Theses and dissertations (Health Sciences)
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Item Chiropractic manipulation and mobilization for postpartum low back pain : a systematic review(2024) Phakathi, Londeka Nokulunga; Thandar, Yasmeen; Venketsamy, YomikaBackground: Prior research has documented empirical support for the effectiveness of chiropractic treatment for postpartum low back pain (PLBP), mostly in pregnancy but very few in postpartum. Nevertheless, the trustworthiness and calibre of the evidence from these studies has not been adequately scrutinised to authenticate their conclusions and determine whether clinical efficacy or effectiveness is present. Therefore, the objective of this study was to assess the current evidence in the literature about the therapeutic effectiveness of chiropractic manipulation and mobilisation for chronic lower back pain/pelvic girdle pain in postpartum women. Method: This study employed a qualitative evidence synthesis methodology, specifically utilising the Cochrane systematic review strategy. The literature was sourced via an electronic literature search (e.g. Google Scholar, PubMed, Medline, ProQuest Health, etc). The key search terms used were ‘low back pain’, ‘pelvic girdle pain’ together with ‘postpartum’, ‘chiropractic’, ‘manipulation’, and ‘mobilisation’. In addition to the key terms listed above, the search strategy for postpartum low back pain encompassed the following terms: ‘post-natal mechanical low back-ache’ or ‘sacroiliac syndrome/dysfunction’ or ‘sacral subluxation’ or ‘sacral pain’ or ‘lumbopelvic’ or ‘lumbar facet syndrome’. For manipulation and mobilisation, the search encompassed ‘sacral adjustment’ or ‘spinal manipulative therapy’ or ‘manual therapy’. A total of 2127 articles were identified, however 8 were suitable for inclusion. Data was extracted from each included study onto a prepared data extraction sheet. There were 4 reviewers that reviewed the 8 (4 RCTs and 4 CRs) articles included. The independent reviewers only reviewed the 4 RCTs. For Critical Appraisal and Quality of Evidence, Rev Man “Risk of Bias” was used tool for randomised controlled trials (RCTs) and for case reports (CRs), the Joanna Briggs Institute Critical Appraisal Tool (JBICAT) was selected was used. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation) system was used to rank the evidence on various levels of clinical strength in relation to treatment outcomes. Results: While 3 of the 4 RCTs demonstrated no significant evidence to support a superior effectiveness of chiropractic manipulation and mobilisation in postpartum low back pain, Pritchard (2001) showed statistically significant evidence in supporting the improvement chiropractic manipulation and mobilisation provided in this demographic. The outcomes in all 4 CRs showed large degrees of favourability to the effectiveness of chiropractic manipulation and mobilisation. However, the quality of the evidence was low to moderate at most, thus affecting the extent to which generalizability can be made, in to relation to postpartum low back pain. Conclusion: This study highlighted a dearth in literature and the need for conducting research of higher quality within this demographic. There were also discrepancies in the utilisation of the LBP term and its clinical scope. It is highly important that these discrepancies are resolved by establishing a more concrete and deliberate guideline or definition of this phrase. The production of more RCTs with larger sample sizes that include a variety of demographic characteristics (race, socioeconomic status, age, etc.), was recommended.Item Practice-related hygiene behaviours utilized by Chiropractors pre, during and post the COVID-19 pandemic in South Africa.(2024) Enslin, Jan-Frederik; Krishna, Suresh Babu Naidu; O’Connor, LauraBackground: The COVID-19 pandemic had an impact on the delivery of healthcare services worldwide. The Allied Health Professions Council of South Africa implemented regulations to control the spread of the virus, including social distancing, face masks/shields, hand sanitisation, surface disinfection, and protective shields. Chiropractors had to incorporate new hygiene measures to ensure the safety of their patients and themselves. Without adherence to proper hygiene protocols, manual therapy poses a substantial risk of transmission for both the practitioner and the patient. There is limited information available regarding the changes made by chiropractors to their practices in response to the pandemic and if these changed behaviours are still being implemented. Exploring and understanding changes in behaviour can help identify areas where chiropractors may need additional support or resources to adapt to new circumstances and can provide valuable information on how the pandemic has impacted the field of chiropractic care. Additionally, by studying how chiropractors adapted during the pandemic can help gain insight into best practices for future challenges or crises that may arise, as well as can help improve patient care and outcomes in the future. Aim: To determine the practice-related hygiene behaviours of chiropractors before, during and post the COVID-19 pandemic in South Africa. Methodology: An anonymous online survey was completed by registered Chiropractors in South Africa (n=119) registered with the Allied Health Professions Council of South Africa, having provided informed consent. The survey consisted of questions related to practice hygiene behaviours pre, during and post the COVID-19 pandemic and distributed via a link on QuestionPro®. The survey closed on 02/02/2024. Results: