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Dissertations / Theses on the topic 'Chiropractics'
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Durant, Claire L. "Chiropractic treatment of patients under 18 years of age, frequency, patterns, and chiropractors' beliefs." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0027/MQ31345.pdf.
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Villanueva-Russell, Yvonne. "On the margins of the system of professions : entrepreneurialism and professionalism as forces upon and within chiropractic /." free to MU campus, to others for purchase, 2002. http://wwwlib.umi.com/cr/mo/fullcit?p3060152.
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Mortenson, Michelle D. "Identifying predictors of chiropractic outcomes." Online version, 2002. http://www.uwstout.edu/lib/thesis/2002/2002mortensonm.pdf.
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Eni, Godwin Onuoha. "Chiropractic medical system : the making of a clientelle." Thesis, University of British Columbia, 1987. http://hdl.handle.net/2429/27298.
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Most sociological explanations for the success of chiropractic in attracting and maintaining its clientele have failed to consider the clinical context and the nature of the interaction between chiropractors and clients. Rather, most studies have focussed on leadership qualities, the professionalization process, and the ancillary role of chiropractic in health care to account for its success with clients.
This study argues that chiropractic in British Columbia is successful in making its clientele because: (1) it is able to persuade new clients toward chiropractic health care by using strategies that are designed to minimize the political, social and economic constraints upon it; (2) chiropractors are able to negotiate successfully, the differences in the health and illness beliefs [HMs] that are held by new clients and chiropractors as well as differences in explanations [EMs] for "present" health problems; and (c) chiropractors are able to provide potential patients with "positive" experiences in chiropractic clinics, which are different, in some respects, from experiences they have had elsewhere, for example, in their relationships with allopathic medicine. This study, therefore, describes how new clients are socialized in chiropractic clinical relationships and subsequently become chiropractic patients.
20 randomly selected chiropractors and a total of 60 new clients were interviewed for their impressions of chiropractic as well as their health beliefs and explanations for "present" health problems prior to encountering each other in the clinical setting. Their interactions were observed in the twenty clinical settings, with special focus on the negotiation of explanatory models. The patients were interviewed again, regarding their experiences and impressions, following their fourth visit to the clinic after their initial encounter. 20 "regular" or long-term chiropractic patients, one from each clinic, were also interviewed regarding their experiences.
Data were analyzed by comparing pre- and post-interview results and by describing the nature of clinical interactions, relationships, and negotiation of explanatory models in the context of Kleinman's ethno-medical perspective and Goffman's social ethnographic perspective on interactions in everyday life.
It was found that chiropractors (1) provide potential patients with "adequate" information and the opportunity to ask questions; (2) express non-judgemental views on the health problems of clients, which provides new clients with the opportunity to fully explain their health concerns; (3) utilize persuasive interaction structures and processes to minimize both the constraints upon chiropractic and the effects of deviancy and marginality labels, and to manage the impressions of potential patients; and (4) negotiate with potential patients over explanations for the causes of their health problems, which enables the delivery of chiropractic treatment by integrating, "shifting" and modifying clients' explanatory models and, to some extent, their own.
These techniques for 'making' the chiropractic clientele appear to be successful. In this study, 53 of the 60 new clients were retained beyond the fifth visit. More generally, chiropractic is now the second largest primary health care provider group in B.C., next to allopathy, and is attracting an increasing number of patients.Arts, Faculty of
Anthropology, Department of
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Distler, Michael. "Chiropractic use, patient income, and frequency of visits." Diss., Connect to the thesis, 2008. http://hdl.handle.net/10066/1446.
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Folk, Holly. "Vertebral vitalism American metaphysics and the birth of chiropractic /." [Bloomington, Ind.] : Indiana University, 2006. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3223040.
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Thesis (Ph.D.)--Indiana University, Dept. of Religious Studies, 2006."Title from dissertation home page (viewed June 26, 2007)." Source: Dissertation Abstracts International, Volume: 67-06, Section: A, page: 2291. Adviser: Stephen J. Stein.
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Field, Jonathan Roger. "Collecting and predicting patient reported outcomes in chiropractic practice." Thesis, University of Portsmouth, 2016. https://researchportal.port.ac.uk/portal/en/theses/collecting-and-predicting-patient-reported-outcomes-in-chiropractic-practice(29fdc29d-f462-4dd7-a3ac-a65876736cdb).html.
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The eight refereed publications and four abstracts of presentations which form the basis of this PhD each deal with patient health outcomes. The publications are drawn predominantly from practice based research in chiropractic services. In a systematic review of the impact of Patient Reported Outcome Measures (PROMs) on the process and outcomes of care for a single patient, Paper 1 describes this occurring across four domains; patient assessment and initial clinical decision making, tracking progress and evaluating current treatment efficacy, influencing the patient / clinician relationship and there is weak evidence to suggest they directly influence patient outcomes. Paper two is a descriptive review of the utility of PROMs to include their ability to improve communication and shared decision making in the patient / clinician relationship. Care Response is a novel, free to use multilingual electronic PROM system developed by the author. It has had significant impact in the chiropractic profession in Europe and Canada and has contributed data to 11 peer reviewed papers and four post graduate degrees (Abstract 1) Electronic PROM systems suffer from lower response rates than paper based systems. Abstract 2 reports a study looking at the impact of this missing information on the generalisability of the overall data collected. Non respondents to an emailed assessment 30 days after starting care were less likely to have had >30 days pain in the last year but were not otherwise significantly different from those returning electronic assessments. In a telephone survey comparing respondents and non respondents, patients global impression of change (PGIC) scores were identical and there was no statistical difference in pain scores. Paper 3 sought to ascertain if patient less likely to do well with chiropractic care could be identified from data routinely collected at baseline in chiropractic practice. Longer duration of symptoms at presentation, females with higher social disability scores and males with more adverse scores for depression were found less likely to describe themselves as much improved a month after starting care. In investigating for a relationship between outcome and components of the fear-avoidance model for chronicity in lower back pain, paper 4 found only a week relationship with catastrophisation at baseline however patient’s scores of catastrophisation, fear avoidance beliefs and low self efficacy just before their second visit were significantly associated with a poorer outcome. Paper 5 looking into a relationship between the risk category patients were placed into by the STarT Back Tool reported that whilst HIGH risk patients has more adverse scores for pain at presentation this rapidly faded and at 30 and 90 days there was no significant difference between the risk groups and patients reports of their recovery (PGIC) . Comparing the health outcomes of 8222 patients accessing chiropractic services either via the NHS or privately Paper 6 described those accessing a NHS route to have had symptoms for longer and more adverse scores across a range of health domains at presentation and to be less well 30 & 90 days later. However both NHS and private patient groups improved well and differences between the two disappeared when controlling for differences at baseline. Paper 7 sought to explore the ability of chiropractic clinicians working from 5 linked practices to identify those patients less likely to do well with care at the time of their initial assessment. It concluded that they generally failed to reliably predict outcomes with most practitioners doing no better than chance. The STarT Back Tool is increasingly being recommended to guide decisions as to care pathway for patients with spinal pain. Paper 8 looked to see if the timing of when this assessment was made had any impact on its ability to detect groups of patients responding differently when undergoing a course of chiropractic care. In the assessed population (n=749) attending 1 of 11 clinics in the UK there was a significant difference with ranking at the time of presentation being unrelated to outcome. When repeated a few days post initial visit over one third of patients had changed risk group with this subsequent group being found to be an independent predictor of improvement in multivariate analysis.
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Wilson, Francis James. "The origins and professional development of chiropractic in Britain." Thesis, University of Southampton, 2012. https://eprints.soton.ac.uk/341659/.
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In June 2001 the title ‘chiropractor’ came to be protected under British law and those who called themselves chiropractors attained a position of increased legitimacy within British society. Yet the details of chiropractic’s journey to statutory recognition have not been thoroughly explored in contemporary literature. The origins and development of chiropractic in Britain have received meagre attention from historical scholars. This thesis uses a neo-Weberian approach to explore the history of chiropractic in Britain through the lens of ‘professionalisation’. It investigates the emergence of chiropractic in Britain, and details how and why chiropractic developed in the way that it did, assessing the significance of processes and events in respect to chiropractic’s professionalisation, and examining intra- and inter-occupational tensions. The thesis is primarily a product of documentary research, but is also informed by interviews undertaken to provide oral testimonies. Although the origins of chiropractic are usually traced back to the 1890s, to Davenport, Iowa, and to the practice of Daniel David Palmer, it is argued in this thesis that it is misleading to claim that chiropractic was ‘discovered’ by Daniel Palmer, or that chiropractic in Britain was entirely an ‘import’ from the United States. Instead, chiropractic’s origins were complex and multifarious and form part of a broader history of manipulative practices. With regard to the development of chiropractic in Britain, chiropractic’s history is intertwined with that of osteopathy, and has involved medicalisation. This study demonstrates that through the course of its evolution chiropractic was subject to processes that can usefully be described in terms of professionalisation, sharing features in common with the professionalisation of other occupational groups described in historical and sociological literature. Even so, chiropractors did not attain the social presence or cultural authority of archetypal professionals such as medical doctors or lawyers. Although protection of title was achieved, many problems have remained, including divisions within the occupation.
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Heale, Graham Stanley. "CPD and practice change : the chiropractors' perspective." Thesis, University of Portsmouth, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.500340.
