Theses and dissertations (Health Sciences)
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Item The knowledge, attitudes, and practice of registered Masters Chiropractic students of dry needling during their clinical practicum(2022-05-13) Seale, Talia Cherise; Maharaj, Praveena; Orton, PenelopeBackground Dry needling (DN) is an effective treatment protocol commonly used by chiropractors and chiropractic students for patients presenting with myofascial trigger points (MFTPs). The efficacy of DN is majorly advantageous in its use in clinical practice, but it is not without risk. As an invasive procedure, requiring the penetration of skin, DN has the potential to cause infection, as well as other adverse events. These range from undesirable short-term side effects to more serious harm that can result in fatality. As such, a practitioner is expected to be well versed in the modality and confident in performing the procedure on patients. This requires a strong educational background in DN, both theoretically and practically, to ensure the safe and effective practice of DN. Despite the call for more research-based investigation into chiropractic education, the literature in this regard is still lacking. Various authors have demonstrated the beneficial nature of the student perspective and in this case, as the involved party, the student experience would best address the successes and shortcomings of the teaching and learning of DN at the Durban University of Technology (DUT). Aim To describe the knowledge, attitudes, and practice of registered Master of Technology in Chiropractic students on the usage of dry needling during their clinical practicum at the DUT Chiropractic Day Clinic (CDC). Method A qualitative approach was used with an exploratory and descriptive design, within an interpretive paradigm. The eight participants chosen were selected by means of purposeful sampling. Their experiences of DN were recorded electronically during semi-structured, individual interviews and were later transcribed verbatim. The researcher then used thematic analysis to interpret the data and discuss the findings. Results One main theme prevailed. Dry needling is an important modality in the treatment of myofascial trigger points and is a clinical skill that is learnt through observation and practice to prevent patient harm. A total of five sub-themes emerged from the data, which categorised the different components discussed in this study. These included: trigger point treatment, pre-clinic teaching and preparedness for dry needling, appraisal of dry needling during the clinical practicum, choice of dry needling practice style, and dry needling high-risk muscles. The participants reported their dissatisfaction with the pre-clinic DN education and their dislike for the rule that prohibits the DN of high-risk muscles (HRM). They indicated that the pre-clinic DN education required more practical exposure and direct supervision. Participants commented on the need for examinations and testing to be more practical in nature. Despite the negative aspects shared by participants, the DN education at DUT left students feeling prepared and confident to DN in clinical practice. They attributed their development of knowledge, skills and confidence to a year of clinical experience and the clinicians’ input during the clinical practicum. This study highlighted the DN knowledge and attitudes of master’s chiropractic students and described their practice of the modality.Item Study into the treatment of active myofascial trigger points using interferential current as an alternative to dry needling agitation(1995) Christie, Kevin Rodney; Kretzmann, HeidiThe aim of this study was to determine whether the use of Interferential Current provided a non-invasive alternative to Dry Needling Agitation in the treatment of Myofascial Pain and Dysfunction Syndrome. A randomised Experimental Method of Single- Variable design was undertaken using the before-and-after-withcontrol design.Item A comparative study of the relative effect of spinal manipulation as opposed to acupuncture treatment in the management of chronic sinusitus(1999) Descoins, Nicole; Jones, Andrew D.The purpose of this investigation was to compare the relative effect of spinal manipulation as opposed to acupuncture treatment in order to determine a more effective approach in the treatment of chronic sinusitis. It was hypothesized that chiropractic treatment and acupuncture treatment would both be effective in the treatment of chronic sinusitis. However, it was proposed that the chiropractic treatment would be more effective than acupuncture treatmentItem The effectiveness of the Impulse Adjusting Instrument® compared to dry needling in the treatment of upper trapezius myofascial trigger points(2017) Laing, Mandy; Varatharajullu, DesireeAim: There is a paucity in the literature regarding the effectiveness of the Impulse Adjusting Instrument® (IAI) in treating myofascial trigger points (MFTPs) and regarding the effectiveness between dry needling and the IAI in the treatment of MFTPs. There are many limitations and an array of contraindications for dry needling. Therefore, an alternative method should be sought as this will be beneficial to the patient. Thus, the aim of this study was to determine the effectiveness of the IAI compared to dry needling in the treatment of MFTPs found in the upper trapezius muscle. Methodology: This study was a randomised single-blinded clinical trial. This study consisted of 41 participants between the ages of 18 and 40 who were divided into two groups. The participants were randomly allocated into their respective groups using a blinded allocation method that was drawn up by the statistician. Groups were divided