Faculty of Health Sciences
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Item The efficacy of detuned ultrasound compared to proprioceptive neuromuscular facilitation of the gluteal musculature both used in conjunction with manipulation in the treatment of sacroiliac syndrome(2001) Paton, Jaqueline; Myburgh, CorneliusThe purpose of this study was to determine the relative efficacy of chiropractic manipulation used in conjunction with detuned ultrasound over the gluteal muscles compared to manipulation used in conjunction with proprioceptive neuromuscular facilitation stretching of the gluteal muscle group in the treatment of sacroiliac syndrome. It was hypothesised that both treatment groups would be effective in the treatment of sacroiliac syndrome but that manipulation used in conjunction with proprioceptive neuromuscular facilitation of the gluteal musculature would be more effective than manipulation used in conjunction with detuned ultrasound, in terms of subjective and objective clinical findings.Item The effectiveness of ultrasound therapy as an adjunct to the treatment of medial tibial stress syndrome type 2 (shin splints)(1998) Van Lingen, Lawrence Hal; Jones, Andrew D.Very few studies of medial tibial stress syndrome type II address the treatment of the condition. There is a need to find a method of hastening the recovery of the condition. Therefore the objective of this study was to determine whether application of ultrasound therapy to medial tibial stress syndrome type Il would influence the recovcrv of this condition.Item The relative effectiveness of spinal manipulation and ultrasound in mechanical neck pain(1998) Moodley, Malany; Brantingham, James W.The aim of this study was to determine the effectiveness of adjustments versus the use of ultrasound in the treatment of mechanical neck pain. It was hypothesized that treatment with adjustments over a four week period, with a further four week follow-up period, would be more effective than ultrasound in terms of improving patients' cervical ranges of motion and their perceptions of pain and disability. Thirty consecutive patients suffering from mechanical neck pain were randomly assigned to either the adjustment or ultrasound groups. An experimental design was employed, whereby both groups received treatment twice a week for four weeks. After a follow-up period of a month, the patients were re-assessed. Measurements of the cervical spine ranges of motion with the CROM goniometer, algometer readings, and the completion of the Numerical Pain Rating Scale-101, CMCC Neck Disability Index and the Short Form McGill Pain questionnaires were performed before the first, fourth and final treatments as well as at the one month follow-up consultation. The data were then transferred to spreadsheets and underwent statistical analyses, using a 95 % confidence level. Analyses within each group were performed, using the Wilcoxon Signed Rank test and various readings were compared. The reading taken before the first treatment was compared to the reading taken before the final treatment. The initial reading was then again compared with the reading taken at the one month follow-up consultation. Comparison of the results of both treatment groups was statistically evaluated, using the Mann-Whitney U-Test. The comparison was made using the readings of the first, fourth and final treatments, as well as the one month follow-up consultation. This was done for all measurement parameters.Item The relative effectiveness of wrist joint manipulation versus ultrasound in the management of carpal tunnel syndrome(2002) Maharajh, Karuna; Van der Meulen, Anthony G.Carpal Tunnel Syndrome is defined as a median nerve entrapment beneath the flexor retinaculum in the carpal canal such that it produces symptoms in the hand, wrist and upper extremity. A review of related literature suggests that statistics on the incidence of Carpal Tunnel Syndrome in South Africa are unavailable. In the U. s. A, Carpal Tunnel Syndrome occurs in 1% of the population and is the most frequently diagnosed peripheral neuropathy. Several studies investigating the use of conservative care in managing Carpal Tunnel Syndrome have been performed, but none have compared the effect of wrist joint manipulation and ultrasound in the management of Carpal Tunnel Syndrome, The purpose of this study was to investigate the effectiveness of wrist joint manipulation compared to ultrasound in the management of Carpal Tunnel Syndrome. This randomized controlled clinical trial consisted of a study population offorty patients. The patients were randomly allocated to two groups of twenty each. One group received wrist joint manipulation while the other received ultrasound application to the palmar-radial aspect of the wrist. Both groups received four treatments over a two week period. Subjective measures included the Numerical Rating Scale-I 