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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 relative effectiveness of combined "action potential therapy" and patella mobilization versus combined placebo "action potential therapy" and patella mobilization in the treatment of patellofemoral pain syndrome
    (2000) Goldberg, Jenifer; Myburgh, Cornelius
    The purpose of this study was to determine the relative effectiveness of combined Action Potential Therapy (APT) and patella mobilization versus combined patella mobilization and placebo Action Potential Therapy in the treatment of Patellofemoral Pain Syndrome. The study was a prospective, randomized, placebo controlled study. The study involved 60 subjects, 30 in each group which were selected from the general population. Group one received patella mobilization and APT while group two received patella mobilization and placebo APT. Patients received four treatments over a period of two weeks. The first treatment consisted of patella mobilization and APT (group one) or patella mobilization and placebo APT (group two), treatment 2,3 and 4 consisted of APT (group one) or placebo A,PT (group two). Subjective assessment was by means of the short form Me Gill pain Questionnaire, Numerical Pain Rating Scale - 101 Questionnaire and the Patient Specific Functional Scale. Objective assessment of tenderness was by means of an algometer. Assessments were taken on the first, second and fifth consultations for all subjective and objective measures. Statistical analysis was completed under the supervision of Dr Myburgh at Technikon Natal, at a 95% confidence interval. The parametric two-sample paired t-test and the non-parametric Wilcoxon signed rank tests were used to analyze data within each group, while the parametric
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    The therapeutic efficacy of action potential therapy in the treatment of myofascial pain syndrome
    (2001) Chettiar, Amarannathan; Myburgh, Cornelius
    The purpose of this investigation was to determine the relative efficacy of Action Potential Therapy (APT) as opposed to placebo Action Potential Therapy in the treatment of myofascial pain syndrome. The study was a prospective, randomized, placebo controlled study. The study consisted of two groups of thirty subjects each, which were selected from the Durban Metropolitan area. Only subjects diagnosed as having active trigger points in either the trapezius or gluteus medius muscle were accepted into the study. Each subject received four treatments over a period of seven to ten days. Group one received an active form of Action Potential Therapy while group two received placebo Action Potential Therapy. Subjective assessment was by means of the short form McGill pain Questionnaire and the N wnerical Pain Rating Scale-l Ol. Objective assessment was by means of an algometer and the Myofascial Diagnostic Scale. Readings were taken twice for each patient. The first assessment was conducted at the initial consultation prior to the first treatment, and the second assessment was completed during the last consultation after the treatment. Intra-group comparisons were made using the parametric two-sample paired t-test and the nonparametric Wilcoxon signed rank test. For the inter-group comparison, the parametric twosample unpaired t-test and non-parametric Mann-Whitney unpaired U test were used. Statistical analysis was completed at a 5% significance level.
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    Immediate effect of two myofascial interventions on navicular position, great toe extension and balance measures in asymptomatic subjects with pronation : placebo controlled
    (2016) Puttergill, Jeff; Kretzmann, Heidi
    Background: Myofascial therapies are widely researched with regards to their effects on pain, disability and range of motion. The benefits of such therapies are attributed to the mechanical changes that myofascial therapies are proposed to have on the fascial and myofascial structures. Breakthrough imaging and laboratory techniques, have allowed the in vivo study of these structures, resulting in new hypotheses regarding the roles that connective tissues might play in proprioception. Objectives: The purpose of this investigation was to assess the effects of two myofascial therapies, in terms of immediate changes in navicular pronation, great toe extension measurements and balance tests, as indicated by the postural stability (eyes open and closed) and limits of stability tests. Pre-, post-intervention analysis was used to determine if there were significant changes between the groups. Aims: The myofascial interventions aimed to reduce myofascial restriction and adhesions, within the plantar and crural fasciae’s of individuals with bilateral pronation. Methods: The study recruited 45 subjects with bilateral pronation (2 or more degrees) and randomly allocated them into a placebo ultrasound, ischaemic compression or myofascial release group. Each subject underwent a case history, physical examination, foot, ankle and knee regional examinations, as well as screened for contraindications. A blinded assistant examiner helped measured and record the baseline measurements for navicular position and great toe extension, using a standard two arm goniometer. The researcher then tested participants for postural stability (eyes open, eyes closed) and limits of stability, on the Biosway Portable Balance System. Subjects were then examined