Theses and dissertations (Health Sciences)

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The effectiveness of spinal manipulation versus spinal manipulation in conjunction with core stabilisation exercises in the treatment of mechanical low back pain
(2002) Boden, Langley Nicholas; Atkinson, M. J.
Low back pain is estimated to effect 60-90% of the world's population sometime during their lives while 20-30% of people suffer from low back pain at any given time (Cassidy and Burton, 1992:3). Locally, epidemiological studies into low back pain have revealed incidence rates of 57.6% amongst black South Africans (Van der Meulen, 1997) and between 70 and 80% amongst Indians and Coloureds (Docrat, 1999). The use of spinal manipulation with the emphasis on restoring joint mobility, has been proven to be one of the most effective and cost effective approaches in the management low back pain of a mechanical origin (Di Fabio, 1992). McMorland (2000), showed in a study of 199 patients, that spinal manipulation resulted in an average of 52.5% and 52.9% reduction in low back pain and disability respectively. Panjabi (1992:1) has postulated a theory of a 'neutral zone' around which the passive lumbar spine operates. He describes the neutral zone as a region of intervertebral motion around the neutral posture where little resistance is offered by the passive spinal column. It is, according to Panjabi (1992:1), possible for this neutral zone to increase with injury to the spinal column or with weakness of stabilising muscles, which could result in low back pain. The trunk muscles therefore have to be able to co-contract isometrically to control the neutral zone and protect the spinal tissue from excessive motion (Richardson et aI.1990). The transversus abdominis muscle and multifidus muscle have been identified as playing an important role in the complex synergistic interaction of the trunk (Norris, 1995). The above concept involving muscles attempting to maintain a neutral zone is commonly referred to as 'core stabilisation' (Norris, 1995).
The efficacy of muscle energy technique in the treatment of rotator cuff tendonitis in terms of subjective and objective clinical findings
(2006) Azizi, Manny; Atkinson, M. J.
Purpose Repetitive strain injuries, especially rotator cuff tendonitis, are increasing and reaching epidemic proportions in certain industries and in most industrialized countries (Yassi et al. 1996). Fatigue of the rotator cuff allows the humeral head to translate anteriorly, with resultant mechanical impingement of the supraspinatus tendon. At this point inflammatory changes become evident (Fu et al. 1995). According to Greenman (1996), muscle energy technique (MET) is a 'manual medicine treatment procedure that involves the voluntary contraction of a patients muscle in a precisely controlled direction, at varying levels of intensity, against a distinctively executed counterforce applied by the operator.' It has been hypothesized that MET can be used to lengthen and strengthen muscles, to increase fluid mechanics and decrease local edema, and to mobilize a restricted articulation (Greenman 1996). However, these statements have been made in the absence or appropriate research in order to support such statements, therefore. the aim of this study was to assess the efficacy of Muscle Energy Technique in the treatment of rotator cuff tendonitis in terms of subjective and objective clinical findings. Methods Objective measures included: Diagnostic ultrasound which was used to evaluate changes in inflammation and thickness of the involved tendon, the algometer was used to assess point tenderness, whilst inclinometer readings were taken to evaluate the associated changes in range of motion that may have taken placei
The relative effectiveness of combined spinal manipulative therapy and occlusional splint therapy in the treatment of chronic tension-type headaches
(2002) Cartwright, Gaynor Dorothy; Atkinson, M. J.
The purpose of this study, was to investigate and determine what role the treatment of nocturnal bruxism, in conjunction with spinal manipulative therapy, would play in the management of tension-type headaches.
A retrospective cross sectional survey of extremity cases on record at the Durban University of Technology chiropractic day clinic (1995-2005)
(2007) Kandhai, Surasha; Atkinson, M. J.
