Faculty of Health Sciences
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Item The relative effectiveness of a non-steroidal anti-inflammatory medication (meloxicam) versus manipulation in the treatment of osteoarthritis of the knee(2001) Tucker, Mark L.; Myburgh, CorneliusThe purpose of this study was to evaluate the relative effectiveness of manipulation versus meloxicam (a Non-Steroidal Anti-Inflammatory Drug) to determine which is more beneficial in treating osteoarthritis of the knee. This was a prospective, randomized clinical trial consisting of a population of sixty voluntary subjects, diagnosed as suffering from osteoarthritis of the knee. The patients were divided equally into two groups of thirty, with Group A receiving chiropractic manipulative therapy on eight consultations over three weeks, and Group B receiving meloxicam 7,5mg tablets once daily for three weeks. Capturing of the subjective and objective data for both groups took place on the first, fourth and eighth consultations. Subjective data was captured using the Numerical Pain Rating scale-l 01, the Visual Analogue scale, as well as the Patient -Specific functional scale. Objective data was gathered from goniometric and pressure algometer measurements.Item The relative effectiveness of action potential therapy compared to diclofenac sodium in the treatment of mechanical low back pain(2001) Bowers, Sonia Claire; Myburgh, CorneliusLow back pain is a major health problem worldwide, and considerable amounts of money are spent on a variety of practitioners including medical practitioners, chiropractors, osteopaths, physiotherapists and others. There is a lack of consensus among these groups regarding the most appropriate therapy or management for low back pain. This disparity leads to the meritable conclusion that more research is required to accurately identify solutions for the management of low back pain (Walker, 1997:95-96).Item The relative effectiveness of Piroxicam versus Protease administration in the treatment of acute grade 1 and 2 ankle inversion sprains(2001) Bellingham, Simon; White, Horace LindsayThe purpose of this study was to evaluate Piroxicam versus Protease administration, in terms of subjective and objective clinical findings, in order to determine the effectiveness of each approach in the treatment of grade 1 and 2 acute ankle inversion sprains. The study was a prospective, randomized, double blinded, controlled study. The study involved 30 subjects, 15 in each group which were selected from the general population. One group received Protease and strapping while the other group two received Piroxicam and strapping. Patients received 3 treatments over a period of one week. Patients in the Protease group received 1200mg (3 x 400mg) of Protease daily before meals for seven days. Patients in the Piroxicam group received 40mg (2 x 20mg) of Piroxicam for the first two days, and then 20mg (1 x 20mg) for the following five days, administered with meals. All patients were taught how to apply an elastic crepe bandage to the ankle, which was to be used at all times, except during bathing for the duration of the studyItem The relative effectiveness of spinal manipulative therapy compared to Diclofenac sodium, in the management of mechanical low back pain(2001) Login, Jacqueline Iona; Van der Meulen, Anthony G.Hendler et al. (1995) describes low back pain as the most common, costly and disabling musculosketetal condition. Giles (1997: 28) supports this, stating that the annual incidence of low back pain in the adult population is between two and five percent, with a lifetime prevalence of well over 50%. For clinicians to choose the most appropriate therapy for managing this common condition it is essential for research to be carried out to define the most effective treatment. Shekelle (1994) explains that spinal manipulative therapy is an effective treatment for patients with low back pain, while Cherkin et al. (1995) states that there is strong evidence to support the use of nonsteroidal antiinflammatory drugs in the management of mechanical low back pain. It is therefore the purpose of this investigation to determine the relative effectiveness of spinal manipulative therapy compared to Diclofenac Sodium, in terms of subjective and objective measures, in the management of mechanical low back pain. This randomized controlled trial consisted of sixty patients between the ages of 18 and 65, complaining of mechanical low back pain. The sixty patients were randomly divided into two treatment groups of thirty each. One group received spinal manipulative therapy and the remaining thirty were administered Diclofenac Sodium. These patients were carefully screened to allow the researcher to diagnose the patient, with Lumbar Facet Syndrome, Sacroiliac Syndrome or Myofascial Pain Syndrome; or any combination of these syndromes. This is in accordance with Kirkaldy-Willis (1992: 105 - 119) classification system. The thorough examination ensured that each patient had no contra-indications to spinal manipulative therapy or Diclofenac Sodium.Item The short term effectiveness of cervical spine manipulation as compared to piroxicam administration in the