and treated bilaterally, for myofascial restrictions in the foot, lower leg and ankle, related or unrelated to the pronation present. Pre- and post-intervention measurements were recorded within a 20 minute window immediately before and after the relevant intervention. Statistical Analysis: Repeated measures ANOVA testing was used to compare the rate of change (between pre- and post-intervention measurements) amongst the three groups, and a p-value <0.05 was considered statistically significant. Post hoc Bonferroni adjusted tests were done to compare all pair wise groups, as well as identify trends between groups. Results and Discussion: The data showed that both myofascial groups, significantly improved in postural stability (eyes closed) overall, post hoc testing showed the ischaemic compression group (p=0.004) and myofascial release group (p=0.031), compared to changes in the placebo ultrasound group.The overall changes were predominantly found in the anterior-posterior axes, with significant improvements in ischaemic compression (p=0.007) and myofascial release group (p=0.053) axes compared to placebo. For the other outcome variables, statistically significant treatment effects were not consistant bilaterally between the groups. Significant (p=0.051) time*group differences for changes in right navicular position. Post hoc testing revealed a borderline significant (p=0.056) improvement in pronation for the myofascial release group in comparison to the ischaemic compression group, which on average got worse. With regards to passive non-weight bearing great toe extension left, significant (p=0.067) improvements for the ischaemic compression group were shown compared to placebo, although this was not consistent for all the great toe extension tests. A borderline significant (p=0.059) time*group effect for postural stability (eyes open) medial-lateral test was obtained. Post hoc Bonferroni adjusted testing showed a non-significant (p=0.063) correlation between the myofascial release group and placebo ultrasound group. Conclusion: The results of this study, rejects the Null hypothesis for changes in balance measurements and suggests that both myofascial interventions had a significant positive outcome for postural stability, compared to placebo. The postural stability (eyes closed) test gave an indication of positive or negative changes in centre of pressure displacement, about the centre of gravity. It is noted that the sham ultrasound, used as a placebo intervention may have produced a treatment effect and is therefore not a reliable placebo measure for this type of investigation.
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    A comparative study of three different types of manual therapy techniques in the management of chronic mechanical neck pain
    (2009) Roodt, Maria Louisa Elizabeth; Wilson, Laura Maie; De Busser, Nikki Lauren
    The prevalence of neck pain in musculoskeletal practice is second only to that of low back pain (Vernon et al., 2007). There is a growing interest in neck pain research due to the escalating disability burden and compensation costs associated with neck pain (Côte et al., 2003). Manual therapies are commonly used in the treatment of neck pain (Côte et al., 2003). After an extensive literature review by Haldeman et al. (2008) they found that manual therapy techniques have some benefit but no one technique was clearly superior to the next. Therefore, the purpose of this study is to compare three commonly used manual therapy techniques in the treatment of chronic mechanical neck pain. OBJECTIVES The purpose of this study was to compare three different manual therapy techniques (SMT, MET and PNF) which are commonly used in the treatment of chronic MNP in terms of range of motion, pain and disability. METHOD Forty-five patients with chronic mechanical neck pain were obtained through non-probability convenience sampling and assigned into one of three treatment groups (15 per group) using a computer generated randomized table. The three different treatment groups were: Spinal Manipulative Therapy (SMT), Muscle Energy Technique (MET) and Proprioceptive Neuromuscular Facilitation (PNF). Each group received six treatments over a period of three weeks with a follow-up consultation. Measurements were taken at the first, third and sixth treatment and at the follow-up consultation. SPSS version 15.0 was used to analyse the data. A p value of <0.05 was considered as statistically significant. An intra-group analysis was done using repeated measures ANOVA testing to assess the time effect for each outcome separately. For inter-group analyses the time x group interaction effect was assessed using repeated measures ANOVA testing, and profile plots were used to assess the trend and direction of the effects. RESULTS Intra-group analysis of the results revealed that all three groups improved significantly between the first and the final consultation, for all measures. Inter-group analysis of the data did not show any difference between the three groups by the end of the final consultation. However, extension range of motion appeared to improve slightly faster in the PNF group iv but it was not significant when compared to the other two groups. Therefore, there was no statistical significance between the three groups. CONCLUSION It was concluded that all three treatment groups responded equally to the treatment, thus, suggesting that MET or PNF techniques can be used if SMT is contra-indicated.