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Continuing professional development (CPD) is now viewed as an integral part of professional practice and yet there is little evidence that traditional approaches to post-graduate learning result in changes to the way clinicians practise. Chiropractic is an independent primary contact profession with priorities and learning needs that are quite different from those practitioners working within the NHS. Evaluating the current level of continuing professional development by assessing the changes to practice introduced by chiropractors will assist in informing the future development of the profession.
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Foster, Phelesia Nakita. "Perceptions of Chiropractors in Mississippi Regarding Obesity." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4786.
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Obesity continues to be a growing problem across the United States. Chiropractors have made claims of providing health promotion services within their treatment protocol; however, there is a lack of empirical research regarding a need for the chiropractic profession to train chiropractors to address Healthy People 2020 public health initiatives. The purpose of this qualitative study was to examine the perceptions of Mississippi Delta Region chiropractors regarding their role in obesity management as nonmedical practitioners that implement public health objectives in their practice. The research questions aimed at addressing possible barriers and limitations that influenced chiropractors' perceptions regarding their role in obesity prevention. The health promotion model which recognizes the vital role of the practitioner to the patient relationship in health outcomes, guided this study. Purposeful sampling was used to recruit 11 eligible board-certified chiropractors in the Mississippi Delta. The participants encountered a 1-time session with open-ended interview questions influenced by the hermeneutic tradition. Interview data were analyzed using thematic analysis. The findings indicated that chiropractors could treat obese patients and provide some services that are mostly provided and billed by other health care practitioners. Chiropractors, however, encounter legislative and insurance challenges. Outreach programs and collaboration with other health care practitioners would improve chiropractors' role in obesity management. The study can contribute to social change by increasing understanding of the chiropractic profession and how they may offer health promotion services to improve patient management of obesity and obesity-related illnesses.
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Bezuidenhout, Lauren Leigh. "Practice characteristics of chiropractic delegates attending the World Federation of Chiropractic's 12th Biennial Congress, 2013." Thesis, 2016. http://hdl.handle.net/10321/1776.
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Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Department of Chiropractic and Somatology, Durban University of Technology, Durban, South Africa, 2016.Background Chiropractic is practiced in over 100 countries and is considered to be the fastest growing health care profession internationally. Several studies investigating the practice characteristics of chiropractors have been conducted in selected countries, however, as far as is known, no study has been conducted where chiropractors from countries across the globe are assessed for their practice characteristics in order to determine if regional differences exist. Gaining insight into chiropractic practice and its influencing factors, relating to both the profession itself and the chiropractor can enable organisations such as the World Federation of Chiropractic to have a greater understanding of how chiropractors are currently practicing and how the profession is being utilised by the public. Improved insight into the profession provides a baseline description for the public and other health care practitioners to fully comprehend what chiropractors can offer to the health care system. Aim: The aim of this study was to determine the demographic profile and practice characteristics of chiropractic delegates attending the World Federation of Chiropractic’s 12th Biennial Congress 2013. Method A pre-validated questionnaire and letter of information and consent was distributed to all registered chiropractic delegates (N = 406) attending the World Federation of Chiropractic Congress in Durban, Kwa-Zulu Natal 2013. The questionnaire was part of the delegate packages and they self-selected to participate. Due to a low response rate at the congress, the questionnaire was made available electronically on Survey Monkey®, for six weeks after the congress. Questions relevant to this study were coded, reduced where necessary and utilised for data analysis with IBM SPSS Version 21. Descriptive data was then summarised and presented using tables and graphs. The study was approved by the Durban University of Technology’s Institutional Research Ethics committee. Results: The response rate was 34.72%, with 52.5% being female, mean age was 42 (SD ± 13years, and all seven geographical regions were represented. The majority of respondents were from Africa (51.1%), followed by North America (22.7%) then Europe (14.2%). South Africa (48.6%) was the most represented country. Respondents held either a Master’s degree in Chiropractic (51.8%) or a Doctor of Chiropractic (DC) degree (48.2%). The mean years since graduating as a chiropractor was 15.7 years (SD ± 3.6). The majority of respondents (71.2%) engaged in full-time clinical practice, for between 5 to 15 years (39.8%) with 51.4% purporting to have an evidence based philosophical approach to practice. The majority (72.5%) viewed the role of a chiropractor in the health care system as a primary health care practitioner with a focused scope of practice. The majority of respondents (n = 52) personally treated 50 patients or less per week, with approximately one third of the respondents (n = 34) having high volume practices (>100 patients weekly). The respondents favoured being one of two chiropractors (36.9%) in a practice setting followed by sole practices (31.6%). The top chiropractic technique utilised was the diversified technique (74.5%) followed by extremity adjusting (68.8%). Various adjunctive, active and passive, axillary techniques were utilised in the daily management of patients. The patient demographics were majority female (55.7%), older than 30 years of age (66.7%) and Caucasian (77%), complaining of head, neck, mid-back and low back pain, which was mostly acute in nature. Trends suggested that females were more likely to select an evidence-based philosophical orientation than males. Females were more likely to delegate adjunctive therapies to non-chiropractic assistants (p = 0.029), and favoured sending patients to a physical therapist (p = 0.018), whereas males were more likely to refer to nutritionists and paediatricians (p = 0.030 and p = 0.038, respectively). Females were less likely to utilise mobilisation techniques (p = 0.008), massage therapy (p = 0.018) and nutritional counselling (p = 0.032). In terms of age, those selecting an evidence-based approach were significantly older than those who adopted a mixer approach to practicing (p = 0.002). The mean age of the respondents, irrespective of the region, was not significantly associated with the number of patients treated per week (p = 0.377) or the hours worked per week (p = 0.474). Trends show that the number of years spent in practice differed among the regions with North American chiropractors spending more years in practice than those from Europe and Australasia. The respondents from South Africa spent fewer years in practice (15 years or less) than respondents from Asia, Australasia, Europe and North America. Geographic region was not significantly associated with practice setting (p = 0.182). The only chief complaint that differed between regions was patients presenting with headaches accompanied by neck pain (p = 0.007), where Asian and North American respondents reported seeing less patients than their colleagues from other regions. Trends suggested that the respondents who attained a Masters of Technology in Chiropractic were more inclined to select a mixer orientation whereas those with a DC qualification selected an evidence-based philosophical approach. Conclusion: The WFC congress provided a platform to successfully determine the demographic profile and practice characteristics of chiropractors from various regions. Similar demographics were evident, with males no longer showing dominance within the profession. Chiropractors adopting an evidence-based and mixer philosophical orientation are synonymous in the role that they play in the health care system and display similarities in chiropractic practice and patient management. Investigating chiropractors who adopt a straight philosophical approach would be beneficial as it will allow for better comparison of demographics and practice characteristics. It is evident that selected demographics do influence how one would opt to practice, with regional differences showing that the chiropractic profession in South Africa is still relatively young.
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Gardner, Patrick. "The effect of desirable behavioural characteristics of the chiropractic intern during the management of mechanical low back pain : a patient perception study." Thesis, 2004. http://hdl.handle.net/10321/2835.
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A dissertation submitted in partial compliance with the requirements for a Masters Degree in Technology: Chiropractic at the Durban Institute of Technology, 2004.Scholars, researchers and health care practitioners have long known that patients not only benefit from the specific manual therapy given from their health care providers, but also from the manner in which it is given. The latter is believed to have significant effects on the patient's perception of quality of care and clinical outcome.
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Keyter, Karin. "The perceptions of South African chiropractors, regarding their professional identity." Thesis, 2010. http://hdl.handle.net/10321/520.
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Dissertation submitted in partial compliance with the requirements for a Masters Degree in Technology, Durban University of Technology, 2010.It is well documented that the chiropractic profession has been searching for a unified professional identity. Acknowledging this need for a professional identity relevant to the public, the World Federation of Chiropractic (WFC) attempted to address these concerns by conducting an international questionnaire based Identity Consultation. However, of the 3689 chiropractors who responded, only 34 were from South Africa. Therefore this study aimed to determine the perception of South African chiropractors regarding their public identity and to compare the results with those from international studies. Objectives: To determine the demographic profile of South African chiropractors, and how they perceived their professional identity relative to their own opinions, those of the public and those of medical doctors. This study investigated how South African chiropractors saw their profession relative to physiotherapy and South African chiropractor’s knowledge of the WFC Identity Consultation. Method: The study was a population based demographic study making use of a descriptive, observational, cross sectional design. It was a quantitative selfadministered questionnaire distributed to those South African chiropractors meeting the inclusion criteria (n=398). The WFC Identity Consultation questionnaire was modified and developed by the researcher to suit a South African audience after permission was obtained from the chairperson of the WFC. Results: A response rate of 30.15% was obtained. Ninety percent of South African chiropractors felt that it was important for their profession to have a clear identity. However, only 1.7% agreed that it did have a clear identity. When asked how the public viewed chiropractic, 45% felt that the public had no clear perception of the profession, with 92.5% viewing it as Complementary and The Perceptions of South African Chiropractors, Regarding Their Professional Identity iv Alternative Medicine (CAM). However, 89.2% of South African chiropractors would like the public to perceive chiropractic as mainstream medicine. When asked how chiropractic was viewed by South African chiropractors relative to physiotherapy, it was agreed that they were two separate professions each with their own identity (74.2%). The chiropractic adjustment was seen as a strong brand advantage over physiotherapy. When asked how they thought medical doctors viewed chiropractic, 73.3% felt that they did not have a clear perception of the profession, with 96.7% considering medical doctors to view chiropractic as CAM. Medical doctors’ perceptions were considered to be very important with respect to inter-professional relations. Just over half (54.2%) of South African chiropractors knew about the WFC identity, less than half of whom (47.5%) agreed with it. Conclusions: The study revealed that there was a significant difference between how South African chiropractors thought the public and medical doctors currently perceived chiropractic and how they would like to be perceived. It revealed that like their international counterparts chiropractors in South Africa are striving for a unified identity that is different to the way they are currently perceived by the health care stakeholders.