treatment of chronic cervical facet syndrome(2001) O'Connor, Brendan John; Mac Dougall, TarrynFor neck pain, the first-line treatment of allopathic physicians is usually the prescription on non-steroidal ant-inflammatory drugs (NSAIDs), whereas the firstline treatment of chiropractic physicians is usually cervical manipulation. The literature shows that both chiropractic manipulation alone and NSAIDs alone are effective for the treatment of cervical facet syndrome, with chiropractic manipulation being much safer than the use of NSAIDs. Furthermore, patients that receive chiropractic care have been shown to generally be much more satisfied than those that receive conventional medical care. The aim of this study was to determine the short-term effectiveness of cervical spine manipulation as compared to Piroxicam administration in the treatment of chronic cervical facet syndrome. The study design that was chosen was that of a comparative clinical trial. Forty consecutive patients diagnosed with chronic facet syndrome of the cervical spine were randomly assigned to either the manipulation group or the NSAID group (twenty patients in each group). Each patient in group A received manipulative therapy of the cervical spine on three consecutive days. Each patient in group B received 40 mg of Adco Piroxicam on the first two days of treatment, and 20 mg daily for the remainder of the seven day treatment period. The patients were assessed by means of objective and subjective data obtained before each consultation on days 1, 3 and 7. The objective data was gathered from algometric pressure-pain threshold readings over the involved facet joint. The subjective information was obtained from the Short-Form McGill Pain Questionnaire, the Numerical Pain Rating Scale - 101 and the CMCC Neck Disability Index, as well as the patients perceived improvement which was recorded as a percentage on days 3 and 7.Item Effectiveness of proprioceptive neuromuscular facilitative stretching combined with administration of Diclofenac compared to proprioceptive neuromuscular facilitative stretching and placebo medication for the treatment of cervical facet syndrome(2001) Upneck, Heidi Sian; Myburgh, CorneliusThe purpose of this study was to test the Effectiveness of Proprioceptive Neuromuscular Facilitative Stretching combined with administration of Diclofenac compared to Proprioceptive Neuromuscular Facilitative Stretching and placebo medication for the treatment of Cervical Facet Syndrome in a clinical experimental setting. Neck pain is a common disorder, which can often be attributed to mechanical dysfunction of the cervical spine. The patient with facet syndrome may complain of sudden onset of unilateral neck pain, often with referred pain. Muscle spasm is usually present causing restricted movement. Pain increases with movement and is relieved by rest. The pain is aggravated by hyperextension and relieved by flexion and often follows a sclerotomal rather than a dermatomal pattern. Forty subjects with mechanical neck pain were screened for facet syndrome and randomly divided into two groups of twenty. Each patient received Proprioceptive Neuromuscular Facilitative (PNF) stretching of the Posterior Cervical and Trapezius musculature. In conjunction with this, half the patients received Cataflam D while the other half received placebo medication. The patients were treated five times over a period of two weeks. Both groups were evaluated in terms of subjective and objective clinical findings by making use of questionnaires (Numerical Pain Rating Scale 101, Short Form McGill Pain Questionnaire and the CMCC) and algometer and goniometer measurements respectively. The data was collected at the initial, middle and final treatments for each patient.Item The relative effectiveness of non-steroidal anti-inflammatory medication as compared to a homoeopathic complex in the treatment of cervical facet syndrome(2000) Hepburn, Stuart Estridge; Till, A. G.The literature shows neck pain, including cervical facet syndrome, to be a common problem. It also provides evidence that inflammation plays a role in cervical facet pathology. Prescription of nonsteroidal anti-inflammatory drugs (NSAIDs) is the first line treatment of allopathic physicians for neck pain. Traumeel S is a complex of homoeopathic remedies indicated in a variety of anti-inflammatory, traumatic and degenerative disorders. It has been clinically shown that Traumeel S is effective in the treatment of inflammation. There is a paucity of clinical research into the treatment of acute neck pain, including cervical facet syndrome, with antiinflammatory agents. The aim of this study was to compare the relative effectiveness of piroxicam, an NSAID, with Traumeel S in the treatment of acute cervical facet syndrome. The study was a double-blind, comparative, clinical trial. Fifty consecutive patients complying with all inclusion criteria were randomly assigned to either the Traumeel S group or the piroxicam group. Each patient in the NSAID group received 40 mg of piroxicam per day for the first two days and 20 mg per day for the following 5 days. The Traumeel S group received the same dosage of placebo piroxicam