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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 the combination of spinal manipulation and Homoeopathic Simillimum in the treatment of chronic mechanical neck pain
    (2017) Belling, Kym; Couchman, Ingrid; Lubbe, Danella
    Background: According to Picavet and Schouten (2003) the incidence of neck pain is increasing at a greater rate than other spine problems (Hoving et al. 2004). Furthermore, chronic neck pain is a substantial burden to society with chronic neck pain being the fourth leading cause of disability worldwide (Hoy et al. 2014). Chronic mechanical neck pain (CMNP) has been defined as localised, asymmetrical neck pain with restricted range of motion and dysfunctional musculature (Grieve, 1988). Treatments for those suffering with chronic pain, which are non-surgical, appear to be the most beneficial for patients according to Haldeman et al. (2008). Giles and Müller (1999) have stated that spinal manipulation is the most effective method of treating spinal pain on its own. However, the literature suggests that there is benefit in combining manipulation with an “anti-inflammatory type” drug (Crawford 1988; Oberbaum 1998; Serrentino 2003). Many studies have been successfully conducted on Homoeopathic complexes to treat neck pain (Fisher 1986; Bohmer and Ambrus 1992; Hepburn 2000; Soeken 2004) however no study has yet to been carried out on the combination of Homoeopathic Simillimum (single remedy) and spinal manipulation for CMNP. Objective: The aim of this study was to determine if spinal manipulation and Homoeopathic Simillimum in combination are more relatively effective than spinal manipulation alone in the treatment of chronic mechanical neck pain. Methodology: This study was a randomised, blinded placebo controlled quantitative trial with a comparative clinical trial design. Thirty consenting participants with CMNP who met the inclusion criteria were randomly distributed between two treatment groups. Group A received spinal manipulation as well as Homoeopathic Simillimum and group B received spinal manipulation with placebo medication. Each participant received three treatments over a period of a week; with subjective and objective readings taken at every consultation. The subjective tools included the Numerical Pain Rating Scale and Canadian Memorial College of Chiropractic Neck Disability Index. Objective tools included the Algometer and CROM-II Goniometer. All data captured was analysed using SPSS version 24.0. Inferential and non-parametric analysis of the data were also be performed. 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 ANOVA subjective and objective measurements i.e. both groups showed improvement. Conclusion: The results of this study concluded that no statistical or clinically significant changes were noticed between the groups and therefore the Homoeopathic Simillimum added no statistical significant improvements in those who received it over those participants who received placebo in the treatment of chronic mechanical neck pain.
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    The relative effectiveness of homoeopathic Simillimum versus oral Traumeel? in the treatment of acute mechanical neck pain
    (2015-05) Rajballi, Ashmitha; Botha, Izel; De Waard, A.H.
    Introduction There is no proper definition of acute mechanical neck pain (AMNP) but it has been theorized that it has a sudden onset pain and lasts for a relatively short time. It occurs with or without injury and presents with pain in the shoulder and upper arm. Acute mechanical neck pain should not be accompanied by an inflammatory disease, neurological disease, fracture, dislocation, neoplasm or infection AIM The purpose of this study was to compare the relative effectiveness of homoeopathic Simillimum against Traumeel® (a commercial homoeopathic complex) in the treatment of acute mechanical neck pain using the neck disability scale, range of motion measurements and a subjective observation. METHODOLOGY This study was a double blind, quantitative, comparative; clinical trial that involved two treatment groups: Half the participants received the homoeopathic Simillimum and the other half received oral Traumeel® drops. Patients self-selected homoeopathic treatment. Patients were screened and only those who fit the inclusion criteria of suffering from AMNP of maximal two weeks duration, were English conversant and between the ages of 18 and 55 were included. Those suffering with AMNP were required to sign an informed consent form after the procedure was explained thoroughly. Each patient read through the procedure of the clinical trial and were informed that their participation was on a voluntary basis and they could withdraw at any time. Convenience sampling was utilised in which an independent person, using a simple sampling method, randomly allocated the patients into the respective groups. Of the 30 patients, 15 received Traumeel® and 15 received homoeopathic Simillimum. It was hypothesized that the homoeopathic Simillimum treatment would be more effective in the treatment of acute mechanical neck pain than oral Traumeel®. The treatment protocol consisted of three homoeopathic consultations within a seven day period, with the consultations scheduled on days one, three and seven. Subjective and objective measurements were taken at each of the three consultations, Durban University of Technology Homoeopathic Day Clinic, Steve Biko Campus. A Simillimum treatment was prescribed for every patient based on full homoeopathic case history. This Simillimum was confirmed by the co-supervisor. Half of the patients were dispensed the Simillimum and the other half received Traumeel® according to the randomisation list. At the first follow up, on day three, the patients were reassessed according to their progress, perception and their range of motion, and the progress of the patient was analysed. In the last consultation on day seven, the progress of the patient was analysed using the perceptive questionnaire of the Neck Disability Index and the objective cervical range of motion. Full physical examinations were carried out during all three consultations. Upon collection of data, the statistical package SPSS 22.0 was used to record and analyse the data. Non parametric statistical tests were used as the data were non parametric - it does not follow any distribution, was ordinal (not relying on numbers but rather a ranking order of sorts). Inter-group comparisons were made using Mann-Whitney U-test. RESULTS The effectiveness of Traumeel® and homoeopathic Simillimum was measured firstly, in terms of the patients’ perception of the responses to the treatment applying the Neck Disability Index and secondly the increase in degree of movement in the range of motion of the cervical region. When applying an ANOVA with repeated measures with a Greenhouse-Geisser correction, the mean scores between groups were statistically not significantly different (p = 0.112). CONCLUSION Both the Traumeel® and Simillimum treatments were effective in the treatment of acute mechanical neck pain, but there was no evidence that one treatment was more beneficial than the other. The p-values (sig.) reported were greater than 0.05, thus implying that there is no significant difference between the groups.