerged from this study indicate that there is a lack of knowledge and understanding surrounding the female athlete triad, its associated risk factors and the appropriate management interventions needed if an athlete were to be diagnosed with FAT. Therefore, it is necessary for not only the chiropractic community but for all health practitioners who may deal with elite female athletes to educate and inform this population about the potential long term health consequences of FAT.
An exploration into the self-reported experiences of musculoskeletal pain in females diagnosed with long Covid within the eThekwini Municipality
(2024) Pillay, Karisa; Abdul-Rasheed, Ashura
BACKGROUND The COVID-19 pandemic caused a worldwide health crisis that prompted an increase in the output of research targeted at expanding the knowledge available about COVID-19, the symptoms experienced and its consequences. Post-acute sequelae of SARS-CoV-2 infection is described as the persistence of symptoms since the initial diagnosis of COVID-19 for more than four weeks and, in most cases, lasting for months at a time. It is also referred to as Long COVID. Musculoskeletal pain (MSP) in relation to this condition is associated with tenderness, discomfort and stiffness of the joints, bones or muscles. Amidst the various reports of symptoms experienced by those affected by Long COVID, MSP has been identified as the most prevalent and debilitating manifestation, common in patients diagnosed with Long COVID. Despite current literature detailing the prevalence of various symptoms associated with Long COVID, a gap in the literature remains in the understanding of the experiences of individuals affected by MSP. Research has identified that women are more likely to endure symptoms of Long COVID, especially MSP, as compared to males. Given that women share a disproportionate burden of Long COVID, it is imperative to get a better understanding of the unique difficulties and lived experiences of women suffering from MSP. A thorough exploration into the various factors that play a role in the onset, development, persistence, and consequences of this symptom is required to fully grasp the experiences women have had whilst enduring MSP. Various factors play a vital role in the influence of an individual’s experiences of MSP throughout their Long COVID journey; these include pre-existing musculoskeletal conditions, the severity of the illness itself, biological changes because of COVID-19, psychological stresses, social determinants of health and health seeking approaches. This qualitative investigation aimed to address this gap in the literature by conducting in depth interviews amongst women with Long COVID experiencing MSP. This approach was to capture the rich perspectives of the participants, detailing daily life experiences, and methods of coping and challenges associated with MSP as a result of Long COVID. The benefits of a deeper understanding of the MSP experiences in women with Long COVID include interventions and support services specifically designed to address the unique challenges and needs that women encounter, resulting in a better quality of life and overall well-being. AIM OF STUDY The aim of this study has been to explore the experiences of MSP as a clinical manifestation of long COVID in women. METHODOLOGY A qualitative, exploratory, descriptive approach was utilised in this study(McLeod 2017). The purpose of a qualitative approach is to obtain a greater understanding of the experiences and perspectives of individuals who provide rich data without the use of quantitative and statistical methods. The sampling strategy utilised in this study was purposive sampling with the snowball method to obtain data. In this study, MSP was explored through the first-hand experiences of women with Long COVID to further understand how this clinical manifestation has affected their quality of life. This study involved conducting individual in-person interviews with a sample size of 12 women with Long COVID, with the purpose of providing personal, engaging interactions to obtain rich, reliable data. The benefit of conducting personal interviews is that it gathers the personal perspectives of individuals and explores responses to questions, which adds reliability to the study. Data was collected until saturation was attained. Data saturation was reached after interviewing the eighth participant, but four additional participants were interviewed thereafter to confirm saturation was reached. RESULTS The data were analysed using Tesch’s method to identify themes and subthemes. This involved the transcription and review of the participant responses, coding the responses according to themes and further categorizing similar themes into subthemes. The main themes that were identified in this study were the common clinical presentation of MSP experience due to Long COVID, negative effects of MSP on the quality of life and the varied and limited choice of healthcare treatment options. The participants shared a commonality with regard to the clinical presentation MSP, as most of them experienced back pain, neck pain, shoulder pain and headaches. The participants reported that they led a poor quality of life due to the extent of MSP which negatively affected their ability to perform daily tasks and resulted in constant fatigue. A high prevalence of anxiety, depression and frustration was experienced by the participants as they were exhausted from trying to find an effective treatment to resolve their pain. Most participants were highly reliant on pain medication to find some type of relief. Others sought alternate methods of care in the form of chiropractic treatment and lifestyle changes. This helped them better manage their pain and improve their general well-being. CONCLUSION The results of this study revealed that MSP is a prevalent and debilitating symptom amongst women with Long COVID. It affects various major aspects of lives, such as physical functioning, socialisation and mental health. A multi-disciplinary approach is imperative to provide efficient and effective health care to patients. Therefore, it is imperative that not only chiropractors but all health care practitioners who come into contact with affected women are able to create well-rounded treatment plans for those patients and converse easily with them to find a solution to their pain.