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Dold, Raymond Gilbert. "A survey of the most commonly used diagnostic methods used by the chiropractors in Gauteng, South Africa for detecting adjustable lesions." Thesis, 2010. http://hdl.handle.net/10210/3097.
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M. Tech.The main purpose of this study was: • To determine the different diagnostic techniques chiropractors use in Gauteng South Africa. Objectives included: • To determine chiropractics attitude and opinions regarding the different Diagnostic Techniques they use in their practices. • To determine any statistically significantly correlations between answers. • To develop a demographic profile of Chiropractors in Gauteng South Africa. In the world today there are 80 000 chiropractors who are the primary physicians performing manipulations in order to treat problems such as lower back pain. Incidentally 85% of the western world will suffer from at some stage of their lives (Hecker and Daniel, 2004). The identification of the common functional and structural components of the adjustable lesion is critical to the management of these conditions. Unfortunately it has also contributed to the misconception that all manipulative disorders have the same pathological basis (Bergman, 2002). A questionnaire-based study comprising a non-probabilistic, non-random, convenience sample was used to determine the diagnostic techniques used v by the chiropractors actively practicing in Gauteng South Africa. A total of 58 Chiropractors responded to the questionnaire, forming the sample population that was used to calculate results. According to this study, all the responding chiropractors practicing here in Gauteng South Africa (n=58/58 100%), examine the spine to identify areas or subluxations that require adjustments/manipulation. There are a variety of diagnostic techniques methods that they use in everyday practice. Most commonly motion palpation(96.5%), static palpation(93.1%), pain description of the patient(82.8%), leg length discrepancy(55%), neurological tests(77.6%), visual postural analysis(61.4%), orthopedic tests(75%), plain static and stress x-rays(44.5%) and kinesiology muscle testing(10.4%) are used. The perceived reliability of these diagnostic techniques are also considered to be good.
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Bar-Gil, Moshe Charley. "The perception of selected chiropractors, medical doctors, health maintenance organisation representatives and chiropractic patients regarding the integration of the chiropractic profession in the Israeli health care system." Thesis, 2009. http://hdl.handle.net/10321/508.
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Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2009.Chiropractic in Israel has become a more integrated part of many aspects of health care policies, in that it is practised in multidisciplinary medical teams, is now included in HMOs and hospitals services, and has contributed to research and military programmes. However, the chiropractic profession still has its problems. Without laws or legitimate recognition to protect chiropractors, the playing fields could never be levelled for all chiropractors in Israel. Patient use and demand for complementary and alternative practitioners, including chiropractors, is gradually increasing. However, there has been no research to investigate the perceptions of chiropractors, medical doctors and chiropractic patients (i.e. key stakeholders) regarding the integration of the chiropractic profession in the Israeli health care system. The purpose of this study was to explore and describe the perceptions of a selected group of stakeholders about the integration of the chiropractic profession in the Israeli health care system. Such an exploration might help the profession to secure its position and claim a higher status in society. This is desirable to educate the public and the authorities on the many positive advantages of chiropractic, include access to chiropractic services for people who traditionally have not been able to use these services because of economic barriers or internal government and authorities limiting laws, as well to enhance its public image such as honesty, integrity and objectivity in the health care, and to avoid any criticism of organized medicine. It therefore stands to reason that the factors that might contribute to this type of development should be considered as soon as possible in those countries where chiropractors practise. This type of investigation is important not only in the Israeli setting, but indeed in every country where the profession is aiming toward increased recognition and awareness of the contribution of chiropractic to health care. Chiropractic now has the opportunity to expand its influence and take a more active role in health care issues. Therefore, although geographically removed, South Africa stands to gain interesting and useful information from an investigation of this nature. The investigation was carried out within a post positivist approach close to that of critical realism, using an interpretive methodology. The sampling was purposive as individuals were targeted for their knowledge in three main topics, these being the scope of chiropractic practice, inter-professional relations between Doctors of Chiropractic (DCs) and Medical Doctors (MDs), and developmental issues. The participants included five chiropractors, three medical doctors and three chiropractic patients, who all resided in the metropolitan area of Tel Aviv. were presented in tabular form in order to facilitate analysis and interpretation. Although there were some discrepancies regarding the knowledge and background of the participants about the topics discussed, all the participants met the inclusion criteria. The results show that chiropractic stands at the crossroads of mainstream and alternative medicine. Therefore it is important to establish a leading statement on identity, which must be clear, concise and immediately relevant to both the public and the profession. Although inter-professional relations between MDs and DCs in Israel are improving, further research should be conducted to provide suggestions on how chiropractors can overcome barriers and improve communication with MDs and other health care professionals in the Israeli health care system. In general, the participants agreed that governmental legislation, recognition and support are important endorsements with respect to the societal relevance and development of the profession. Therefore issues such as public awareness of chiropractic education and scope of practice, research and evidence-based practice must be emphasized accordingly in order to facilitate the development of chiropractic practice in Israel.
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d'Hotman, de Villiers Jason. "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." Thesis, 2015. http://hdl.handle.net/10321/1681.
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Submitted in partial compliance with the requirements for a Master's Degree in Technology, Durban University of Technology, Durban, South Africa, 2015.Background 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.
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Fletcher, Sheryn Judy. "A survey of treatment regimes of chiropractors in South Africa." Thesis, 2009. http://hdl.handle.net/10210/2841.
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Palmer, Robert H. "An investigation into patient management protocols for low back pain by chiropractors in greater Durban area." Thesis, 2009. http://hdl.handle.net/10321/476.
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Submitted in partial compliance for a Masters Degree in Technology: Chiropractic, Durban University of Technology, 2009.The aim of this study was to investigate patient management protocols of low back pain (LBP) by chiropractors in the greater Durban metropolitan area. In this investigation a more generalized approach was chosen to investigate trends within the field of patient management and education for LBP. The study population of 80 chiropractors in the greater Durban metropolitan area, required a minimum response rate of 70% to obtain statistical significance (Esterhuizen, 2008), which was achieved. This study involved a quantitative descriptive design utilizing a questionnaire developed and validated by the researcher and focus group. The questionnaire was comprised of three sections, including personal information, treatment protocols and patient management with advice and education. Statistical analysis involved the use of SPSS version 15.0 (SPSS Inc., Chicago, Illinois, USA), a data analysis tool. Descriptive objectives were analysed with frequency tables and cross-tabulation tables (Esterhuizen, 2008). Demographic variables and practice variables were assessed for association with responses to the questionnaire using Pearson’s Chi square test in the case of categorical demographics and responses (Esterhuizen, 2008). Bar graphs were included to reflect the treatments that were always or frequently used by respondents (Esterhuizen, 2008). There appeared to be a wide range of influences on practice philosophy and methods, independent of demographics and training institute. A chiropractor’s age was regarded as significant with regard to philosophical orientation. However, the majority of these chiropractors obtained their qualifications from international colleges. vi Spinal manipulations directed at quadratus lumborum myofascial trigger points were strongly advocated by respondents. Specific short lever manipulations were the preferred manipulation technique for treatment of LBP. Sacroiliac joint manipulation was also considered important by a significant proportion of respondents. Respondents most commonly recommended the use of mobilizations and cryotherapy when contra-indications to manipulation were evident. There was consensus in the number of days before the first follow-up after an initial treatment for a presentation of acute LBP, where 96.42% of respondents recommended follow-up at day 1 or 2. In chronic LBP first follow-up after initial treatment was recommended by 41.1% of respondents on day 2; 28.6% day 3 and 8.9% on day 1. Management protocols for acute LBP appeared to be more uniform when compared to management of chronic LBP. Despite the variances in philosophy and management protocols amongst respondents, there remains consensus that manual articular manipulation remains the mainstay in chiropractic treatment protocols for both acute and chronic LBP.
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Gordon, Julani. "A study to explore the perceptions that South African chiropractors have regarding the perceived role and impact of research within the profession." Thesis, 2012. http://hdl.handle.net/10321/725.
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Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2012.The Chiropractic profession has made significant progress with regard to the production of high quality and clinically relevant research in the last 20 years. This correlates with a spike in development within the chiropractic profession as well as its acceptance by the medical fraternity and public. The responsibility for continuing this positive trend is dependent on the chiropractic graduates and practitioners of the future. Therefore, it is important to establish the current perceptions and utilization of research by Chiropractors, so that future research can be built around the needs and requirements of today’s practitioners, thereby ensuring the profession’s continued development and future in health care. The aim of this study was to determine the perceptions that Chiropractors have of research and its relevance / utilization in practice. Method: The study was a quantitative questionnaire based, self administered survey. The sample group included all Chiropractic practitioners currently practising in South Africa (N=515). Results: There was a response rate of 35% (n=174). The results indicated that the perception of research was very positive overall, with the strongest positive response being that research adds credibility to the profession. However, most respondents disagreed with the statement that chiropractors who had done research had an advantage above those who had not. There was a positive, albeit weak correlation between perceptions and utilization of research, indicating that as perceptions increased, so did utilization of research. The area of greatest concern was that even though a high degree of research utilization was reported by chiropractors, research was least likely to be used to change conditions, policies or practices in practice. v Conclusion: The most significant factors associated with positive perceptions and utilization were found to be publishing in a journal and receiving referrals from other health care practitioners. Chiropractors who indicated an interest in doing research again were also very positively linked to utilization. It would seem that even though chiropractors perceive research positively, their implementation into practice has some hurdles that impede the full integration of research into practice. As very few demographic and personal attributes of the South African chiropractor were found to be primarily responsible for low utilization of research in practice, it can be hypothesised that the factors impeding research implementation are most likely environmental in nature.
