Faculty of Health Sciences
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Item The efficacy of genesen acutouch pointers in the treatment of osteoarthritis of the knee(2001) Robertson, Brendon Ian; White, Horace LindsayThe purpose of this study was to determine the efficacy of Genesen Acutouch pointers in the treatment of osteoarthritis of the knee. This was a prospective, randomized clinical trial consisting of sixty patients who volunteered from the general population of Durban. The patients, diagnosed as having osteoarthritis of the knee, were randomly divided into two different treatment groups. Each group consisted of thirty patients between the ages of eighteen and eighty five years. One group received active Genesen Acutouch Therapy, while the second group received placebo Genesen Acutouch Therapy. Data capturing took place for both groups on the first, fifth and ninth consultations. Subjective data was collected using the Numerical Pain Rating Scale-l Ol, the Visual Analogue Scale and the Patient Specific Functional Scale. Objective data was gathered from goniometer and algometer readings. For statistical analysis, only parametric tests were used in all hypothesis tests due to the large sample size. All readings were considered to be continuous variables. The twosample (unpaired) two-tailed t-test was used to compare two independent samples. The two-sample paired t-test was used to compare results from related samples. All tests were conducted at a = 0.05 level of significanceItem The efficacy of patella mobilization in patients suffering from patellofemoral pain syndrome(1999) Rowlands, Brett; Brantingham, James W.The purpose of this study was to determine the efficacy of patella mobilization in patients suffering from patellofemoral pain syndrome, This was a prospective, randomized, placebo controlled, pilot study, Group A received patella mobilization, while Group B, the placebo group, received detuned ultrasound, The study involved 30 subjects, 15 in each group selected from the general population, Each subject was treated eight times within a four week period, however if they became asymptomatic prior to their eighth treatment the subjective and objective data normally collected on the eighth treatment was collected on their last consultation, patients were required to return for a one month follow-up from the date of their last consultation, Each subject was assessed by means of the short-form Mc Gill Pain Questionnaire, Numerical Pain Questionnaire and the Patient-Specific Functional Scale, Objectively their pressure-pain threshold and tolerance was assessed by means of an algometer, Assessments were taken at the first, eighth, and follow-up consultation for all the subjective and objective measurements, Algometer readings were also obtained at the fourth consultation, the pressure was applied at approximately one kilogram per centimeter squared per second, Excessively high or low readings were retaken, Statistical analysis was completed under the guidance of the statistician at Technikon, Natal, using the non-parametric Wilcoxon sign-rank test and the Mann- Whitney unpaired test comparing intra-group and inter-group data respectfully,Item The relative effectiveness of a single dry needle insertion compared to multiple fanning dry needle insertions in the treatment of myofasciitis in the cervical and upper thoracic spine(2001) Rowley, Neil Charles; Mathews, RobertMyofascial Pain Syndrome (MPS) is a clinical syndrome of soft tissue pain arising from skeletal muscle. It is manifested by characteristic trigger points (TrPs) in palpable taut bands of muscle fibres with typical referred pain patterns, restricted range of motion and local twitch responses. Treatment of MPS appears to be aimed at disrupting the reverberating neural circuits responsible for the self-perpetuation of the pain-spasm pain cycle. This occurs through inactivating the active TrP through releasing the taut bands with various techniques including massage, ischaemie compression, spray and stretch, ultrasound, hydrocollator moist heat, trigger point injection, dry needling, and TENS. There are many treatments available yet little research substantiating efficiency of one specific therapy over another, with the result that choice of treatment often becomes based on personal preferences rather than clinical evidence. Among many authors, dry needling has been shown to be an effective form of treatment. The therapeutic effect of dry needling relies on the mechanical disruption or direct stimulation of the TrP and that the strongest analgesic effect is achieved when the most painful spot is precisely reached with a fme needle, normally an acupuncture needle. This immediate analgesia produced by needle puncture of a TrP has been termed theItem The perception, knowledge and utilisation of research and its role in the chiropractic profession as determined by chiropractors attending the World Federation of Chiropractic biennial conference 2013(2015) d'Hotman de Villiers, Jason; O'Connor, LauraBackground The Chiropractic profession is considered a form of complementary and alternative therapy which began as a vitalistic approach to health care. Over the years research has become a main focus of the profession in order to validate its claims for its treatment modalities, with the profession having made advances in producing high quality research (Newell and Cunliffe, 2003). In an era of evidenced based practice medical professionals are required to use research findings to guide their practice therefore their perceptions towards using research are important to ascertain. Although there is some literature on Chiropractors' perception of research most studies focus on specific regional populations. Very few if any studies have assessed perceptions of research from different Chiropractic populations at the same time. The aim of this study was to determine the perception, knowledge and utilisation of research and its role in the Chiropractic profession as determined by Chiropractic