An exploration into the utilization of vitamins and minerals by chiropractors in the management of musculoskeletal conditions in runners
(2024) Niemand, Lori Louise; Abdul-Rasheed, Ashura; Thandar, Yasmeen
Background Chiropractors are primary healthcare providers who provide a holistic form of healthcare for the treatment and management of neuromusculoskeletal disorders. The South African chiropractic scope of practice includes dietary advice or supplement recommendations in adjunct to other treatment options when managing a patient. Chiropractors treat a variety of runners of diverse levels, ages, genders and who participate in various domains of running. Runners are at a high risk of developing musculoskeletal (MSK) conditions, with numerous risk factors identified in literature. Musculoskeletal conditions may have a negative impact on a runner’s recovery, performance, quality of life, psychosocial wellbeing and cause financial burdens. Chiropractic treatment is often used to manage MSK conditions in runners but it is unknown what role the utilisation of vitamins and minerals may have in the management of conditions in runners. The utilisation of vitamins and minerals by chiropractors when managing runners has not been investigated; thus, it is unknown how chiropractors prescribe, dispense, or provide nutritional education to runners. The type of supplement recommended for certain conditions in runners remains unknown and the influence that supplementation may have in the management of runners is also unknown. The benefits of understanding supplement utilisation methods by chiropractors will assist the profession in the prevention, treatment and management of MSK conditions in runners. Improved treatment outcomes will assist runners’ recovery, performance and injury rates and promote beneficial outcomes in the chiropractic profession. Aim of the study The study aims to explore the utilisation of vitamins and minerals by chiropractors in the management of MSK conditions in runners. Methodology The study employed a qualitative, exploratory descriptive design to investigate how chiropractors utilise vitamins and minerals in the management of MSK conditions in runners. Interviews were conducted with 15 South African chiropractors, guided by predetermined open-ended questions in a semi-structured manner. The participants needed to be registered with the Allied Health Professions Council of South Africa (AHPCSA), practicing for a minimum of three years, regularly treat runners, and recommend nutritional supplements to runners. The research questions asked chiropractors how they utilise vitamins and minerals when they manage MSK conditions in runners; what type of supplements they advise; for what conditions do they advise supplements; and if supplementation had an influence in the management of runners. The data were analysed to identify themes and sub-themes, using Tesch’s method of data analysis. Results From the data, four main themes with their associated sub-themes emerged. The themes described the active utilisation of nutritional supplements by chiropractors for runners. Sub themes described the factors and reasoning for the recommendation of supplements to runners by the chiropractors. Furthermore, supplement recommendations were identified for both MSK and non-MSK conditions in runners. The data revealed the type of supplements which the chiropractors recommended for certain conditions in the runners. A positive influence of supplementation in runners was reported by the chiropractors. The sub-themes described improvements in the treatment outcomes after supplementation, improved recovery and performance of the runner, and decreased injury rates. A theme of holistic management of runners by chiropractors emerged, which included the use of dietary advice, monitoring of supplementation and interdisciplinary care of the runner when necessary. Conclusion This study determined how chiropractors selected, prescribed and dispensed nutritional supplements to runners. This study revealed which nutritional supplements the chiropractors recommended to runners and for certain MSK and non-MSK conditions, as well as the influence of supplementation in runners. As previous literature has not investigated the recommendation of supplements by chiropractors in runners, this study generated new information to fill a gap in the literature.