0 1 Questionnaire and the Carpal Tunnel Pain and Disability Form and objective measures consisted of the grip strength reading and goniometer readings for wrist flexion and extension. Both the subjective and objective measures were taken before the first and third visit and at the fifth follow- up consultation which took place during the following week. Inter-group analysis was done using the Mann- Whitney U test. Friedman's T test was used for intra-group analysis. ct was set at the 0.05 level of significance. The results were illustrated by means of tables and bar- charts. The results indicated that for intragroup analysis, a statistically significant difference existed for both groups, warranting the use of a multiple comparison procedure (Dunn' s procedure) to determine at which stage the treatment made a significant difference. For all the measures except the wrist extension reading in the ultrasound group, most improvement occurred between the first and fifth consultations. For inter-group analysis, no significant difference for any of the measures, except the wrist extension readings, was present between the two groups indicating that both wrist joint manipulation and ultrasound were equally effective in treating Carpal Tunnel Syndrome. The improvement in wrist extension, in the wrist joint manipulation group was significantly better than that in the ultrasound group. Although this study was limited by its single researcher design and could not clarify which treatment protocol was more effective, it supports the existing body of evidence in favour of both wrist joint manipulation and therapeutic ultrasound application in the management of Carpal Tunnel SyndromeItem The relative effectiveness of pulsed ultrasound as an adjunct to foot manipulation in the treatment of plantar fasciitis(2002) Du Plessis, Juan; Shaik, JunaidPlantar fasciitis (PF) is a syndrome that causes pain at the insertion of the plantar fascia to the medial calcaneal tubercle of the calcaneaus. This syndrome has been described as an overuse injury with subsequent inflammation at the insertion of the plantar fascia to the bone. The literature describes inflammatory changes that occur within the body and attachment of the plantar fascia, together with biomechanical aberrances that may be the result of the PF. The purpose of this study was to determine the relative effectiveness of pulsed ultrasound as an adjunct to foot manipulation in the treatment of plantar fasciitis. The foot manipulations are used to correct the biomechanical abnormalities, while the pulsed ultrasound is used for its anti-inflammatory properties. The combination of pulsed ultrasound and foot manipulation was compared to foot manipulation alone to determine if this ultrasound manipulation combination had any beneficial effect over and above foot manipulation alone. Thus determining whether it is of importance to o approach and treat both aspects of the syndrome described. This was a prospective, randomised, comparative controlled trial. Forty subjects were diagnosed with plantar fasciitis and chosen to participate in the study. They were subsequently divided into two groups (Group A and Group B) of twenty. Group A was the experimental group receiving foot manipulation and ultrasound as treatment, and Group B, the control group received foot manipulation alone as treatment. Each subject received six treatments within a period of three weeks, with a seventh follow-up within one week of the sixth treatment. There was no treatment at the seventh consultation; this was used for obtaining subjective and objective readings. Subjective assessment was by means of the Foot Function Index, and objective was by means of the manual algometer. Both the subjective. and objective readings were taken prior to the first, sixth and at the seventh (final) consultations.Item A double-blinded placebo-controlled investigation into the effect of therapeutic ultrasound on radial artery blood flow(2009) Varatharajullu, Desiree; Shaik, JunaidAim: To investigate the effect of therapeutic and sham ultrasound on radial artery blood flow (m.s-1) and radial arterial lumen diameter (mm). Subjects: Fifty healthy asymptomatic volunteers between the ages of 18-38 years. Methodology: The subjects were randomly allocated into one of five intervention groups (A-E). Group A received continuous ultrasound at 0.2 W.cm-² for 5 minutes, Group B received pulse ultrasound at 0.2 W.cm-² for 5 minutes, Group C received continuous ultrasound at 1.5 W.cm-² for 5 minutes, Group D received pulse ultrasound at 1.5 W.cm-² for 5 minutes and Group E received sham ultrasound at 0 W.cm-² for 5 minutes. Baseline radial artery blood flow (m.s-1) and radial artery lumen diameter (mm) readings were taken prior to the commencement of the therapeutic or sham ultrasound application using a Doppler ultrasound. At four minutes of application (during