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Davies, Natalie. "Perceptions of chiropractors in the eThekwini Municipality on the integration of chiropractic into the public healthcare sector of South Africa." Thesis, 2018. http://hdl.handle.net/10321/3065.
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Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2018.Background Currently, chiropractic is not incorporated into the South African public healthcare sector despite its emphasis on the values of wellness and health. This is due to a poor relationship with mainstream medical practitioners, the construct of chiropractic education and its long standing isolation within the healthcare system within South Africa. The public healthcare sector in South Africa is strained. Low back pain is one of the main reasons patients seek medical attention from primary medical doctors. A growing body of evidence is now emerging which supports the role of chiropractic in post-surgical rehabilitation and the treatment of extraspinal non-pathological musculoskeletal conditions. Based on the findings of these studies, an argument could be made for the transition of chiropractic from a mainly private practice base to one that would enable it to reach to the wider population in the public healthcare sector. Aim The aim of the research study was to explore and describe the perceptions that chiropractors have about the integration of the chiropractic profession into the South African public healthcare sector. Method A descriptive exploratory qualitative approach was used to guide the study. In- depth interviews were conducted with ten chiropractors within the eThekwini municipality. The main research question for this study was “What are the perceptions of chiropractors in the eThekwini Municipality on the integration of chiropractic into the public healthcare sector of South Africa?” The data was analysed through thematic analysis. Results The main themes that emerged were the role of chiropractic in the healthcare system, the integration of chiropractic into the healthcare sector and the challenges facing chiropractors in the healthcare system. The themes and sub- themes were as follows;; • Theme 1 Role of chiropractic in the healthcare system Sub-theme 1.1 Primary contact for neuromuscular medicine. • Theme 2 Integration of chiropractors into the public healthcare sector Sub-theme 2.1 Relief of overworked healthcare workers. Sub-theme 2.2 Decrease costs in surgical and medication use. Sub-theme 2.3 Increased learning opportunities. Sub-theme 2.4 Use of chiropractic in post-surgical care. Sub-theme 2.5 Need for pre-surgical assessment. Sub-theme 2.6 Integration facilitated by the Chiropractic Association of South Africa (CASA). • Theme 3 Challenges facing chiropractors in the public healthcare sector Sub-theme 3.1 Opposition from medical doctors. Sub-theme 3.2 Opposition from within the chiropractic profession. Sub-theme 3.3 Inability to function as the primary practitioners. Sub-theme 3.4 Unfamiliar structure of the public health care sector. Conclusion A lack of clarity on the identity and role of chiropractic in the public healthcare sector emerged from the findings of this study. Individual chiropractors, the professional body (CASA) and the Allied Health Professions Council of South Africa (AHPCSA) need to engage in active roles in the integration of chiropractic into the public healthcare sector of South Africa.
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Mathews, Michael. "The prevalence and factors associated with occupational overuse syndrome in the hands and wrists of chiropractors in South Africa." Thesis, 2006. http://hdl.handle.net/10321/194.
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Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban University of Technology, 2006
116 leavesThe aim was to evaluate the prevalence of hand and wrist pain, as well as the relationships between occupational overuse syndromes in the hands and wrists of chiropractors in South Africa as a result of their daily use of manual therapy techniques while at work. There are very few statistics available that disclose the nature and incidence of work related injuries. However those statistics that do exist suggest that hands on patient activities place physical therapists at greater risk of injury in comparison to other health care workers (Lunne et al., 2000). A study conducted by Bork et al.(1996) determined the prevalence of work-related musculoskeletal injuries sustained by physical therapists. Hand pain (29.6%) and back pain (45%) where the leading cause of pain in physical therapists (Bork et al., 1996.) Chiropractic and physiotherapy are both health care professions that specialize in the treatment of disorders pertaining to the neuro-musculo-skeletal system (Hunter, 2004). Physical therapists use manual therapy techniques as part of their daily working activities, so it can be assumed that chiropractors too will have a high prevalence of hand and wrist pain as they utilize similar therapeutic techniques to physical therapists. Cromie et al.(2000) evaluated the prevalence, severity, risks, and responses of disorders in physical therapists. He identified 4 categories of major risk factors commonly associated with workers musculo-skeletal disorders in physical therapists 1. Risk factors related to specific activities. 2. Postural risk factors. 3. Risk factors with regard to work load issues 4. Risk factors in regard of work capacity and health of the participant (Cromie et al., 2000). Physical risk factors found to be associated with neck, shoulder, or hand and wrist disorders in cross sectional studies are heavy lifting, monotonous work, static work postures, vibrations and repetitive jobs, and a high work pace (Alfredsson et al., 1999). Other factors that have been associated with musculoskeletal pain are higher age and female gender (de Zwart et al., 2001; Wahlstedt et al., 2001; Feveile et al., 2002).
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Pieterse, Riaan. "The ICD-10 coding system in chiropractic practice and the factors influencing compliancy." Thesis, 2009. http://hdl.handle.net/10321/443.
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A dissertation presented to the Faculty of Health, Durban University of Technology, for the Masters Degree in Technology: Chiropractic, 2009.Background: The International Classification of Diseases (ICD) provides codes to classify diseases in such a manner, that every health condition is assigned to a unique category. Some of the most common diagnoses made by chiropractors are not included in the ICD-10 coding system, as it is mainly medically orientated and does not accommodate these diagnoses. This can potentially lead to reimbursement problems for chiropractors in future and create confusion for medical aid schemes as to what conditions chiropractors actually diagnose and treat. Aim: To determine the level of compliancy of chiropractors, in South Africa, to the ICD-10 coding procedure and the factors that may influence the use of correct ICD-10 codes. As well as to determine whether the ICD-10 diagnoses chiropractors commonly submit to the medical aid schemes, reflect the actual diagnoses made in practice. Method: The study was a retrospective survey of a quantitative nature. A self-administered questionnaire was e-mailed and posted to 380 chiropractors, practicing in South Africa. The electronic questionnaires were sent out four times at two week intervals for the duration of eight weeks; and the postal questionnaires sent once. A response rate of 16.5% (n = 63) was achieved. Raw data was received from the divisional manager of the coding unit of Discovery Health (Pty) Ltd. in the form of an excel spreadsheet containing the most common ICD-10 diagnoses made by chiropractors in South Africa, for the period June 2006 to July 2007, who had submitted claims to the Medical Scheme. The spreadsheet also contained depersonalised compliance statistics of chiropractors to the ICD-10 system from July 2006 to October 2008. SPSS version 15 was used for descriptive statistical data analysis (SPSS Inc., Chicago, Ill, USA). Results: The age range of the 63 participants who responded to the questionnaire was 26 to 79 years, with an average of 41 years. The majority of the participants were male (74.6%, n = 47). KwaZulu-Natal had 25 participants (39.6%), Gauteng 17 (26.9%), Western Cape 12 (19%), Eastern Cape four (6.3%), Free State and Mpumalanga two (3.1%) each and North West one (1.5%). The mean knowledge score for ICD-10 coding was 43.5%, suggesting a relatively low level of knowledge. The total percentage of mistakes for electronic claims was higher for both the primary and unlisted claims (3.93% and 2.18%), than for manual claims iv (1.57% and 1.59%). The total percentage of mistakes was low but increased marginally each year for both primary claims (1.43% in 2006; 1.99% in 2007; 2.33% in 2008) and unlisted claims (0% in 2006; 2.61% in 2007; 3.07% in 2008). CASA members were more likely to be aware of assistance offered, in terms of ICD-10 coding through the medical schemes and the association (p = 0.131), than non-members. There was a non-significant trend towards participants who had been on an ICD-10 coding course (47.6%; n = 30), having a greater knowledge of the ICD-10 coding procedures (p = 0.147). Their knowledge was almost 10% higher than those who had not been on a course (52.4%; n = 33). Most participants (38.1%; n = 24) did not use additional cause codes when treating cases of musculoskeletal trauma, nor did they use multiple codes (38.7%; n = 24) when treating more than one condition in the same patient. Nearly 70% of participants (n = 44) used the M99 code in order to code for vertebral subluxation and the majority (79.4%; n = 50) believed the definition of subluxation used in ICD-10 coding to be the same as that which chiropractors use to define subluxation. According to the medical aid data, the top five diagnoses made by chiropractors from 2006 to 2007 were: Low back pain, lumbar region, M54.56 (8996 claims); Cervicalgia, M54.22 (6390 claims); Subluxation complex, cervical region, M99.11 (2895 claims); Other dorsalgia, multiple sites in spine, M54.80 (1524 claims) and Subluxation complex, sacral region, M99.14 (1293 claims). According to the questionnaire data, the top five diagnoses (Table 4.24) were: Lumbar facet syndrome, M54.56 (25%); Lumbar facet syndrome, M99.13 (23.3%); Cervical facet syndrome, M99.11 (21.7%); Cervicogenic headache, G44.2 (20%) and Cervicalgia, M54.22 (20%). Conclusion: The sample of South African chiropractors were fairly compliant to the ICD-10 coding system. Although the two sets of data (i.e. from the medical aid scheme and the questionnaire) regarding the diagnoses that chiropractors make on a daily basis correlate well with each other, there is no consensus in the profession as to which codes to use for chiropractic specific diagnoses. These chiropractic specific diagnoses (e.g. facet syndrome) are however, the most common diagnoses made by chiropractors in private practice. Many respondents indicated that because of this they sometimes use codes that they know will not be rejected, even if it is the incorrect code. For more complicated codes, the majority of respondents indicated that they did not know how to or were not interested in submitting the correct codes to comply with the level of specificity required by the medical aid schemes. The challenge is to make practitioners aware of the advantages of correct coding for the profession.