The study examined the distribution of hand and equipment disinfection in a healthcare setting, before and after the COVID-19 pandemic. The response rate for the survey was 22.45%. A total of 36% of chiropractors had been practicing for seven years and 60% lived in urban or major cities. Most practitioners returned to their work in level 4 of lockdown and practiced as a sole practitioner. The study found a significant statistical difference that sanitiser availability and the use of personal protective equipment were less prevalent before and after the pandemic than during the pandemic. Most chiropractors (78%) felt that the COVID-19 hygiene protocols made them more aware about practice hygiene behaviours. However, 30% of chiropractors believed they were likely to contract COVID-19 if they did not adhere to proper hygiene practices. Barriers to implementing hygiene practices during COVID-19 included patient reluctance, lack of time, resources and difficulty in adhering to hygiene practices. Half of the chiropractors agreed to continue with good hygiene practices post COVID-19. Conclusion: The COVID-19 pandemic resulted in increased adherence to practice related hygiene behaviours with the implementation of safety precautions such as protective screens and face masks. Many of the chiropractors continued to utilise these behaviours after the pandemic.Item Attitudes and perceptions of chiropractic care among pregnant women of the eThekwini Municipality : a qualitative study(2024) Perumal, Sumeshni; Varatharajullu, DesireeBackground: Pregnancy often brings about musculoskeletal discomfort and chiropractic care has been recognised as a beneficial treatment for addressing these issues. However, little qualitative research is available exploring the attitudes and perceptions of pregnant women towards chiropractic care, particularly in a South African context. Aim: This qualitative study aimed to explore the attitudes and perceptions of pregnant women receiving chiropractic care in the eThekwini Municipality, South Africa, with a focus on understanding their experiences, communication with chiropractors and common presenting complaints. Methods: Semi-structured interviews were conducted with 12 pregnant women receiving chiropractic care. Thematic analysis was employed to identify and explore the key themes related to the women’s attitudes and perceptions of chiropractic care during pregnancy. Results: A total of five major themes emerged from the interviews: (1) Positivity towards chiropractic care, (2) Perception of chiropractic care and safety, (3) Readiness to seek chiropractic care after treatment and patient satisfaction, (4) Communication between the patient and chiropractor, and (5) Common presenting complaints. Conclusion: The study offers insightful information about how pregnant women feel about chiropractic care, emphasising the value of emotional support, safe and efficient treatment methods and effective communication. The results highlight the need for more investigation into how pregnancy affects the musculoskeletal system and how chiropractic care might help treat musculoskeletal discomfort associated with pregnancy. The study’s suggestions highlight the value of a patient-centred approach to healthcare and have real-world consequences for raising the standard of care given to expectant mothers.Item 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, YasmeenBackground 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.Item The prevalence, selected risk factors and burden of primary headaches in lecturers at a University of Technology (UoT) in KwaZulu-Natal during the COVID-19 pandemic(2024) Chetty, Deidre; Orton, Penelope Margaret; O’Connor, LauraBackground: Headaches are a common disabling condition that affect many people worldwide. Headaches have been under-studied in developing countries and there is a paucity of literature documenting headaches in lecturers. The COVID-19 pandemic has forced lecturers to adapt to online teaching, which may have resulted in headaches. It is envisaged that this research will be beneficial to chiropractors, other healthcare providers and lecturers. Aim of Study: The aim of this study was to determine the prevalence, selected risk factors and burden of primary headaches in lecturers at a university of technology (UoT) in KwaZulu Natal during the COVID-19 pandemic. Methodology: A quantitative, descriptive cross-sectional design, where 685 lecturers employed at the Durban University of Technology, through self-selection, were selected to participate, using consecutive sampling. A minimum sample size of 247 was calculated, using a confidence level of 95% and confidence interval of 5%. Lecturers from all six faculties were invited to participate. The headache-attributed restriction, disability, social handicap and impaired participation (HARDSHIP) questionnaire was administered electronically via QUESTIONPRO®. Each participant was required to initial a consent form prior to answering the questionnaire. The diagnostic algorithm was utilised to diagnose headaches according to the diagnostic questions in the HARDSHIP questionnaire. All data were captured on an Excel spreadsheet and subsequently analysed using SPSS version 28. Results: There was a total of 255 completed questionnaires. The mean age of respondents was 45.66 years old. Of the total sample (n=255), 51.8% were headache sufferers. Most respondents suffered from probable tension-type headache (41.9%; n=54), followed by migraine-type headache (27.9%, n=36). Social risk factors revealed a significant relationship between alcohol and headaches, and sleep