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Theses and dissertations (Health Sciences)

Permanent URI for this collectionhttp://ir-dev.dut.ac.za/handle/10321/12

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    The effect of four different manipulative techniques on Iliotibial Band Friction Syndrome (ITBFS) in terms of primary and secondary outcome measures
    (2016) Botes, Jacques Andre; Gomes, Adrian Neil; Korporaal, Charmaine Maria
    Background: Iliotibial band friction syndrome is a common dysfunction seen in athletes. Athletes develop biomechanical changes yet still continue with their sport. However, this syndrome limits their ability to participate at peak performance. This study determined which participants benefitted in terms of biomechanical and clinical outcomes in one of four groups: ankle joint, superior tibio-fibular joint, sacroiliac joint or a combination manipulation group (which contained any two of the three joint restrictions). Methods: This Durban University of Technology Institutional Research and Ethics Committee approved prospective clinical trial, utilised stratified sampling, with 48 participants across four groups: ankle (14); superior tibio-fibular (11), sacroiliac (12) and combination (11). The participants underwent six treatments in three weeks. Data collection occurred before consultations one, three, five and seven. The data included primary measures of the knee score questionnaire (KSQ), the algometer, the visual analogue scale (VAS) and the secondary measures of the Feiss line, the heel leg alignment, bilateral leg length, Q angle and tibio-femoral angle. All data was computed utilising the ANOVA testing, with a p-value <0.05 being significant and a 95% confidence interval. Pearson’s correlations were completed for intragroup associations between primary and secondary outcome measures. Results: The intragroup analysis revealed that all groups had significant changes in the KSQ and VAS, with the exception of the sacroiliac joint manipulation group (KSQ outcome not significant). Intergroup analysis revealed no differences between the groups with the exception of the combination group, which showed a significant increase in the tibio-femoral angle. Most commonly, the Pearson’s correlation revealed that changes in leg length were related to differences in primary outcome measures, irrespective of the group being tested. Conclusion: The outcomes of this study indicated that manipulation of the distal kinematic chain improved alignment and clinical outcomes to a greater degree than manipulating proximal restrictions. It is suggested with caution (due to limited sample size) that patients should first have their distal kinematic chain manipulated before more proximal joints are manipulated to achieve better outcomes.
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    The prevalence and profile of musculoskeletal pain in elite wheelchair basketball players of different point classifications in South Africa
    (2016) Mateus, Isabel Sita Maharaj; Pillay, Julian David; Padayachy, Keseri
    Background There has been a remarkable increase in the participation of sport for athletes with disabilities. Consequently, there have been many international studies on injuries in athletes which have shown a high prevalence in wheelchair basketball, largely attributed to the fast-paced, high intensity nature of the sport. This sport has grown worldwide including South Africa, however, very little research has been published on South African wheelchair basketball players and more research is, therefore, needed. Aim To determine the prevalence and profile of musculoskeletal pain in elite wheelchair basketball players of different point classifications in South Africa. Hypothesis 1: Upper extremity (including neck and back) pain is experienced more commonly in lower point classified wheelchair basketball players than in higher point classified players. Hypothesis 2: Lower extremity pain is experienced more commonly in higher point classified players than in lower point classified players Method This study was a quantitative, cross-sectional, questionnaire-based study. The questionnaire comprised of sub-sections on demographics and disability characteristics; activity levels pertaining to wheelchair basketball and other sport/physical activity; the prevalence of pain and the impact thereof on wheelchair basketball and/or activities of daily living. This questionnaire was administered to 48 wheelchair basketball players who were competing in the 2015 Supersport League. A response rate of 70% was decided as the lower limit cut-off for statistical power. Results Fourty-three participants responded yielding an 89.58% response rate. The mean age of participants was 33.3 (SD:9.5) years and the majority of participants (n=35) were male and African (n=29). Out of the 43 participants, 79.1% (n=34) used mobility devices, the majority (n=20) used wheelchairs. Most of the participants (n=41) played wheelchair basketball for more than five years and 32 participants did not participate in other sport. Almost half of the participants (n=25) experienced musculoskeletal pain in the last twelve months or at present, 75% of whom (n=12) visited a Physiotherapist for the pain. More than half of these participants (n=15; 60%) reported that the pain negatively affected their basketball performance. It was established that arm pain occurred frequently in lower point classified players (1.0-2.5 point players) and that hand and wrist pain was also more prevalent in lower point players than in higher point players. The prevalence of lower extremity pain was low and there was no statistically significant difference between higher and lower point classified players. Conclusions and Recommendations The finding that upper extremity pain occurred more frequently in lower point classified players was in keeping with the first hypothesis (the null hypothesis was, therefore, rejected). The second hypothesis was, however, rejected (and the null hypothesis was, therefore, accepted) as lower extremity pain did not occur more frequently in higher point classified players than in lower point classified players. The Eta scores may have been higher and may have shown a much larger than typical relationship between point classification and the prevalence of musculoskeletal pain had there been a larger sample size. Notwithstanding this limitation, it is a challenge to obtain a significantly larger sample size due to the nature and limited number of participants in this sport. More studies are warranted on this group of individuals, as a large number experienced pain which affected more than half of the participants’ performance in wheelchair basketball. These studies are important for the future success of the South African players and the sport in South Africa.
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    The relative effect of manipulation and core rehabilitation in the treatment of acute mechanical lower back pain in athletes
    (2007) Campbell, Jennifer; Korporaal, Charmaine Maria; White, Rowan
    Objectives The objectives were to compare the relative effect of manipulation and core rehabilitation in the treatment of acute mechanical lower back pain in athletes. Project Design: The study design was a randomized controlled parallel group trial. A quantitative study was performed, by making use of a pre à à à ¢ and post experimental investigation (Nansel et al. 1993 and Naidoo, 2002). Setting: Participants presenting with acute low back pain with an onset of 7 days or less, to the Chiropractic Day Clinic at the Durban University of Technology. Subjects: Thirty athletic participants, either male or female, between the ages of 18 and 45 years presented at the initial consultation which included participant screening and establishment of their suitability for the study. These were then divided into either group A (which received a manipulation) or group B (which received core exercises). Outcome measure: A correct contraction of the core stability muscles was maintained, with a decrease in pressure (in mm Hg) on a Pressure Biofeedback Unit, and an increase in length of time (in seconds). Results: It was found that there was no significant difference between the manipulation and the core rehabilitation groups. Although both groups showed v improvement with regards to their acute mechanical low back pain, the core rehabilitation group improved at a significantly faster rate than the manipulation group with regards to endurance on the stabilizer. Conclusions: Both treatments were equally beneficial for most of the quantitative outcomes measured in this study. However, for the outcome of time on the stabilizer, the core rehabilitation group improved at a significantly faster rate than the manipulation group (p=0.006).