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Theses and dissertations (Health Sciences)

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    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, Penelope
    Background 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.
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    Study into the treatment of active myofascial trigger points using interferential current as an alternative to dry needling agitation
    (1995) Christie, Kevin Rodney; Kretzmann, Heidi
    The 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.
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    The effectiveness of myofascial trigger point therapy on myofascial pain syndrome trigger points
    (1994) Jones, Andrew D; Liebenberg, H. S.
    The efficacy of myofascial trigger point therapy in treatment of myofasciitis was evaluated in a single blind, randomised, placebo controlled trial. The patient population consisted of twenty individuals who presented with one of the following: upper-back pain, shoulder pain, and neck-pain and or headaches and who were diagnosed as having myofasciitis.
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    An investigation into the association between the role of myofascial trigger points of the lower extremity and the clinical diagnosis of iliotibial band friction syndrome
    (2004) Broadhurst, Michele; Korporaal, Charmaine Maria
    The purpose of this study was to investigate the association between the role of Myofascial Trigger Points of the lower extremity to the clinical presentation of lIiotibialband Friction syndrome
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    A study of the effectiveness of myofascial trigger point therapy on iliotibial band friction syndrome in sports persons
    (1997) Hall, Thandi Antonia; Jones, Andrew D.
    Iliotibial Band Friction Syndrome is a common problem for patients as well as physicians. Many treatments have been devised for Iliotibial Band Friction Syndrome, but there is very little research to substantiate which of these treatments is most effective. Myofascial trigger points are a frequently overlooked and misunderstood phenomenon in the medical curriculae, yet with correct diagnosis and appropriate treatment the prognosis of these trogger points is usually excellent. The aim of this placebo-controlled study was to justify the hypotheses which stated that myofascial trigger point therapy would be effective in the treatment of Iliotibial Band Friction Syndrome (IBFS), as compared to detuned ultrasound as a form of treatment.
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    The immediate effect of myofascial trigger point dry needling of four shoulder girdle muscles on the 100m lap- times of asymptomatic competitive swimmers in Bloemfontein
    (2017) Schmidt-Kinsman, Sarah; Harpham, Graeme John; Korporaal, Charmaine Maria
    Background Competitive swimming, as with most other sports that are participated in at more than a recreational level, involves a substantial amount of training. Training excessively results in the overuse of muscles. The overuse of muscles commonly causes the production of myofascial trigger points (MFTPs) within the overworked muscles. The presence of MFTPs is a condition known as myofascial pain syndrome (MPS). Myofascial trigger points may be active or latent. Either way, they produce a wide range of effects. This study focuses on the effect of reduced muscle strength. Muscle strength is essential to athletes as it determines performance. Swimmers with MFTPs will not perform at their full ability. Dry needling is an effective form of treatment for MFTPs as it produces immediate relief from the effects of MFTPs. There is not enough information on the immediate effects of dry needling on athlete performance. Since dry needling brings about the immediate relief of MFTPs, this study aims to restore a swimmer’s muscle power and hence improvement of their swimming performance post-intervention. Aim The aim of this study was to determine the immediate effect of dry needling common myofascial trigger points (MFTP) found in four muscles of the shoulder girdle on competitive swimmers’ 100m freestyle lap-times. Methods The design was a pre-test post-test quasi-experimental study. Thirty five competitive swimmers between the ages of 16 and 30 years old participated in this study. Each participant underwent one assessment. Participants’ lap-times were taken using a Sportline Econosport Stopwatch. The pre- and post-intervention lap-times were compared to each other using statistical analysis. The intervention for the purpose of the study was trigger point dry needling. Myofascial trigger points were assessed using manual palpation and the Myofascial Diagnostic Scale (MDS). Results The median lap time was slightly longer post intervention (0:01:16.10) than pre-intervention (0:01:16.03), and was highly statistically significant (p=0.001). The results of the study were inconclusive, however, as there were too many confounding variables (for example, fatigue due to repeatedly swimming laps, swimmers of a lower caliber and hence quicker fatigue rate being included in the study)which negated the effect of dry needling and so the poorer performance of the participants post-intervention could not be attributed entirely to the intervention. A small number of participant’s lap-times decreased post-intervention i.e. they performed better post-intervention. These individualswere predominantly sprint-swimmers. Conclusion Dry needling negatively affects immediate lap-time performance. Future studies should reduce the number of variables affecting the study, for example, having a sprinter versus long-distance swimmer group, testing the outcome of dry needling after the swimmer has had sufficient time (for example, a day) to rest post-intervention.
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    The effectiveness of the Impulse Adjusting Instrument® compared to dry needling in the treatment of upper trapezius myofascial trigger points
    (2017) Laing, Mandy; Varatharajullu, Desiree
    Aim: 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.