The increasing contribution of chiropractors in health care has generated greater interest in understanding the characteristics of chiropractic practice patterns and treatments (Mootz et al., 2005). However, despite the rapid growth and extensive use of chiropractic, good descriptive data on chiropractors and their patients remains limited (Coulter and Shekelle, 2005). Even fewer studies have been reported which deal specifically with patients attending chiropractic-teaching clinics (Nyiendo and Olsen, 1988). According to Nyiendo and Haldeman (1986), there remains a paucity of empirical data regarding the type of patients seeking care at a chiropractic-teaching clinic and the types of treatments provided at these clinics. According to Till and Till (2000), South Africa is largely a developing country with scattered developed communities. Its requirements and opportunities as they relate to chiropractic may differ significantly from those in other developed countries. It was also estimated that in South Africa only a fraction of the country’s population have any notion of what chiropractic is, thus the largest challenge lies with educating the public about chiropractic (http://www.chiroweb.com, 2005). The lack of attention given to the chiropractic management of extremity conditions has contributed to a perception that chiropractic is unable to manage extremity conditions proficiently (Hoskins et al., 2006). There is a noted lack of research on the management of extremity conditions within chiropractic (Hoskins et al., 2006); therefore the current study focused on all components of the extremity system. Objectives: The purpose of this research is to conduct a descriptive study of extremity cases on record at the Durban University of Technology Chiropractic Day Clinic from 1995 to 2005 and the objectives are as follows: •To determine the prevalence of extremity complaints over the past decade at the Durban University of Technology Chiropractic Day Clinic. •To identify the demographics of patients that visited the Durban University of Technology Chiropractic Day Clinic. •To identify the most common presenting region and complaints of the extremity system as well as the aetiology and associated signs and symptoms of these complaints at the Durban University of Technology Chiropractic Day Clinic. •To identify the nature of the interventions and methods most commonly used in the management of patients at the initial consult and where possible contra-indications to any treatment modality
A retrospective cross sectional survey of thoracic cases on record at Durban University of Technology chiropractic day clinic
(2007) Benjamin, Rhoda Lynn; Atkinson, M. J.
The purpose of this research is to conduct a descriptive study of cases that presented with thoracic complaints to Durban University of Technology chiropractic Day Clinic from the 13 January 1995 to 30 November 2005. This is a retrospective, quantitative, non-experimental, clinical survey. The sample size for this study included 7111 cases obtained from the Durban University of Technology chiropractic day clinic. There were no thoracic cases recorded in the random sample for the year 1995, therefore the random sample allocated for this year was subtracted from the total sample. 249 Thoracic cases were included in this research. The overall prevalence for the time period 1996 - 2005 was 3.5%. Gender: 248 of the 249 patients had recorded gender information. The majority were female 54.8% while 45.2% were male. Age: The ages ranged from 11 to 73 years. The mean age was 33.3 years. Occupation: 241 patients had a recorded occupation. 21.6% of them were classified as active or non-sedentary while the majority had sedentary jobs. The main complaint was mid-back pain which was noted in 41.4% of the population. Thoracic facet syndrome was the primary diagnosis given in 74.7% of the population; myofasciitis was the second most diagnosed condition with 8.8% of the population having this primary diagnosis. The most common treatment was joint manipulation, which was used in 82.6% of the cases, followed by soft tissue therapy (79.4%) and stretches (44.9%). The facets that were most commonly found to be fixated were in the T5 toT8 region. The investigative procedure that was used most often in the sample was x-rays. Fourteen patients were sent for x-rays (5.6%). One patient was sent for a blood test (0.4%). No other investigative procedures were used in these patients. Even though the overall prevalence of thoracic pain sufferers was only 3.5% over the ten year period, it is still an area of pain that must be investigated. The thoracic spine has been overlooked as a major region for research. This study has proved that there is need for continuing research in this area, to assist chiropractors to treat the thoracic spine more effectively.
A retrospective cross-sectional survey of lumbo-sacral cases recorded at the D.U.T. Chiropractic Day Clinic (1995-2005)
(2007) Jaman, Ravina; Atkinson, M. J.
To determine the prevalence and demographics of lumbo-sacral cases recorded at the D.U.T Chiropractic Day Clinic from 13th January 1995 to 30th November 2005. To identify the aetiology, common lumbo-sacral diagnoses, associated signs and symptoms, management and contra-indications to chiropractic treatment recorded on the initial consultation of patients with lumbo-sacral complaints.