deprivation and headaches. Medial risk factors revealed a significant relationship between a head injury and headache and sinusitis and headache. Although there was a relationship between psychological risk factors and headache, it was not significant. Many work-related risk factors were significantly related to headache. There was a greater number of headache sufferers who tested positive for COVID-19. Many respondents experienced loneliness and their workload increased during the pandemic. Most of the respondents’ headaches interfered with work, and they usually took medication to treat their headache. Conclusion: Headaches are common in lecturing staff with, tension type headaches being most prevalent. There are many risk factors which are strongly associated with headaches and its impact caused an interference with work and negatively affected the suffers mental health. Family, social or leisure activities are also neglected when a headache occurred. This study adds to the current literature on headache prevalence in the lecturer population and increases awareness.Item The prevalence, knowledge, attitude and practice regarding self-administered over-the-counter analgesic use among patients with chronic musculoskeletal pain attending the Durban University of Technology Chiropractic Day Clinic(2023) Engelbrecht, Donna; Thandar, YasmeenChronic pain is a major concern globally, with the greatest contributor being chronic musculoskeletal pain (CMSP). CMSP decreases quality of life, affects activities of daily living, increases work absenteeism and health care expenses. Recommendations for the management of CMSP include exercise and the use of analgesics, such as non-steroidal anti-inflammatory drugs (NSAIDs), or more potent analgesics, including opioids. Amongst those suffering from CMSP, it is common to self medicate with analgesics. Over-the-counter (OTC) analgesics, in particular, help patients manage their own CMSP symptoms. However, OTC medicine use can be a problem when misused. The common reasons why patients self-medicate with OTC analgesics is the easy access to these medications; previous experience with treating their condition; and financial and economic difficulties, which prevent visiting a primary physician (for more potent analgesics), especially in developing countries. There are many studies that have examined the prevalence of self-medication of OTC analgesics using population-based studies and some among health science students at universities but these do not focus on the prevalence of self-medication among those with CMSP. There appears to be limited research conducted in South Africa with regards to the prevalence of self-administered OTC analgesic use among patients with CMSP, especially within a chiropractic clinic setting, where the treatment of CMSP consumes a large portion of primary care. It has also been noted in the literature that information and research needed to quantify the scale of misuse is currently lacking. Primary care physicians, including chiropractors, who more frequently treat chronic pain, are thus best suited to ascertain this by assessing the attitudes, knowledge and practices regarding self-administered OTC analgesic use amongst patients suffering from CMSP. Method This study is a quantitative, descriptive cross-sectional study, whereby a survey was conducted (using questionnaires) to collect data and make statistical inferences about the Chronic pain is a major concern globally, with the greatest contributor being chronic musculoskeletal pain (CMSP). CMSP decreases quality of life, affects activities of daily living, increases work absenteeism and health care expenses. Recommendations for the management of CMSP include exercise and the use of analgesics, such as non-steroidal anti-inflammatory drugs (NSAIDs), or more potent analgesics, including opioids. Amongst those suffering from CMSP, it is common to self medicate with analgesics. Over-the-counter (OTC) analgesics, in particular, help patients manage their own CMSP symptoms. However, OTC medicine use can be a problem when misused. The common reasons why patients self-medicate with OTC analgesics is the easy access to these medications; previous experience with treating their condition; and financial and economic difficulties, which prevent visiting a primary physician (for more potent analgesics), especially in developing countries. There are many studies that have examined the prevalence of self-medication of OTC analgesics using population-based studies and some among health science students at universities but these do not focus on the prevalence of self-medication among those with CMSP. There appears to be limited research conducted in South Africa with regards to the prevalence of self-administered OTC analgesic use among patients with CMSP, especially within a chiropractic clinic setting, where the treatment of CMSP consumes a large portion of primary care. It has also been noted in the literature that information and research needed to quantify the scale of misuse is currently lacking. Primary care physicians, including chiropractors, who more frequently treat chronic pain, are thus best suited to ascertain this by assessing the attitudes, knowledge and practices regarding self-administered OTC analgesic use amongst patients suffering from CMSP. Method This study is a quantitative, descriptive cross-sectional study, whereby a survey was conducted (using questionnaires) to collect data and make statistical inferences about the indicated that they use their own experience of what helps relieve their pain; a further number (39.3%) indicated that