delegates attending an international Chiropractic conference. In order to provide information to the profession as to how Chiropractors from varying regions perceive research and to see if the shift seen in other health care professions towards evidence based practice is seen in the chiropractic profession. Method This quantitative, cross sectional, descriptive survey was administered to Chiropractic delegates attending the World Federation of Chiropractic biennial conference 2013 in Durban, South Africa. The questionnaire was compiled by using the available literature and validated by means of a focus group and pilot testing. The questionnaire was administered to the delegates as part of their delegate packs at the conference and was made available electronically via SurveyMonkey© after the conference. Participants were required to give written informed consent prior to partaking in the research. The research protocol was approved by the Durban University of Technology Institutional Research Ethics Committee (REC 26/13). On completion the questionnaire and the signed letter of information and consent were deposited into separate sealed containers at the conference or stored on SurveyMonkey© . When the study closed, data was coded into an excel spread sheet and imported into IBM SPSS version 21 for statistical analysis. Descriptive and inferential statistics were used to analyse the data Results A response rate of 34.48% (n = 140) was obtained. More than half of the respondents were male (52.2%), from the African region (51.1%), in possession of a master's degree in Chiropractic (51.4%), and were involved in professional chiropractic practice (60.7%). The respondents had a favourable perception towards research (51.4%), with almost all respondents perceiving that research was essential to the progression of the Chiropractic profession (97.5%). A more favourable perception of research was found in those who were from Europe as opposed to Africa (p = 0.001) and had an evidence based practice (EBP) philosophical orientation as opposed to a mixer or straight approach (p < 0.001). Overall the respondents displayed an adequate knowledge of research terminology (59.2%), with those from Europe as opposed to Africa (p = 0.001) having improved research knowledge along with those who had an EBP philosophical orientation (p < 0.001) compared to the straights and mixer approaches. In terms of research utilisation the respondents showed a high utilisation of research to improve clinical practice (88.9%), for self-development (90.1%) and to change their approach to conditions, polices and practice in their area of the Chiropractic profession (83%). There was a trend that being from Europe, North America and Australisia resulted in high research utilisation than those from Africa and Asia. The effectiveness of Chiropractic care for various musculoskeletal conditions was seen as the primary research focus area for the profession (95.1%), with 75% of the respondents wanting the profession to move in the direction of science as opposed to a philosophical focus. The respondents perceived research to play an integral role within Chiropractic by promoting its acceptance among other health care professionals (87%) and by third party payers (70%). Conclusion The respondents in this study had a favourable perception, knowledge and utilisation of research and supported the role of research and science in the future of the Chiropractic profession. Future studies should be conducted on more diverse groups of Chiropractors to see if the findings of this study are replicated, as well as investigate the disparity observed between developed and developing countries.Item Manipulative and multimodal therapy for upper extremity and temporomandibular disorders : a systematic review(Elsevier, 2013-03) Korporaal, Charmaine Maria; Tong, Victor; Pollard, Henry; Robb, Andrew; Pribicevic, Mario; Bonnefin, Debra; Cassa, Tammy Kay; Brantingham, James W.Objective The purpose of this study was to complete a systematic review of manual and manipulative therapy (MMT) for common upper extremity pain and disorders including the temporomandibular joint (TMJ). Methods A literature search was conducted using the Cumulative Index of Nursing Allied Health Literature, PubMed, Manual, Alternative, and Natural Therapy Index System (MANTIS), Physiotherapy Evidence Database (PEDro), Index to Chiropractic Literature, Google Scholar, and hand search inclusive of literature from January 1983 to March 5, 2012. Search limits included the English language and human studies along with MeSH terms such as manipulation, chiropractic, osteopathic, orthopedic, and physical therapies. Inclusion criteria required an extremity peripheral diagnosis (for upper extremity problems including the elbow, wrist, hand, finger and the (upper quadrant) temporomandibular joint) and MMT with or without multimodal therapy. Studies were assessed using the PEDro scale in conjunction with modified guidelines and systems. After synthesis and considered judgment scoring was complete, evidence grades of “A, B, C and I” were applied. Results Out of 764 citations reviewed, 129 studies were deemed possibly to probably useful and/or relevant to develop expert consensus. Out of 81 randomized controlled or clinical trials, 35 were included. Five controlled or clinical trials were located and 4 were included. Fifty case series, reports and/or single-group pre-test post-test prospective case series were located with 32 included. There is Fair (B) level of evidence for MMT to specific joints and the full kinetic chain combined generally with exercise and/or multimodal therapy for lateral epicondylopathy, carpal tunnel syndrome, and temporomandibular joint disorders, in the short term. Conclusion The information from this study will help guide practitioners in the use of MMT, soft tissue technique, exercise, and/or multimodal therapy for the treatment of a variety of upper extremity complaints in the context of the hierarchy of published and available evidence.