into dry needling (Group one (n=18)) and IAI (Group two (n=23)) treatment groups. Subjective neck pain level was determined using a numerical pain rating scale (NRS). The neck disability index (NDI) subjectively assessed the effect neck pain had on the participants’ activities of daily living before and after treatment. The Patients Global Impression of Change (PGIC) tool was used to determine the participants’ subjective impression of treatment outcomes since the beginning of the treatment. Objective pain pressure thresholds (PPT) were measured with an algometer. Objective cervical range of motion (CROM) in lateral flexion (LF) was measured with a goniometer. Each participant had four visits over a two week period, which included three treatments and a final visit for final measurements. Data was analysed using IBM SPSS version 23. Repeated measures ANOVA was used to examine the effect on each outcome measure. Directional trends in effectiveness were drawn up using profile plots to assess the direction and trends of the effects. A p value of < 0.05 was considered to be statistically significant. Results: Intra-group and inter-group statistical analysis revealed all subjective measurements improved in both groups with no significant differences between the groups. With respect to objective measurements, there was no statistical improvement in LF CROM and dry needling had no improvement in PPT. Impulse Adjusting Instrument trigger point therapy showed an increase in PPT, however, when compared to dry needling there was no statistical difference in PPT. Conclusion: The conclusion for this study states that the trends in each of the outcomes suggest that the IAI is as effective as dry needling for the treatment of MFTPs.Item A randomized comparative clinical trial of the relative effectiveness of manipulation or manipulation and acupuncture for the treatment of lower back pain(1999) White, Horace Lindsay; Nook, B. C.Among the many modalities used by chiropractors is acupuncture. However, it has not yet been put to the test by research whether the addition of acupuncture for the treatment of lower back pain is of benefit or not to the patient. It is hypothesised that the addition of the acupuncture modality with the chiropractic adjustment will be of more benefit than the chiropractic adjustment alone. As the purpose ofthis study was to compare a chiropractic adjustment to a chiropractic adjustment followed by acupuncture the experimental method was used. The adjustments used were those indicated after following the diagnostic protocol of Natal Technikon using the Diversified Technique of Chiropractic. The acupuncture points used were the Urinary Bladder, 23, 25, 31, 36 and 40 and Gall Bladder 30 in all patients in the group receiving acupuncture. Thirty patients were selected randomly and split into two groups of 15. Patients were treated a maximum of 8 times or less if they become pain free in less treatments. The results of the Oswestry Low Back Pain Disability, Numerical Pain Rating Scale-101 and McGill Pain Questionnaires were recorded before the 1st, 5th, and after the last treatment and again at the 1 month follow up consultation, along with the BROM II and Algometer readings. The statistical tests used were the Intragroup Wilcox Signed Rank Test, the Intergroup Mann Whitney U Test and Power statistics according to the UCLA web site. Both treatments wereItem An evaluation of the efficacy of acupuncture and homoeopathic treatment in helping people to stop smoking(1996) De La Rouviere, Alexandra Mary; Boyer, R. P.The aim acupuncture of this study was to compare the treatment and homoeopathic treatment smoking cessation. The study was a clinical trial, in which an acupuncture treatment group group. Thirty was compared with a homoeopathic treatment volunteers who were anxious to stop smoking participated in the trial and were randomly divided into two groups. One group received acupuncture treatment (n=l5), while the other group received homoeopathic treatment (n=l5) in the form of isotherapy. The study took place over a period of 9 months and each participant completed a 3-month trial period. Prior to the trial period each sUbject completed a set of questionnaires. These ~ncluded the Fagerstrom Tolerance Test which determined their dependence on nicotine; a questionnaire to determine if the subject smoked predominantly for reduction of negative affect, for positive affect or as an habitualaddiction; and a questionnaire to determine the subject's estimation of the health risks of smoking.Item The therapeutic efficacy of invasive needling techniques in the management of myofascial pain and dysfunction syndrome(1996) Broome, Richard John; Peers, A. V.Myofascial trigger points are a frequently overlooked and misunderstood phenomenon in medical curricula, yet with correct diagnosis and appropriate treatment the prognosis is usually excellent. Many effective treatments have been devised for myofascial trigger points, but the problem is that there is very little research to substantiate which of these treatments are the most effective. The aim of this randomised uncontrolled study was to justify the hypotheses which stated that both dry needling and saline injection would prove to be effective in the treatment of myofascial trigger points, with saline injection proving to be the most effective of the two. Patients were obtained for this study by convenience sampling, whereby any patients presenting to the Chiropractic clinic at Technikon Natal with neck,\xB7 upper back or shoulder pains were considered for the study. Of these patients, only those who conformed to the specified delimitations and diagnostic criteria were accepted. The sample size of thirty patients was randomly