capsules and 3 Traumeel S tablets in crushed form, per day. Placebo Traumeel Stablets, also in crushed form, were taken 3 times a day by the NSAID group to facilitate blinding. III Patients were assessed on days 1, 3 and 7 of the trial. Subjective assessment involved two questionnaires: the CMCC Neck Disability Index, and the NRS-101Item The efficacy of combined diclofenac therapy and spinal manipulation compared to combined placebo therapy and spinal manipulation in the treatment of mechanical low back pain(2001) White, Powan Harvey; Mathews, RobertThere are many non-surgical treatments that are available to patients with low back pain but few have been proven effective in controlled clinical trials. Arguably, the treatments with the greatest evidence for efficacy are nonsteroidal anti-inflammatory drugs (NSAIDs), some muscle relaxants and spinal manipulation (Deyo et al.(1983) and Shekelle et al.(1992). Non-steroidal antiinflammatory drugs are the most widely used agents for musculoskeletal pain and inflammation. The widespread use of NSAIDs augments the impact not only of their benefits but also the risk of their adverse effects. The effectiveness of chiropractic management is now firmly established for most patients with acute and chronic low-back pain (Koes et aI.1996). The purpose of this study was to determine the relative efficacy of combined diclofenac sodium therapy and spinal manipulation compared to combined placebo therapy and spinal manipulation in the treatment of mechanical low back pain. Sixty subjects were selected and randomly divided into two groups of thirty subjects. Subjects were treated four times over a two-week period, including a diclofenac or placebo medication course, taken three times daily for five days, starting from the first consultation. The results of the Numerical Pain Rating Scale-101, Revised Oswestry Low Back Pain Disability Questionnaire, Orthopaedic Rating Scale and Algometer readings were taken before the first, third and fourth consultations. The statistical tests used were the parametric two-sample unpaired t-tests and the paired t-tests, and the nonparametric intra-group Friedman test, multiple comparison procedure, Wilcoxon Signed Ranks test and the inter-group Mann Whitney U-test at the 95% level of significance using the SPSS statistical package. There was a statistically significant improvement in both treatment groups for both subjective and objective clinical findings, suggesting that spinal manipulation combined with either an NSAID or placebo medication will ultimately give relief to a patient suffering from lower back pain. The conclusionsItem 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.Item The efficacy of phonophoresis with Traumeel® S in the treatment of upper trapezius myofasciitis(2012-08-20) Deonarain, Virosha; Docrat, AadilBackground:Myofascial Pain Syndrome is characterized by localized muscle pain, in which affected muscles are in a chronically-shortened state and contain trigger points.It is the single most common source of musculoskeletal pain that is encountered in clinical practice. Modalities such as electrotherapy, cryotherapy, thermal therapy, dry-needling and ultrasound are used in its management. The use of phonophoresis has generated much interest; and literature around this modality continues to accumulate. Numerous studies have demonstrated the efficacy of phonophoresis with an anti-inflammatory in the treatment of musculoskeletal disorders, attributing the efficacy to the penetration of the coupling medium by means of the ultrasonic waves. Traumeel®S, is a homeopathic anti-inflammatory, that has successfully been used in the treatment of musculoskeletal injuries.It has anti-oedematous, anti-exudative, anti-inflammatory and analgesic properties. Its efficacy as a coupling agent in phonophoresis has not been tested for myofascial pain syndrome. Methodology:This study was designed as a prospective, double-blinded, randomized, and controlled experimental investigation. Sixty subjects were randomly allocated to three groups of 20 subjects each. Group Areceived active phonophoresis with Traumeel® S gel;Group B received sham phonophoresis with Traumeel® S gel; Group C received an application of Traumeel® S gel only.Algometer and Numerical Pain Rating Scale 101 (NRS) readings were taken immediately before treatment at visit one and thereafter at visits three and four. Results:Repeated measures ANOVA testing was used to examine the intra-group effect of time and the inter-group effect of treatment on the outcomes of NRS and algometer readings. Profile plots were used to assess the direction and trends of the effects. An intra-group analysis revealed that, objectively and subjectively, all groups responded positively to treatment over time, with no significant time-group interaction. It was noted that there was a higher rate of improvement in Group A over time; however, this difference was not statistically significant. Conclusion:The results from this study revealed that all three treatment groups responded favorably to the alleviation of pain. It was concluded that phonophoresis with Traumeel® gel had no significant additional beneficial effects.