the therapeutic or sham ultrasound application), another set of blood flow and arterial lumen diameter measurements were taken. The final blood flow and arterial lumen diameter measurements were taken one minute after the therapeutic or sham ultrasound application was stopped. Results: The mean (± SD) radial artery blood flow and radial artery lumen diameter at baseline was 0.197 (± 0.060) m.s-1 and 2.4 (± 0.6) mm respectively. In Group A, the mean (± SD) radial artery blood flow during ultrasound application and one-minute after ultrasound application was 0.193 (± 0.070) m.s-1 and 0.179 (± 0.073) m.s-1 respectively. The mean (± SD) radial artery lumen diameter in Group A at the two time intervals was 2.2 (± 0.5) mm and 2.2 (± 0.3) mm respectively. In Group B, the mean (± SD) radial artery blood flow during ultrasound application and one-minute after ultrasound application was 0.187 (± 0.067) m.s-1 and 0.195 (± 0.041) m.s-1 respectively. The mean (± SD) radial artery lumen diameter in Group B at the two time intervals was 2.4 (± 0.4) mm and 2.3 (± 0.5) mm respectively. In Group C, the mean (± SD) radial artery blood flow during ultrasound application and one-minute after ultrasound application was 0.225 (± 0.088) m.s-1 and 0.186 (± 0.071) m.s-1 respectively. The mean (± SD) radial artery lumen diameter in Group C at the two time intervals was 2.4 (± 0.7) mm and 2.7 (± 0.8) mm respectively. In Group D, the mean (± SD) radial artery blood flow during ultrasound application and one-minute after ultrasound application was 0.215 (± 0.080) m.s-1 and 0.200 (± 0.081) m.s-1 respectively. The mean (± SD) radial artery lumen diameter in Group iv D at the two time intervals was 2.4 (± 0.8) mm and 2.4 (± 0.7) mm respectively. In Group E, the mean (± SD) radial artery blood flow during ultrasound application and one-minute after ultrasound application was 0.200 (± 0.067) m.s-1 and 0.182 (± 0.075) m.s-1 respectively. The mean (± SD) radial artery lumen diameter in Group E at the two time intervals was 2.5 (± 0.7) mm and 2.3 (± 0.5) mm respectively. There was no significant change in radial artery blood flow and radial artery lumen diameter over time in any individual group or between groups (p > 0.05; repeated measures ANOVA). There was an overall weak positive correlation between radial artery blood flow and radial artery lumen diameter at baseline (r = 0.508), during (r = 0.541) and after (r = 0.532) the therapeutic or sham ultrasound application. Conclusion: The results of this study showed that continuous, pulse or sham ultrasound had no significant effect on radial artery blood flow and radial artery lumen diameter. Furthermore, active ultrasound (continuous and pulse) was not superior to sham ultrasound in significantly affecting blood flow in a muscular artery.Item The treatment of myofascial pain syndrome using therapeutic ultrasound, on upper trapezius trigger points : a double-blinded placebo controlled study comparing the pulsed and continuous waveforms of ultrasound(2003) Pillay, Magendran GanasThis study was a prospective, randomised, double blinded, placebo controlled, comparative clinical trial to establish the efficacy of therapeutic ultrasound and compare the effectiveness of the two waveforms of ultrasound in the treatment of myofascial pain syndrome.Item The relative effectiveness of periosteal pecking combined with therapeutic ultrasound compared to therapeutic ultrasound in the treatment of medial tibial stress syndrome type II(2003) Robertson, Moira EleanoraMedial Tibial Stress Syndrome Type II (MTSS), otherwise known as shin splints, accounts for approximately 13% of injuries in American runners. Van Mechelen (1992) reported that 37-57% of recreational runners experience an injury over the course of a year, from which 54-75% of all injuries are caused by overuse. The American Medical Association defines shin splints as “pain and discomfort in the leg from repetitive activity on hard surfaces, or due to forceful, excessive use of foot flexors. The diagnosis should be limited to musculoskeletal inflammations excluding stress fractures and ischemic disorders.” (Thacker et al., 2002) Treatment protocols vary from biomechanical interventions (orthotics), to non-steroidal anti-inflammatory drugs and modalities such as ultrasound all with varying degrees of success (Noakes, 2001). Apart from therapeutic interventions it is the overriding symptom of pain, which patients are left with (Noakes, 2001). A therapeutic intervention called periosteal pecking has received increased interest with regards to symptomatic treatment of shin splints. Periosteal pecking is a form of *dry needling in which the tip of the needle contacts the periosteum (Raso,1997). The aim of this study is to establish the effect of periosteal pecking in the clinical setting with and against that of an established intervention, namely therapeutic ultrasound.