divided into two treatment groups of fifteen, one of which received saline injection and the other dry needling of active myofascial trigger points. Both groups were educated with regards to the nature and perpetuating factors of the condition, \xB7andwere instructed to follow a specific stretching programme.Item The efficacy of dry needling in patients suffering from lateral epicondylitis(2002) Haswell, Garrick David; White, Horace LindsayLateral epicondylitis is a relatively common disorder affecting approximately one third of the nearly thirty-two million tennis players worldwide. It usually presents as a chronic disorder that follows a remitting relapsing course, and as such represents a challenge to manage. At present the scientific literature does not favour any particular treatment modality and as such well designed placebo studies are required to assess the efficacy of the various modalities of treatment, with a long term view of establishing an effective treatment protocol to manage lateral epicondylitis. The purpose of this study was to determine the efficacy of dry needling the posterior distal muscles of the upper extremity as a treatment for lateral epicondylitis. Sixty patients were included in the study. They all under went a case history, physical examination and an elbow regional examination. They were then randomly allocated into the experimental or control groups. The thirty patients in the experimental group received dry needling while the thirty included in the control group received placebo or 'sham' needling. All participants in the study received three treatments over a nine-day period with subjective and objective measurements being taken before the 1st. 2nd, and 3rd treatments, with a 4th being taken after the third treatment. Examination of the statistical data revealed that a significant improvement in the experimental group versus the control group in terms of both subjectiveItem The effectiveness of spinal manipulation and dry needling versus spinal manipulation and Traumeel®S injectable solution in the treatment of mechanical neck pain associated with trapezius myofascial trigger points(2014-04-09) Abdul-Rasheed, Ashura; Docrat, AadilBackground: Mechanical neck pain is a common complaint characterized by pain, limited range of motion and myofascial trigger points. The most common treatments for it are manual therapy and drug therapy. The former includes massage and exercise therapy and more specific to this study spinal manipulation and dry needling. The latter includes non-steroidal anti-inflammatories (NSAIDs) and analgesics. Manipulation assists in increasing range of movement and reduces muscle spasm, while dry-needling inactivates trigger points and decreases local and referred pain. NSAIDs reduce pain and muscle spasm by inhibiting inflammatory pathways. Traumeel®S is a commonly used, safe and well tolerated homoeopathic anti-inflammatory with similar efficacy as NSAIDs but without the adverse gastrointestinal effects. It has also been shown to be highly effective in the treatment of myofascial pain. Methodology: This study was designed as a randomized comparative clinical trial. Fourty participants between ages 18-55 years of age were randomly allocated to two groups of twenty participants each. Group A received spinal manipulation and dry needling in trapezius trigger point two; while Group B received spinal manipulation and Traumeel®S solution injection in trapezius trigger point two. The study took place over a period of two weeks and involved four consultations. Subjective and objective readings were taken at every consultation. Subjective tools included the Numerical pain rating scale (NRS) and Canadian Memorial Chiropractic College (CMCC) neck disability index. Objective tools included the pressure algometer and cervical range of motion (CROM-II) goniometer. SPSS version 20.0 was used in the data analysis. A p-value of <0.05 was considered as statistically significant. Results: The results showed that no statistically significant differences were observed between the two groups in terms of subjective and objective measurements. However, there were statistically significant improvements seen in both groups equally in terms of subjective and objective measurements i.e. both groups showed improvement. Conclusion: The results of this study concluded that the effectiveness of spinal manipulation and dry needling versus spinal manipulation and Traumeel®S Injectable solution in the treatment of mechanical neck pain associated with trapezius myofascial trigger points is equivalent to each other. No statistically or clinically significant changes were noticed between the groups.Item The relative effectiveness of three treatment protocols in the treatment of medial tibial stress syndrome type II(2007) Payne, Liza; Korporaal, Charmaine MariaObjective: The aim of this study was to investigate the relative effectiveness of TENS, versus, needling, versus Electro-needling in the treatment of MTSS. First objective The first objective was to evaluate the effectiveness of TENS therapy on MTSS with respect to the patients subjective and objective responses to the treatment. Second Objective The second objective was to evaluate the effectiveness of needling therapy on MTSS, with respect to the patient’s subjective and objective responses to the treatment. Third Objective The third objective was to evaluate the effects of electro-needling on MTSS, with respect to the patients’ subjective and objective responses to the treatment. Fourth Objective The fourth objective was to integrate the subjective and objective data collected in order to determine the viability of each of the therapies in comparison to one another as treatment options of MTSS.