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    The relative effectiveness of cryotherapy and moist heat in the treatment of myofascial pain syndromes
    (1998) Andersen, Martin Steenfeldt; Smith-Parkin, G.
    Myofasciitis IS a very common yet misunderstood problem. There are many treatments available yet there is no research to substantiate which of the many treatments available is the most effective (Travell and Simons 1983:6). The purpose of this study was to investigate the relative effectiveness of Cryotherapy versus moist heat in the treatment of myofasciitis of the shoulder girdle muscles. Patients for this comparative, randomized clinical trial were obtained by consecutive sampling. Any patient between eighteen and fifty-five presenting to the Chiropractic Clinic at Technikon Natal with neck pain, upper back pain or shoulder paIn was considered a potential candidate. Thirty patients underwent a screening process to assess their viability for the study. This screening procedure consisted of questions regarding the pattern of pain referral and of palpation of the relevant zones for muscle spasm, twitch responses, patient jump sign and/or referred palll. The thirty patients were randomly divided into two groups of fifteen. One group received cold and passive stretching and the other group received moist heat and passive stretching. Each patient was treated five times within a three week period. Thereafter a follow-up appointment was scheduled one month after the final treatment to assess the long term effects of the treatments . The subjective information was questionnaires: (1) the CMCC Neck Numerical Pain Rating Scale-l0l assessed us Ing three Disability Index, (2) the and (3) the Short Form McGill Pain Questionnaire. These three forms were used to subjectively assess vanaus aspects of the patient's pain. Patients were required to fill these forms out at the first and
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    The effectiveness of needling of myofascial trigger points on internal- external muscle peak torque and total work ratios of the shoulder rotator myoatatic unit in overhead throwing athletes suffering from myofascial pain and dysfunction syndrome
    (2005) Royce, Nicholas; Kruger, Brian; Korporaal, Charmaine Maria
    The purpose of this study was to determine whether dry needling of myofascial trigger points (TrP's), found in the shoulder rotator myotatic unit, had an effect on the peak torque and total work parameters of the shoulder myotatic unit and by inference, the relative external rotation strength deficit in over-head throwing athletes. Athletes who perform overhead throwing sports such as: baseball, javelin, swimming/waterpolo and tennis, are susceptible to sustaining a micro-traumatic injury of the rotator myotatic unit of the shoulder, owing to repetitive high velocity mechanical stress placed on the shoulder at the extreme ranges of motion. The inherent structure of the shoulder, with three external rotators and five internal rotators, causes a muscle imbalance before an activity, such as throwing occurs, and this can predispose an athlete to Repetitive Stress Injuries (RSI) as a result of overuse or overload. The incidence and activation of TrP's in shoulder muscles can be accounted for on the basis of mechanical stress such as overuse / overload and thus could change muscle fiber co-ordination (muscle activity) and precipitate a painful lesion. It can be seen in current literature that TrP's produce a number of signs and symptoms such as: spasm of other muscles, weakness of involved muscle function, loss of co-ordination and decreased work tolerance of the involved muscle . Therefore the TrP's present in the shoulder rotator unit could contribute to changes in internal/external rotation ratios in over head athletes, and thus by deactivating or eliminating these TrP's, it is possible that these ratios may be
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    The relative effectiveness of spray and stretch compared to ice and stretch in the treatment of myofascial trigger points
    (1999) Backlund, Gary; Mathews, Robert
    Pain arising from myofascial trigger points is common and is often so disabling that the need for fast effective treatment is urgent. Of the many documented treatments for trigger points, there is little evidence to support one treatment over another. It is thus the purpose of this study to determine the relative effectiveness of stretch and ice to stretch and spray in the treatment of myofascial trigger points found in the upper trapezius muscle. This comparative clinical study involved the participation of thirty patients presenting with myofascial trigger points of the upper trapezius muscle. By means of consecutive sampling, patients complaining of neck pain, and/or headaches, and/or shoulder pain or a combination thereof, and who were between the ages of sixteen and sixty-five, underwent a screening processes to determine if they had active myofascial trigger points in the upper trapezius. Those that were eligible for the study were randomly assigned to either the stretch and ice group or the stretch and spray group. The subjective primary data consisted of three pain questionnaires, namely the Short Form McGill Pain Questionnaire, CMCC Neck Disability Index, and Numerical Rating Scale-101. The objective data was supplied by readings taken from an algometer. The patients underwent three consultations in the first week, two consultations in the second week and a final consultation one-month after the fifth treatment. All the primary data was collected at four occasions. These were at the first, third, fifth and one month follow-up consultations. Intra-group analysis using the Wilcoxon Sign-Rank Test determined if each group improved significantly with respect to the data collected. The Mann-Whitney U test was used to determine which group was statistically better than the other. The results, including the standard deviation, standard error, mean and power