The immediate effects of thoracic spine grade III mobilisation on the muscle activity of the middle and lower trapezius muscle
(2022-05-13) Smit, Shinay Elizabeth; Abdul-Rasheed, Ashura
Background: Thoracic spine dysfunction often presents with regional hypomobility which is often caused by abnormal muscle activity in the overlying area. Such as the trapezius muscle. Joint dysfunction is often treated by manual therapies such as joint mobilisation. Previous studies have established that joint mobilisation improves joint mobility, achieves hypoalgesia, improves stability, range of motion and proprioception. Although documented in the literature, the direct benefits of joint mobilisation on muscle activity are not well understood. Therefore, an investigation into the effects of mobilisation on muscle activity was explored. Aim: This study aim was to determine the immediate effects of thoracic spine grade III mobilisation on the muscle activity of the middle and lower trapezius muscles. Methods: This was a quantitative, experimental, study with a pre-test post-test design. Surface electromyography was used to measure the muscle activity of the middle and lower trapezius muscle. A sample size of 48 asymptomatic participants were recruited and randomly divided into the intervention or control group. The intervention group received thoracic grade III mobilisation and the control group remained prone between the pre-test and post-test readings. Within group comparisons was achieved using paired T-tests. Within group and between group comparisons of the change between pre and post intervention was achieved using repeated ANOVA testing. A p-value below 0.05 was considered significant. Results: Spinal mobilisation had no effect on muscle activity. Despite the lack of statistical evidence, there was a positive trend in the effects of thoracic spine mobilisation with a borderline treatment effect in the left middle trapezius muscle (p = 0.063). There was an overall decrease in muscle activity in the intervention group. Conclusion: The results showed that mobilisation did not produce a noteworthy change in muscle activity of middle and lower trapezius muscles between the intervention and control groups and the null hypothesis was not rejected.
An investigation into musculoskeletal pain associated with primary dysmenorrhea in students at a University of Technology : a descriptive study
(2022) Chapman, Heidi Michaela; Abdul-Rasheed, Ashura
Primary dysmenorrhea (PD) is the most frequent gynaecological complaint affecting women across different backgrounds. Growing evidence has demonstrated a strong link between PD and comorbid musculoskeletal pain (MSK), carrying significant impact for the lives of sufferers. Despite this, few studies have isolated and investigated this association, particularly in a South African context. Aim: The aim of this study was to determine the prevalence, risk factors, management, and impact that MSK pain associated with PD has on female university students. Methodology: A quantitative, descriptive cross-sectional survey was conducted at a university of technology in KwaZulu-Natal, South Africa. Data were obtained through voluntary self-administered surveys from 324 participants. The surveys consisted of six parts: demographic characteristics, menstrual history, MSK pain characteristics, risk factors, management approaches and impact. Data were analysed using IBM SPSS version 27. Results: A total of 300 participants were included. A high prevalence of MSK pain was noted. Clinical characteristics showed that the pain was moderate and distributed across anatomical regions, with low back pain being most affected. There was a high prevalence of headaches and myofascial pain. The mode of transportation, as well as heaviness of menstrual flow were significant risk factors. Various management approaches, including home remedies, allopathic and complementary healthcare, were utilised by participants. Overall impact was high across personal, social, and academic domains. Conclusion: This study showed a strong correlation between PD and comorbid MSK pain among female university students, with various management approaches for participants. Pain appeared to carry significant impact across all aspects of life.