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Ford, Timothy William. "Chiropractic and public health : a study on the perceptions and attitudes of chiropractors on health promotion and disease prevention in South Africa." Thesis, 2014. http://hdl.handle.net/10321/965.
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Submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic at the Durban University of Technology, 2013.Background: Considering the quadruple burden of disease and chronic shortages of health care professionals in South Africa, the stance of the chiropractic profession on public health (PH) matters has not been established. Therefore, this study aimed to determine the attitudes and perceptions of chiropractors practicing in South Africa on PH, health promotion (HP) and disease prevention (DP). The objectives were to determine demographic profile, lifestyle practices and attitudes and perceptions of practicing chiropractors in South Africa regarding PH agencies, HP and DP. Methods: An IRB approved quantitative survey (electronic and postal) was used to collect data from a total sample of practicing chiropractors in South Africa (meeting inclusion criteria). Follow up email and telephone calls were made to encourage response from participants. After a 17 - week period, returned questionnaires were collected and data analysed. Results: A response rate of 45% was obtained. Of the participants, 51.7% were female, 60.3% practiced in upper – middle income communities and 66.4% perceived themselves as neuro - musculoskeletal specialists. Over 90% of practitioners regularly counselled patients on postural habits, injury prevention and ergonomic risk reduction. Where as 35.1% agreed to counselling patients on STI / HIV prevention, tobacco cessation and related risks (41.4%), alcohol abuse (53.4%) and cancer prevention (56.9%). Regarding evidence – based practice (EBP) and PH agencies, 39.1% could not identify the statistical significance of the p value and 46% were unable to provide examples to journals they used to inform best practice. Similarly, 59% of the participants could not identify PH agencies to refer to for information on smoking cessation / risks or PH agencies to refer patients on HIV (57%), notifiable diseases (59%) and terminal illnesses (45%). Conclusion: The results suggest that chiropractors from this study were proficient on topics of DP, but were reletively less proficient in regards to PH, HP and EBP. It was recommended that further research be done regarding EBP within the profession and that greater emphasis be placed on topics of HP and PH in chiropractic training programmes.
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Black, Elmi. "A retrospective survey of the career paths and demographics of Durban University of Technology (DUT) chiropractic graduates." Thesis, 2008. http://hdl.handle.net/10321/439.
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Dissertation presented to the Faculty of Health at Durban University of
Technology in partial compliance with the requirements for the Master’s Degree
in Technology: Chiropractic, 2008.Aims and Objectives: To assess the demographics, career paths and factors affecting chiropractic graduates of Durban University of Technology (DUT) from June 1994 to June 2007. Method: A retrospective qualitative survey was conducted on 62 chiropractic graduates of DUT. The sample represented 25.5% of the total chiropractic population. Raw data regarding the demographics, respondents’ perception of their education, current career paths, the factors responsible for affecting these career paths, as well as a profile of chiropractic practices in South Africa (SA) was obtained. All data acquired was assessed using SAS (Statistical Analysis System) version 9.1.3. The data was purely descriptive, describing respondents’ career paths and their experiences, and no specific hypothesis was investigated. Results: The average respondent was found to be a married, white male who started his chiropractic career at age 25-26 years. A total of 98.4% (n = 61) of the respondents were currently in practice, with 80.6% (n = 50) indicating career satisfaction. The majority (62.9%; n = 39) of respondents perceived there to be a growing acceptance of chiropractic within the medical community, whilst 98.4% (n = 61) stated that they are currently part of an active referral system between various other medical practitioners. 46% (n = 23) listed DUT as their preferred choice of chiropractic institution. Conclusion and Recommendations: The majority of respondents’ indicated DUT as the preferred choice of chiropractic institution due to its location and the system of chiropractic taught (diversified). However, shortcomings in the education were highlighted to be a lack of practically applicable knowledge taught at undergraduate level, most especially business skills and speciality areas and that respondents’ perceived the qualification not to be as versatile and widely accepted as other international chiropractic qualifications. Factors responsible for positively affecting the career paths of chiropractic graduates were indicated to be the personality type of the graduate, the means to finance a practice, support from parents and spouse or partner and the level of acceptance graduates received from the public and other professions within the medical sector. A recommendation for future studies is that a longer time period be given for questionnaires to be returned and a larger sample group be established in order to ensure that the sample group and total population is homogenous.
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Kleingeld, Stefan. "An investigation into the diagnosis and management of patients presenting with selected headaches by chiropractors in the greater Durban area." Thesis, 2016. http://hdl.handle.net/10321/1524.
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Submitted in partial compliance for a Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2016.Introduction There is a worldwide need for research into headaches in order to improve and add to the current model of literature to develop more efficient management strategies for headaches. Headaches can present clinically similarly and present a diagnostic challenge. Currently it is not known what the clinical accuracy of headache diagnosis is or which management strategies chiropractors prefer to use in practice to manage certain headaches. The aim of this study was to investigate the diagnosis of certain headaches by chiropractors in the greater Durban area and to determine how certain headaches commonly treated by chiropractors were managed. Methodology Based on the quantitative paradigm, this is a descriptive questionnaire based study involving a population of 88 chiropractors practicing in the greater Durban area. The final sample size was 63, a response rate of 72%. The questionnaire was developed specifically for this study and was validated by an expert group and tested by a pilot study to ensure construct and face validity. Data regarding demographic information, diagnostic approach to cervicogenic headache (CEH), intracranial haemorrhage, meningitis, migraine (MEH) and tension type headache (TTH) and management of CEH, TTH and MEH was collected from the sample. SPSS version 22 was used to analyse the data. Descriptive statistics were reported in frequency tables. Continuous variables were compared between independent categories using one way ANOVA tests. Trends were shown in cross tabulations and interpreted descriptively where Chi square tests could not be calculated. Results The sample size consisted of 63 chiropractors in the greater Durban area, South-Africa, of which 49.2% (31) were male and 50.8% (32) were female. The mean age was 37 years (range 25 to 71 years). The majority of the sample had between six- to nine years of practice experience, with the majority being in full time practice (82.5% (52)). The majority (92.1% (58)) of the sample had graduated from DUT. Seventeen point five percent (11) of the sample had additional tertiary qualifications, the most common of which was a Master’s degree of Medical Sciences (Sports Medicine), with a total of 19 additional short courses being reported by 79.4% (50) of the sample. Seventy five point one percent (41) of the sample indicated usage of chiropractic specific journals, with 38.1% (24) of the sample indicating that these journals had an impact on the way they manage headaches in practice. Seventy seven point eight percent (49) of the sample attended health related conferences on a regular basis, with 38.1% (24) of the sample indicating that these conferences influenced their management of headaches in practice. Seventeen point five percent (11) of the sample had practiced internationally, with a range of international practice from one month to 12 years. The majority of the sample indicated that they practiced according to a combination of mixer and evidence based philosophy. The accuracy of diagnostic outcome for meningitis was 98.4% (62), TTH was 47.6% (30), MEH was 82.5% (52), CEH was 82.5% (52) and intracranial haemorrhage was 30.2% (19). The results for the management of CEH, TTH and MEH indicated that a minimum of 98.6% (62) would adjust a patient with these headaches; the sample predominantly preferred application of specific adjustments to fixated segments in the cervical and thoracic spine. A minimum of 66.7% (42) regarded spinal manipulative therapy (SMT) as the primary focus of treatment across all three headaches. The most commonly selected modality to be used in conjunction with SMT was massage therapy (with a minimum selection frequency of 68.3% (43) across CEH, MEH and TTH). Massage therapy was the most commonly selected modality to be used when SMT is contra-indicated (minimum selection frequency of 61.9% (40) across CEH, MEH and TTH). A minimum of 98.4% (62) of the sample indicated that they would treat MFPTs if associated with headaches, most commonly using dry needling. For the majority of the sample, the interval of choice for a second appointment was two to three days and the number of treatments expected for relief of symptoms was two to three treatments. Further investigations were considered necessary by the majority of the sample after seven days without any relief of symptoms. The majority of the sample recommended pain free care. Regarding patient advice and education, there was agreement on postural and ergonomic advice, home stretching, stress management techniques and proprioceptive exercises. If treatment goals were not obtained, the majority of the sample agreed to change the treatment plan, reassess all of the previous findings and if necessary refer the patient to another non-chiropractic health care provider. Conclusion Based on the case scenarios used in this study, meningitis, CEH and MEH were accurately diagnosed by the majority of the sample. There appeared to be some confusion with regard to the diagnosis of TTH as nearly half of the sample confused it for CEH. The accuracy with regard to the diagnosis of intracranial haemorrhage was concerning as the minority of the sample correctly diagnosed this condition. A relatively similar approach was used by chiropractors to treat headaches, with relatively little change in the treatment options between CEH, TTH and MEH. Most of the treatment methods, used by most of the sample, have moderate evidence for efficacy in treatment of musculoskeletal conditions. The management options chosen by the majority of the sample could be of potential benefit for the management of the respective headaches. Few differences were noted with regard to the impact of demographic information on the diagnostic outcome and management approaches. Some, but not enough, evidence indicates that the older participants provided less accurate diagnoses. The headaches which were less accurately diagnosed possibly due to an age difference were meningitis, TTH and MEH. With regard to management of headaches the only statistically significant differences were noted for the management of TTH for which age appeared to influence the specificity of adjustments used in TTH.