they read the information insert inside the medication box. The percentages do not add up to 100% because the participants had chosen more than one option in the question. Regarding the number of participants who responded to the use of different analgesics, most participants (70.3%) were using NSAIDs; followed by paracetamol only (57.7%); combination analgesics not easily obtainable without a prescription (54.1%); combination analgesics that can be obtained without prescription (41.1%); aspirin (15.3%) and other (0.9%). It was determined that more participants (66.7%) indicated that they did not experience any side effects from the analgesics that they were consuming (p<.001). Gender has shown to have an influence on self-administered analgesic use. It was found that there was a significantly larger number of females (86.2%) who used self-administered analgesics compared to males (69.1%) (p=.001). The age group 35–44 was found to be statistically more likely to use self-administered painkillers (88.9%), followed by those aged 65+ (88%) (p=0.48). A significant number of Black participants (p=0.43) indicated that they did not use self administered OTC analgesics (29.1%) and a significant number of participants who indicated “Other” also did not use self-administered OTC analgesics (44.4%) (p=0.43). Conclusion The findings from this study reinforce that primary care physicians, including chiropractors, need to take better initiatives in educating, providing better guidelines and promoting safe and effective OTC analgesic use to their CMSP patients. Considering that this study demonstrated a high prevalence of CMSP, and a high prevalence of OTC analgesic use, it is important that chiropractors understand patients with chronic pain and why they may make certain decisions. Seeking additional pain relief options like chiropractic treatment for CMSP earlier may help reduce reliance on OTC analgesic medication.Item 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, AshuraA 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 preparednessItem An epidemiological investigation into musculoskeletal pain in KwaZulu-Natal orchestral musicians(2024) Muhondo, Linley; Thandar, Yasmeen; Kell, ColetteBackground Non-communicable diseases pose a significant health threat worldwide. Of those diseases, musculoskeletal diseases are most responsible for a significant portion of occupational injuries in all job-sectors, including the musical sector. Musicians are prone to suffering from musculoskeletal injuries, more so than other populations. These injuries are termed playing-related musculoskeletal diseases (PRMDs). There are several risk factors associated with acquiring PRMDs including being of the female gender, age, and the type of instrument played. While most literature on musicians’ has been documented in countries abroad, there is a paucity of literature looking at the risk factors and attributes of African, and specifically South African, musicians. This is notable, as African musicians may have different characteristics to their international counterparts. The aim of this research was to examine orchestral musicians in Kwa Zulu-Natal from all sections of the orchestra to determine the prevalence of musculoskeletal injuries and the potential risk factors for these injuries, as well as their musculoskeletal injury profile. Methodology This study was a quantitative, cross-sectional descriptive study based on a self administered questionnaire. The questionnaire was piloted electronically and the necessary alterations were made. The final questionnaire was administered to members of 2 orchestras in Kwa Zulu-Natal, namely the Pietermaritzburg City Orchestra (25 members) and the Durban City Orchestra (30 members), making the targeted sample 55 musicians in total. All musicians who met the inclusion criteria were invited to participate in the study. The anonymously completed questionnaires were placed into marked boxes after completion to ensure musician anonymity. The data was analysed using IBM SPSS version 28. Association between specific risk factors and 12-month prevalence of MSK was assessed using Fisher’s exact 2-sided tests for categorical risk factors, and t-tests for continuous risk factors. A p-value of <0.05 was taken as statistical significance. Results Of the 55 musicians targeted, 30 of them participated, resulting in a response rate of 54.5%. Majority of the respondents were female (n=20). The data showed that the annual prevalence of PRMDs in the two orchestras was 46.7%. The point and one month prevalence were both 40%. The most injured section of the orchestra were the strings, followed by the woodwind section. The string section also reported the highest number of average affected areas in the orchestra (n=4). The most frequently injured anatomical sites of the body were the shoulders and wrists. There was no statistical significance found between the risk factors and injuries acquired. However, the results showed that females were injured more than the males (55%). Most of the respondents that reported musculoskeletal injury fell within the 18-24 age range and majority of the injured musicians fell in the overweight BMI body category. Most of the music teachers and the single career musicians in the study reported suffering from PRMDs and playing instruments for more than 16 hours a week on average. Conclusion The prevalence of playing-related musculoskeletal disorders among musicians was relatively high among the orchestral musicians in Kwa Zulu-Natal. Though not statistically significant, factors such as instrument played, age, and female gender