Faculty of Health Sciences
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Item The relative effectiveness of spinal manipulation in conjunction with core stability exercises as opposed to spinal manipulation alone in the treatment of post-natal mechanical low back pain(2006) Wilson, Dean Paul Charles; Myburgh, CorneliusCore strengthening has become a major trend in the rehabilitation of patients suffering with lower back pain. Clinical trials have shown that core strengthening is beneficial for patients with low back pain. According to the literature, core strengthening consists of activating the trunk musculature in order to stabilize hypermobile symptomatic joints and thus lessen mechanical stress to the spine. Spinal manipulative therapy has also proved itself to be beneficial, particularly in the case of post-natal low back pain sufferers, as manipulation may correct hypomobility associated with spinal subluxations. Literature suggests that spinal manipulative correction of spinal subluxations in combination with core stability exercises, that stablise symptomatic hypermobile joints, may have more advantages than using these interventions singularly in the treatment of post-natal low back pain. However, the combination of a core stability muscle training program with spinal manipulative therapy has yet to be investigated. In order to choose the most appropriate therapy for managing this condition, it is essential for research to be carried out to identify the most effective treatment, which would allow for better overall management of low back pain during the post-natal period. Therefore this study was designed to establish the effectiveness of a combined protocol of spinal manipulation and core stability exercises in the treatment of postnatal and mechanical low back pain and to establish whether this protocol should be utilized routinely in the management of this condition.Item Relative effectiveness of three treatment protocols with and without brace aided pelvic stabilization in patients with chronic low back pain(2011) Marques, Ricardo; Boodhoo, VilashBackground: Wong and Deyo (2001) believe that 98% of the LBP cases are musculoskeletal (mechanical) in origin and 51,7% of these individuals are chronic sufferers (Andersson, 1999). Weak spinal stability muscles have shown to be an aetiological cause (Chok, Lee and Latimer, 1999). Wolff, Weinik and Maitin (2003) agree a combination of brace aided pelvic stabilization combined with a spinal stability programme may be the best treatment intervention for chronic low back pain (CLBP). Objective: The purpose of this research was to determine the relative effectiveness of three treatment protocols with (Group A-Groovi-SI-Belt®; Group B-standard SI belt) and without (Group C-control) brace aided pelvic stabilization in patients with CLBP. Method: Forty-six patients suffering from CLBP were randomly allocated to one of the three treatment groups. A spinal stability programme was progressively taught and enforced in all three groups. Weekly follow-up consultations were required to assess subjective and objective outcomes of the three treatment interventions. Outcomes were obtained by using the Numerical Pain Rating Scale (NRS); Quebec disability scale; Active straight leg raiser test; Biofeedback device and the static trunk extensor endurance test. Results: Data was analysed using the SPSS version 15.0 (SPSS Inc. Chicago, Ill, USA).Comparing pre and post outcome measurements using a p value <0.05 which was considered to be statistically significant. All three treatments improved most outcomes significantly over time. The Groovi-SI-Belt® showed non significant trends of quicker rates of improvement. . Conclusion: This study revealed that brace aided pelvic stabilization combined with a spinal stability programme was a beneficial treatment intervention with the Group A being superior to Group B.Item An investigation into the short term effectiveness of whole body vibration training in acute low back pain sufferers(2008) Van der Merwe, Nicolaas TjaartCore strengthening has become a major trend in the rehabilitation of patients suffering with acute low back pain. Clinical trials have shown that core strengthening is beneficial for patients with low back pain. According to the literature, core strengthening consists of activating the trunk musculature in order to stabilize hypermobile symptomatic joints and thus, lessen mechanical stress to the spine. Literature suggests that vibration/acceleration training may be a more effective and sufficient method of core stability exercises, with regards to core muscle endurance and activation in treatment of acute low back pain. This may have more advantages than using traditional core stability exercises in the treatment of acute low back pain. However, vibration/acceleration training as core stability exercises has yet to be investigated. In order to choose the most appropriate treatment protocol for managing this condition, it is essential for research to be carried out to identify the most effective treatment, which would allow for better overall management of low back pain during the acute period. Therefore, this study was designed to establish the effectiveness of vibration/acceleration training as a core stability exercise in the treatment of acute low back pain and to establish whether this protocol should be utilized routinely in the management of this condition.Item The immediate effect of a lumbar manipulation on the clinical and performance measures of amateur tennis players suffering from lower back discomfort associated with playing tennis(2006) Tyfield, Susan; De Busser, Nikki LaurenLower back pain and lower back injuries have been documented as one of the most common musculoskeletal problems in both amateur and professional tennis players. It has also been documented that the serve, which may be considered one of the most important strokes of the game, is also the most likely stroke to cause back pain. A good tennis serve requires considerable trunk rotation. The serve is the highest stress strain action during tennis. In a two set game the minimum number of serves a player may hit is 24 with a maximum excluding deuces and advantages of 96. The “Topspin serve” in particular requires the player to arch their back and this puts the lumbar spine into hyperextension. These movements thus put considerable pressure on the facet joints and multifidi muscles. It stands to reason that any joint related clinical entity can change biomechanics and affect the serve. In research done on golfers with mechanical lower back pain, it was found that club head velocity as well as pain decreased in symptomatic golfers with mechanical lower back pain after manipulation (Jermyn, 2004). No research has yet been done on manipulation of tennis players with lower back pain. The aim of this investigation was to determine the immediate effect of a lumbar manipulation on the clinical and performance measures of amateur tennis players suffering from lower back discomfort associated with playing tennis.Item The relative effectiveness of spinal manipulation in conjunction with core stability exercises as opposed to spinal manipulation alone in the treatment of post-natal mechanical low back pain(2006) Wilson, Dean Paul Charles; Myburgh, CorneliusCore strengthening has become a major trend in the rehabilitation of patients suffering with lower back pain. Clinical trials have shown that core strengthening is beneficial for patients with low back pain. According to the literature, core strengthening consists of activating the trunk musculature in order to stabilize hypermobile symptomatic joints and thus lessen mechanical stress to the spine. Spinal manipulative therapy has also proved itself to be beneficial, particularly in the case of post-natal low back pain sufferers, as manipulation may correct hypomobility associated with spinal subluxations. Literature suggests that spinal manipulative correction of spinal subluxations in combination with core stability exercises, that stablise symptomatic hypermobile joints, may have more advantages than using these interventions singularly in the treatment of post-natal low back pain. However, the combination of a core stability muscle training program with spinal manipulative therapy has yet to be investigated. In order to choose the most appropriate therapy for managing this condition, it is essential for research to be carried out to identify the most effective treatment, which would allow for better overall management of low back pain during the post-natal period. Therefore this study was designed to establish the effectiveness of a combined protocol of spinal manipulation and core stability exercises in the treatment of post-natal mechanical low back pain and to establish whether this protocol should be utilized routinely in the management of this condition.