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Shen, Lu-Chi, and 沈祿集. "The Practices of Chiropractic Care." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/49691263434987262914.
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Huang, Joyce Ju-Yu, and 黃如玉. "Conventional Medicine Practitioners’Perception on Chiropractic." Thesis, 2008. http://ndltd.ncl.edu.tw/handle/20061325609243934992.
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碩士國立臺灣大學
醫療機構管理研究所
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Background: Chiropractic is a health care profession in the Western society for over a century. It is the largest profession in the Complementary and Alternative Medicine system, and is considered as the closest to the mainstream. After massive amount of research, it is evident that chiropractic not only gains high patient satisfactory rate, it is also a very cost-effective approach on treating neuromusculoskeletal conditions. However, it is not widely introduced in the Asian countries, especially in Taiwan. Public, as well as health care workers may not have a clear understanding of what chiropractic profession is all about. Objective: The objective of this study is to understand medical doctors’ perception on chiropractic and to determine the necessity of establishment of such a profession in Taiwan. Method: In-depth, semi-structured interviews were conducted in Mandarin language to twelve licensed medical doctors in Taiwan. Results in the form of narratives were analyzed using common coding technique. Result: Among the twelve medical doctors, most associate chiropractic with rehabilitation or folk therapy. All of them have heard of the term chiropractic, but most have limited knowledge about the scope of practice, length and content of education of the profession. Most participants do not know that chiropractors earn a doctoral credential, and thus relate chiropractors to therapists or technicians. Almost all participants support the legislation to regulate those who perform spinal manipulations, but qualification is a debate. About half of the respondents emphasize on the importance of evidence-based practice. Conclusion: After these in-depth interviews and the narrative analysis, it is evident that numerous misunderstanding about the profession due to lack of knowledge have impeded the development of chiropractic profession in Taiwan. Further research including long-term randomized controlled trials on the efficacy and public demand of chiropractic in Taiwan are recommended.
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Bromfield, Bridget Francoise. "Chiropractic management of primary dysmenorrhea." Thesis, 1996. http://hdl.handle.net/10321/2056.
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A dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 1996.The purpose of this investigation was to determine the efficacy of chiropractic treatment in the management of primary dysmenorrhea. The sample consisted of 30 patients who were randomly assigned to 2 groups, the control and experimental. This single blind study consisted of 16 visits, twice a week for the first 4 weeks and thereafter once a week for the next 8 weeks. During a menstrual cycle, prior to commencement of treatment, the patients were required to complete a Short-Form McGill Pain Questionnaire on the last day of dysmenorrhea and a Numerical Pain Rating Scale 101 on each day of experienced menstrual pain. These questionnaires were completed at home. Treatment for the experimental group consisted of soft tissue massage of the lumbar and thoraco-lumbar paravertebral. musculature combined with spinal manipulative therapy of the areas of fixation in the' lumbar and sacra-iliac regions. The control group received purely soft tissue massage of the lumbar and thoraco-lumbar paravertebral musculature. The areas of fixation were determined by motion palpation, joint challenge and tenderness to spinal palpation. There was no follow-upvisit conducted in this study. An analysis of the data revealed a statistically signiflcant improvement in the experimental group in terms of the Short Form McGill Pain Questionnaire (p=< 0,001) as well as for the control group (p=< 0,01), whilst in terms of the Numerical Pain Rating Scale 101 the experimental group showed an improvement (p=< 0,05) but the control group failed to show a significant change (p= 0,068).
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Ferreira, Werner. "Chiropractic management of fibromyalgia syndrome." Thesis, 2009. http://hdl.handle.net/10210/2678.
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Huang, Joyce Ju-Yu. "Conventional Medicine Practitioners'Perception on Chiropractic." 2008. http://www.cetd.com.tw/ec/thesisdetail.aspx?etdun=U0001-0506200814180300.
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Taverner, Charles Bryce. "The perception of veterinarians towards chiropractic and the chiropractic treatment of animals in South Africa." Thesis, 2011. http://hdl.handle.net/10321/623.
Full textAbstract:
Dissertation submitted in partial compliance with the requirements for the
Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2011.Introduction: The chiropractic treatment of animals has been integrated into the veterinary health care systems of various countries outside of South Africa. While South Africa has seen the integration of the chiropractic treatment of humans into its health care system, the chiropractic treatment of animals has been slow to develop in this country. This is evident in the lack of a professional association or education system concerning the chiropractic treatment of animals in South Africa. Veterinarians represent the primary contact for animals to receive chiropractic care through referral in South Africa. It is therefore important to ascertain the knowledge and perception that veterinarians have towards chiropractic and the chiropractic treatment of animals as their views and participation could influence the future integration of chiropractic into the veterinary health care system of South Africa. Primary Objective: To determine the perception of veterinarians towards chiropractic and the chiropractic treatment of animals in South Africa. Methods: A questionnaire was set up on an Internet based website. An electronic mail (e-mail) was then sent to all the South African veterinarians with a functional e-mail address registered with the South African Veterinary Council (SAVC), requesting participation in this research. This amounted to 1841 veterinarians. The veterinarians who met the inclusion criteria were then able to access and complete the questionnaire electronically. Results: A response rate of 13.8% was achieved. The respondents were predominantly white (87.1%) with an average age of 41.5 years and a nearly even split between male and female. The veterinary respondents expressed a poor level of confidence relating to their knowledge of chiropractic and its application to the health care of animals. The objective knowledge scores for chiropractic and the chiropractic treatment of animals were 65% and 63%, respectively, giving a reasonably high overall knowledge score of 64%. It was found that the knowledge scores were stronger in the respondents who had iii personally utilized a chiropractor as well as being stronger regarding human chiropractic and overall chiropractic knowledge in those who had referred an animal to a chiropractor. The average score for perceptions of the respondents was relatively low (48%), but positive correlations were found between the knowledge and perceptions of the respondents regarding chiropractic and \ or the chiropractic treatment of animals. It was found that the majority of the veterinarian respondents (79.9%) felt that chiropractors should only be allowed to practice on animals in South Africa under referral from a veterinarian. The majority of respondents (62.4%) further believed that the chiropractic treatment of animals should be governed by the South African Veterinary Council (SAVC) and 57.7 % of the respondents indicated that they would be in favour of the chiropractic treatment of animals being affiliated to the South African Veterinary Association (SAVA). It was determined that 84.4% of the respondents were in support of the formation of a course concerning the chiropractic treatment of animals in South Africa, with 49.1% further stating they would be interested in attending such a course. The majority of respondents indicated that they believed both veterinarians and chiropractors should administer (77.2%) and be able to attend (75.1%) such a course. Conclusion: This study has established a knowledge base that will facilitate greater understanding of the perceptions that South African veterinarians have towards chiropractic and the chiropractic treatment of animals as well as the part they perceive chiropractic to play in the South African veterinary health care system. The various outcomes should be noted when considering the future education of South African veterinarians regarding chiropractic, as well as the development of the chiropractic treatment of animals in South Africa.
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Dell, Charmaine. "The effects of diversified chiropractic manipulation versus sacro-occipital technique in chiropractic management of sacroiliac syndrome." Thesis, 2008. http://hdl.handle.net/10210/959.
Full textAbstract:
Purpose: The purpose of this pilot study was to assess the effects of Diversified Manipulation versus Sacro-Occipital Technique in the management and treatment of Sacroiliac Syndrome. Method: This study consisted of two groups, a Diversified group consisting of 15 subjects with Sacroiliac Syndrome and a Sacro-Occipital Technique group consisting of 15 subjects with Sacroiliac Syndrome. The subjects were between the ages of 18 and 55 years. Potential candidates were examined and accepted based on the inclusion and exclusion criteria. The Diversified group received Diversified Manipulative therapy to the sacroiliac joint, while the Sacro-Occipital group received SOT Category 2 blocking, from which the subjective and objective findings were based. Procedure: Each successful candidate was treated six times over a two-week period. Before the commencement of the treatment one, three and six, the candidate completed the Oswestry Back Pain and Disability Index questionnaire and the Numerical Pain Rating Scale. Digital Inclinometer readings were taken of the thoracolumbar and lumbosacral regions of the spine. Sacroiliac Manipulation was then administered to the Diversified group based on the restrictions obtained during motion palpation. Category 2 blocking was administered to the Sacro-Occipital Technique group based on the SOT Category 2 categorization test findings. The same treatment was administered at each of the six treatment sessions. Results: Objective statistically significant differences were noted on lateral flexion range of motion, in favour of the Sacro-Occipital Technique group. Subjective readings also showed statistically significant differences with regards to Oswestry Back Pain and Disability Index and Numerical Pain Rating Scale in favour of both the Diversified group and the Sacro-Occipital Technique group. Conclusion: The results of the study indicate that both Sacro-Occipital Technique and Diversified have a positive effect on patients suffering from Sacroiliac Syndrome. However, Sacro-Occipital Technique proved to have a greater overall benefit compared to Diversified manipulation in the treatment and management of Sacroiliac Syndrome. It should be emphasized that the present study was a pilot study to determine the effects of Diversified manipulation versus Sacro-Occipital Technique in the management of Sacroiliac Syndrome. Accurate conclusions could not be formulated due to the remainder non-significant statistical findings obtained from the study; therefore further research needs to be conducted on this comparative study.Dr. B. Losco Dr. C. D. Losco
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Slabbert, John George Lochner. "An investigation of the factors affecting referral of patients between chiropractors and physiotherapists in the eThekwini municipality." Thesis, 2014. http://hdl.handle.net/10321/960.