were the factors that had the greatest influence on injury rates. The pain experienced was mild in nature and felt worse after playing their instruments. While the pain did not affect their activities of daily living, it did cause a few to change their way of playing or stop playing entirely for a period of time due to their pain. Majority of the players were aware of musician’s playing related health problems, and acknowledged that they are a problem, but none of them had received formal methods of education regarding them. The COVID-19 pandemic was a phenomenon that also affected the musicians in various ways.Item Muscle recruitment patterns of selected upper extremity muscles in Chiropractors within the eThekwini Municipality while performing a simulated sacroiliac joint manipulation(2024) Luke Hardy, Benjamin; Murphy, Bernadette; O’Connor, LauraBackground: Spinal manipulative therapy in the form of a high velocity, low amplitude manipulation, is a specialised therapeutic technique utilised by chiropractors and other manual therapists. Little is known about the shoulder muscular recruitment pattern utilised by practitioners/student’s to deliver this technique. This study aims to profile the muscle recruitment patterns of selected upper extremity musculature during a simulated sacroiliac joint manipulation to provide objective teaching material for future spinal manipulative therapy students regarding this specific manipulation. Methods: A quantitative, descriptive, observational design in which surface electromyography (sEMG) was used captured muscle activation patterns of 11 shoulder muscles in 20 qualified chiropractors who practiced in the eThekwini Municipality. Muscle activity was recorded while the chiropractors performed a simulated sacro-iliac joint manipulation, while simultaneous live video recording was obtained. The manipulation was assessed during its three phases: preload, thrust and resolution. Participants gave informed consent. Raw data was processed and normalised for comparability. Results: All 11 muscles displayed activity throughout the three phases of the adjustment. During preload, the clavicular and sternal pectoralis major and biceps brachii had the greatest mean and median muscle activation magnitude, with the middle and upper trapezius and clavicular pectoralis major showing the greatest maximum muscle activation magnitude. In the thrust phase all muscles showed high activity levels, except for the posterior deltoid which showed moderate activation. The middle and lower trapezius and infraspinatus had the greatest mean, median and maximum muscle activation magnitude. During the resolution phase, the greatest median muscle activation magnitude was found in the middle and lower trapezius and posterior deltoid muscle. This was similar to the greatest mean and maximum muscle activation with the triceps brachii replacing the lower trapezius. The maximum force output during the adjustment was averaged at ± 1.9 Kg. Conclusion: This study highlights the role of the shoulder muscles, specifically the pectoralis and the scapular stabilizer muscles, especially the middle trapezius, in the execution of the spinal manipulative technique investigated in this study. Future studies should confirm these findings in larger population where subgroup analysis can be undertaken.Item An injury profile of high school soccer players on a synthetic surface at a private school in the eThekwini municipality(2024) Timul, Asthiq; Ally, FazilaBackground In South Africa, sport is a compulsory activity in the majority of schools and most of the population that play soccer at schools are amateur players. Many schools in Durban have astroturf courts on which the scholars play soccer. Astroturf is a synthetic surface that has gained much popularity due to it being cost effective and easy to maintain. Despite the benefits associated with playing on astroturf, one of the concerns is increased risk if injury to the players. Over the last decade, soccer injuries have become commonplace amongst scholars, with the most affected age group being between 13–15 years of age. The aim of this study is to determine the injury profile of amateur scholar soccer players playing on a synthetic surface at a private school in the eThekwini municipality. Methodology The research study is a quantitative study with a descriptive design. An organised, quantitative questionnaire was handed out to 108 registered learners at Al-Falaah College. The responses of the questionnaire were used to establish the demographic and injury profile of the soccer players in this study. Results A 100% response rate was recorded. The majority (n=24; 22.2%) of the learners were in the 14 year age group of Indian (n=98; 90.7%) ethnicity. The most common site of injury was recorded as the knee joint (n=54; 50%), followed by the ankle joint (n=36; 33.3%), wrist (n=29; 26.9%) and foot (n=28; 25.9%). The most common mechanism of injury reportedly occurred during tackling (n=61; 56.5%) and the least number of injuries were reported as occurring during heading (n=4; 3.7%). Most of the participants were found to be using incorrect footwear when playing on a synthetic surface, such as, studded boots (n=63; 58.3%) and sneakers (n=39; 36.1%). Conclusion The majority (79.6%) of the injuries reported were characterised as mild to moderate. The lower extremity was the most frequently injured, specifically the knee and ankle joint. Ligament and muscular injuries were the most common injury affecting the lower extremity. Younger individuals are more likely to face injury when playing soccer on a synthetic surface.