Perception of chiropractic students in their preparedness in the diagnoses and management of headache disorders at a selected University of Technology
(2024) Abrahams, Tamia; Abdul-Rasheed, Ashura
A headache is defined as “pain found in the head above the orbito-meatal line and or nuchal ridge” and widely affects both males and females globally. Chiropractic treatment and the management of headaches is substantial, with one in five new patients’ chief complaint being a headache and, thus, the use of chiropractic care in the management and treatment of headaches is popular. The term “self-perceived preparedness” refers to how people view themselves in terms of confidence and competency with regard to certain skills. Self-perceived preparedness is essential as it relates to one’s confidence and the ability to accurately diagnose and manage headache disorders. There is a definite scarcity in South African literature as to the self-perceived preparedness of students in the diagnosis and management of headache disorders. In a South African chiropractic context, the literature, with regard to students’ confidence, awareness and self-assessment of skills is lacking. There are a number of advantages that can come from exploring the concept of self-perceived preparedness. The benefits include, but are not limited to, the assessment of whether or not the curricula goals have been achieved, the readiness of chiropractic students to confidently and correctly diagnose and manage patients sufficiently, and the different aspects that can lead to one feeling unprepared. Aim The aim of this study was to explore and describe the self-perceived preparedness of the chiropractic students’ in the diagnosis and management of headache disorders. Methodology This study design employed a qualitative, explorative and descriptive design. Purposeful sampling was utilised and individual, semi-structured interviews were conducted with 13 Master’s degree students in the chiropractic programme. These interviews took place “in person” and an interview guide was utilised in each interview. The interviews were conducted over a week from the 18th to the 23rd of September 2023. The questions surrounded the topics of self-perceived preparedness, confidence, challenges (whether educational or personal) and the effect of clinical exposure on one’s confidence and skills. The interviews were analysed and themes were extracted utilising Tesch’s eight-step approach of data analysis. Results The chief themes that emerged from the data collection included the level of preparedness, educational and environmental challenges, as well as the positive role that clinical exposure had on students’ views of their self-perceived preparedness. The participants felt largely unprepared to deal clinically with headache disorders. This stemmed from the feeling of isolation within academia, lack of support from staff and clinicians, lack of practical aspects within the curriculum and the COVID-19 pandemic, which resulted in a lack of in-person interaction. Conclusion The findings of this study highlighted the lack of confidence and feeling of under-preparedness to deal with headache disorders within a clinic setting by chiropractic Master’s students. This was mainly attributed to educational and environmental challenges. However, the exposure students gained within a clinical environment greatly improved their feeling of overall self-perceived preparedness
The prevalence, risk factors and management of musculoskeletal injuries in male amateur indoor soccer players in the eThekwini Municipality
(2022-05-13) Nair, Caleb; Abdul-Rasheed, Ashura; Prince, Cleo Kirsty
Background: Soccer is a popular sport played and viewed globally. Furthermore, indoor soccer has been gaining popularity, especially in South Africa. Investigating the prevalence and risk factors of musculoskeletal injuries associated with indoor soccer, creates an awareness among health practitioners and players, especially when there is limited literature on this sport. Aim: The aim of this study was to determine the prevalence of musculoskeletal injuries, the associated risk factors and effective management of musculoskeletal injuries in amateur male indoor soccer players in the eThekwini Municipality, Durban, South Africa. Methodology: The study utilized a quantitative paradigm and a cross-sectional survey design. A total of 166 male participants, between the ages of 18 and 40 years, were recruited for this study. The sample population included amateur indoor soccer players from the eThekwini Municipality. The survey was distributed via links in which participants completed the survey. Data were analyzed using SPSS version 26 and exported into Microsoft Excel. Results: A total of 89 participants sustained musculoskeletal injuries due to indoor soccer. This resulted in a prevalence rate of 74.2% which indicates more than half of indoor soccer players sustain musculoskeletal injury. Muscle strains are seen as the most common injuries by accounting for 32.6% of the total injuries. The study further revealed that players are more likely to sustain an injury through twisting and turning playing mechanisms as 20.2% of injuries were sustained due to this mechanism of play. Playing with a chronic condition was regarded as a significant risk factor for musculoskeletal injuries. While 58.4% of injured participants implemented a management protocol, 38.5% utilized a home remedy as their management protocol. Conclusion: This study revealed that high musculoskeletal injury prevalence rate exists among amateur indoor soccer players, in the eThekwini Municipality. Male indoor soccer players are commonly prone to muscle strains and sprains with the knee being the most common site of injury. The twisting and turning playing mechanism utilized in indoor soccer appears to be a common mechanism that predisposes players to musculoskeletal injury. Players with chronic conditions should play with caution as chronic conditions may predispose players to injuries and exacerbate health conditions. Urgent measures are required to educate indoor soccer players on injuries and effective management as the results demonstrated high rates of injury and poor management protocols.