Full textAbstract:
A dissertation submitted in partial compliance with the requirements for a
Master's Degree in Technology: Chiropractic, Durban University of Technology, 2013.Objectives: Collaboration between health care practitioners has many advantages including a focus on disease prevention and health promotion, improving service access and the provision of multidisciplinary health care teams. To achieve this ideal health care provision, understanding the current landscape of referral/interaction between practitioners and the factors which influence this network are important. This enables effective delivery of health care demanded by the public. As identified factors impacting the inter-referral of patients between practitioners are contextual, they differ in different contexts. Thus, this study aimed to investigate the factors affecting the referral of patients between chiropractors and physiotherapists in the eThekwini municipality.
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Louw, Jan Daniel. "The knowledge of general practitioners about chiropractic as a factor that may influence health care integration in South Africa." Thesis, 2005. http://hdl.handle.net/10321/191.
Full textAbstract:
Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005
ix, 62, 7 leaves : ill. ; 30 cmSeveral studies in Europe, Canada and the USA indicate that communication between GP’s and chiropractors is not ideal. Langworthy and Birkelid’s (2001) study concluded that with increasing emphasis on multidisciplinary health care, greater understanding and better communication is needed in order for the patient to obtain optimum benefits. The medical profession in the past has generally been opposed to the theories and practice of chiropractic, for a variety of reasons, including lack of scientific validity as well as unsubstantiated management utility (Silver, 1980). However, a Canadian study indicates that much progress has been made in diminishing the gap between GP’s and chiropractors (Verhoef and Page, 1996). Few studies have investigated GPs’ knowledge, awareness and attitudes toward complementary and alternative health care providers, especially in relation to the balance between market rivalry and interprofessional care (Langworthy and Smink, 2000). One such study performed in the Netherlands by Brussee et al. (2001) found that a statistically significant relationship existed between the level of knowledge of chiropractic and the frequency of referral of patients by GP’s. In the UK, it was found that many GP’s were more comfortable in referring to physiotherapists because they felt they had a better understanding of the treatment involved (Breen, et al., 2000). The chiropractic profession is attempting to improve co-operation with the medical profession via the scientific validation of its theories and practice through research (Rubens, 1996). The current perception in South Africa is that GP’s do not tend to refer patients to chiropractors. This has implications for chiropractic in the South African context in terms of integration. Therefore, as the current “gatekeepers” of primary healthcare, it is important to ascertain the perception and knowledge that this group has of the chiropractic profession in South Africa. The purpose of this investigation was therefore to determine the current knowledge and perception of GP’s in South Africa of chiropractors and chiropractic treatment in general. This should establish a knowledge base to facilitate greater understanding and co-operation between GP’s and chiropractors.
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Pillay, Keshnee. "The relative effectiveness of muscle energy technique as opposed to specific passive mobilization in the treatment of acute and sub-acute mechanical low back pain." Thesis, 2005. http://hdl.handle.net/10321/200.
Full textAbstract:
Thesis (M.Tech.:Chiropractic) - Dept. of Chiropractic, Durban Institute of Technology, 2005
xvii, 58 leaves, Annexures A-JIt has generally been accepted that 60 to 80% of the general population will suffer from low back pain at some point in their life. (Kirkaldy - Willis, 1992). The use of manipulation for the treatment of low back pain is well documented but lumbar mobilization has undergone comparatively little investigation (Goodsell et al., 2000). Furthermore, there remains little evidence to advocate the use of Muscle Energy Technique (MET) in the form of a randomized clinical trial (Wilson, 2003). The purpose of this study was to determine whether patients with acute and sub-acute low back pain would demonstrate a reduction in disability after being treated with MET or specific passive mobilization. Both interventions are joint mobilization techniques the only difference being that one is passive and the other (MET), is an active technique
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Kleynhans, Andries Mentz. "The design of an undergraduate chiropractic curriculum." Diss., 1998. http://hdl.handle.net/10500/17099.
Full textAbstract:
Evidence is provided to support Kierkegaard's phenomenology that only what is learned
through experience is truly known. It is demonstrated that the chiropractic curriculum
represents a unique area of investigation and that it is possible to define curriculum; to create
a functional and integrative model which subsumes elements from the traditional, cyclical
and process models; and to design an integrative, problem-based, evidence-based,
experiential chiropractic curriculum. A taxonomy is proposed for curriculum design in four
domains which deal respectively with a) curriculum processes which include the selection,
motivation and interaction of curriculum developers, curriculum definitions and models, and
an algorithm for curriculum design; b) curriculum organisation which addresses
philosophical, sociological, cultural and psychological foundations, curriculum paradigms
and a chiropractic conceptual framework; c) curriculum development which concerns design
strategies, situational analysis, intent, content, design and organisation of learning
experiences and assessment of student performance; and d) curriculum application, which
includes the learning climate, quality management, management of change, self-evaluation
and external accreditationCurriculum and Instructional Studies
M. Ed. (Didactics)
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Philips, Gina. "Parents perception of paediatric chiropractic in Johannesburg." Thesis, 2012. http://hdl.handle.net/10210/4326.
Full textAbstract:
M.Tech.Objectives: To gain statistics on the perception parents in Johannesburg have regarding paediatric chiropractic and to educate the public as to the value of paediatric chiropractic in infants and children and increase the number of paediatric patients presenting to chiropractic practices. Methods: One-hundred-and-fifty questionnaires were completed by willing participants attending various antenatal classes throughout Johannesburg. Thereafter, a brief educational talk on paediatric chiropractic was given to all participants and information brochures were distributed. Results: A total of 34.50% of the participants had been previously treated by a chiropractor, with only 12.80% having been treated during their pregnancy and a further 15.70% who intended to receive chiropractic treatment while they were pregnant. Throughout the various age groups majority (54.20%- 56.30%) of the participants felt that might consult a chiropractor for the treatment of a child, although very little was known about the paediatric conditions that may be treated by chiropractors. Majority of the participants felt that chiropractic treatment of paediatrics and during pregnancy was completely safe. Conclusions: Although the participants were not entirely opposed to paediatric chiropractic (the treatment of children and pregnant mothers) they had very little knowledge regarding the topic of paediatric chiropractic, the conditions it may be successful in treating and the health benefits for children who receive chiropractic treatment. Majority of the participants were interested in furthering their knowledge regarding the topic of paediatric chiropractic.
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Higgs, Madelaine. "A demographic and descriptive survey of chiropractic patients at the chiropractic clinic at Kimberly [i.e. Kimberley] Public Hospital Complex." Thesis, 2009. http://hdl.handle.net/10321/452.
Full textAbstract:
Submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban University of Technology, 2009.Objective: The majority of information available on chiropractic patients originates from private practices in developed countries. However, recently reports describing chiropractic patients in South Africa have emerged, reporting on private practices and teaching clinics. Therefore, the overall purpose of this study was to determine the characteristics of patients presenting to a public chiropractic facility at the Kimberley Hospital Complex (KHC) in South Africa; and compare to the local and international private practices and teaching clinics. Methods: The period prevalence was three months in which information was extrapolated from patient files of the patients that presented to the KHC Chiropractic Clinic (KHCCC). Information that was collected included demographic data, common presenting complaints, patient history and common management protocols. Results: Data for 157 patients were recorded. The mean age of patients was 47.5 years, majority of the patients were female (70%), comprised of coloured and black patients (85%), where the greater part had a primary education level. Less than half the patients were employed in manual type of occupation, whilst almost one quarter of the patients were pensioners. By far, the greatest reason that patients visited chiropractors within the public health care sector at the KHCCC in South Africa was for chronic musculoskeletal complaints (68%). Majority presented with spinal complaints of the lower back (n=144), the most common diagnosis made was sacroiliac syndrome (48%). X-rays were the most common special investigation requested by KHCCC. The most common co-morbidities reported were hypertension, followed by diabetes and allergies. More than half the sample had undergone previous surgery. Thirty seven percent of patients received treatment for fewer than six visits. Contraindications to chiropractic treatment were indicated in only three patients. The treatment protocols that were predominantly used at the KHCCC were joint manipulation, followed by dry needling, kinesiotape and soft tissue therapy. Two thirds of all patients that were referred to the KHCCC were referred from within the medical profession. With regards to the chiropractic patients globally, similarities respect to patients in the public sector in South Africa to all sectors both locally and internationally, include factors such as majority female patients, top five anatomical locations of complaint, common usage of x-rays as a special investigation, similarities with co-morbidities including cardiovascular and endocrine, the repeated number of visits for the same complaint and manipulation remained treatment of choice. Conclusion: Although this was purely a demographic and descriptive study in nature, it gave a better understanding of patients that presented to a public hospital in a developing country like South Africa. With this demographic and descriptive information obtained in this study, it confirmed that although there is a unique population utilising chiropractic services within the public sector of South Africa, meaningful similarities have been found between patients in the different sectors in South Africa and internationally.
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"The effect of the chiropractic adjustment with a strengthening protocol compared to chiropractic adjustment or a strengthening protocol alone." Thesis, 2009. http://hdl.handle.net/10210/2999.
Full textAbstract:
M.Tech.OBJECTIVE: The aim of this study was to determine whether adjustment of the cervico-thoracic motion segment in individuals with altered or decreased motion at that segment, in conjunction with a strengthening protocol, had a greater increase in triceps brachii muscle strength compared to a strengthening protocol or chiropractic adjustment alone. By reducing the negative neural and other effects caused by aberrant movement between vertebra, chiropractic adjustment could allow the body’s muscle physiology to function at its best, thereby allowing it to adapt to changes more readily. DESIGN: Thirty subjects participated in this study. The subjects were randomly and without being aware of it, assigned to one of three groups. The only requirement for inclusion in the research was a restriction of the seventh cervical vertebra based on motion and static palpation. Patients in two of the groups were asked to perform tricep brachii muscle strengthening exercises and patients from two of the groups received chiropractic adjustment to the cervico-thoracic motion segment. Patients were seen a total of three times over a period of two weeks. MEASUREMENTS: Triceps brachii muscle strength testing was performed using an isometric dynamometer. Three pre-treatment readings and three post-treatment readings were performed, with one-minute intervals, on all the subjects. This was done to determine if there was a change before or after treatment and if there was a long-term effect. CONCLUSION: Although measurements were taken on each visit before and after each treatment, there was only a statistically significant difference in triceps brachii muscle strength between the experimental and the other two groups before treatment on the third visit. This does however; suggest that there was a favourable result and that a combination of treatments does indeed produce better results than one of the other treatments alone.
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Du, Plessis Christine. "A comparative analysis of animal chiropractic regulation within seven countries." Thesis, 2017. http://hdl.handle.net/10321/2554.
Full textAbstract:
Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa. 2017.Introduction: Chiropractic treatment of animals is a young and dynamic field of interest among chiropractors, veterinarians and animal owners. As a young profession, regulation of animal chiropractic is limited to only a few countries, with regulatory models in various legal paradigms. Bosman (2012) determined through a qualitative investigation that in order for the profession to grow, it would require well defined guidelines, proper governance, appropriate legislation and set educational standards. Presently there is a paucity in the literature regarding animal chiropractic regulation. Through a comparative study of current international animal chiropractic regulatory models, possible international trends in animal chiropractic regulation can be identified. This could assist in identifying any possible short comings or positive developments and possible future areas of progress in the regulation of animal chiropractic. Aim: To determine the regulatory status of animal chiropractic in selected countries, at statutory and professional association level, in order to ascertain whether an international trend in animal chiropractic regulation exists. Method: The study was a comparative analysis. The sample consisted of ten jurisdictions spread over seven countries. These were Australia (Victoria and Queensland), Canada (Ontario and Alberta), Ireland, New Zealand, South Africa, the United Kingdom and the United States of America (Texas and California). The validated data collection sheet (Appendix B) was used to extract quantitative data through the various organisations’ web pages and communication with the relevant organisations. Results: The regulation of the practice of animal chiropractic was found to be in various stages of regulation, with it being unregulated or largely unregulated in three out of the ten jurisdictions included in this study. In seven out of the ten jurisdictions the regulation of the practice of animal chiropractic fell under government devolved authority to the veterinary statutory regulatory body, although regulation was not very extensive in most of these jurisdictions. Four of the jurisdictions with regulation of the practice of animal chiropractic through government devolved authority had national animal chiropractic professional associations and two of the jurisdictions in which the practice of animal chiropractic was unregulated had a national professional association. None of these professional associations held government sanctioned authority. Statutory regulation played a more significant role in regulation of the practice of animal chiropractic in terms of the existence of codes of ethics, complaints and disciplinary procedures and CPD requirements than the national animal chiropractic professional associations did. Significance was also found in the legal requirement of registration as veterinarian or chiropractor in jurisdictions where veterinary referral was a legal requirement for chiropractic practitioners of animal chiropractic and where post-graduate animal chiropractic qualifications were only recognised by the veterinary statutory regulatory bodies if it was a legal requirement for registered veterinarians and chiropractors. No professional statutory regulatory body regulated or required regulation by educational statutory regulatory bodies or international accreditation of animal chiropractic education. The significance of national animal chiropractic professional associations was limited to their codes of ethics as it correlated with their limitation of membership by the professional association to mostly registered veterinary and chiropractic practitioners holding a post-graduate animal chiropractic qualification. Several trends were identified that could either hinder or promote the development of appropriate regulation for the practice of animal chiropractic. Conclusion: From the comparison of the current animal chiropractic regulation it was found that cooperation between veterinary and chiropractic statutory regulatory bodies appears to be important for the development of suitable and effective regulation of the practice of animal chiropractic. The study suggests that there is a need for standardisation and regulation of animal chiropractic education and the definition of the animal chiropractic scope of practice. This study also suggests continuation of cooperation between chiropractors and veterinarians that has been sought since the inception of the animal chiropractic profession. Involvement of functioning national animal chiropractic professional associations with the development of appropriate regulation, defining of animal chiropractic scopes of practice and promotion of the unity, integrity and identity of the animal chiropractic profession is recommended to achieve growth for animal chiropractic as a profession.
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Lombard, Barend Jacobus. "An investigation into the patient management protocols of selected cervical spine conditions by chiropractors in KwaZulu-Natal." Thesis, 2016. http://hdl.handle.net/10321/1509.
Full textAbstract:
Submitted to the Faculty of Health Sciences at the Durban University of Technology in partial compliance with the requirements for a Master’s Degree in Technology: Chiropractic, Department of Chiropractic, Durban University of Technology, Durban, South Africa, 2016.Background: Neck pain is an extremely common condition and the treatment of neck pain forms an integral part of chiropractic practice. The optimal treatment of neck pain is provided when practitioners incorporate available evidence, experience, and knowledge regarding the clinical presentation of the patient into their treatment regimes. Current evidence suggests that a combination of manual therapy, specifically manipulation and/or mobilization, and rehabilitation may offer the optimum treatment for mechanical neck pain. However, numerous factors other than available evidence, experience and clinical presentation may influence treatment choices made by practitioners. Through the assessment of practice patterns, one may asses if the optimal treatment for a neck pain is being provided by practitioners and assess if factors specific to a practitioner may influence the treatment of neck pain. Objectives: The aim of this study is to determine the chiropractic treatment and management of mechanical neck pain, to compare this to evidence based recommendations for the conservative treatment of mechanical neck pain and to assess if factors other than the available evidence may influence the treatment of mechanical neck pain. Method: A quantitative, cross-sectional descriptive survey compiled using available literature and validated by means of a focus group and pilot testing, was administered to chiropractors practicing in KwaZulu-Natal. Upon completion of the questionnaire, the data was coded into an Excel spread sheet and imported into IBM SPSS version 20 for statistical analysis. This research protocol was approved by the Durban University of Technology Institutional Research Ethics Committee (REC 82/13) and the study took place from March to July 2014. Results: Ninety-six practitioners responded to the study which is a response rate of greater than 70%. Practitioners favoured the use of spinal manipulation, auxiliary therapeutic techniques (specifically those which were manual in nature), rehabilitation, and numerous forms of education. Specific variations in treatment pattern existed when comparing various patient presentations indicating that practitioner based factors impacted on treatment choices made by practitioners. The most significant findings included the increased utilisation of auxiliary therapeutic techniques by female practitioners, the increased utilisation of traction by practitioners identifying with the straight philosophy of chiropractic. Other significant findings included the increased utilisation of cervical collars by practitioners of increased age and experience and the increased utilisation of auxiliary therapeutic techniques by practitioners who did not attend health related conferences at least once every second year or did not attend short courses or subscribe to journals or magazines since qualification. Conclusions: This study indicates that treatment for mechanical neck pain offered by chiropractors in KwaZulu-Natal is in line with current evidence based recommendations for the treatment of mechanical neck pain, with practitioners commonly using modalities which were recommended, whilst rarely using modalities which were not recommended. The use of rehabilitation was, however, slightly lower than expected. Patient presentation and practitioner based factors were found to influence the treatment of mechanical neck pain; however, as a whole these variations were small with the majority of practitioners favouring the use of modalities which were recommended within the literature. Future studies should address the gap in the literature regarding the conservative treatment of cervical radiculopathy.
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Bosman, Pieter Jacobus. "An exploration of the current status quo of animal chiropractic in South Africa." Thesis, 2012. http://hdl.handle.net/10321/710.
Full textAbstract:
Dissertation submitted in partial compliance with the requirements for a Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2012.Background: Animal chiropractic, an internationally sanctioned profession, assists veterinarians with a complementary approach to animal healthcare therapy. Animal chiropractic in South Africa appears to be within its novel stages of development and no clear parameters define its present position. As a result of ambiguity and present concern dictated by veterinary regulation, animal chiropractic has not developed along well defined parameters, and it is thought that this study will contribute to achieving some clarity in this regard. The impetus for this study originated as a result of an increased awareness within the complementary and alternative medicine (CAM) field of these CAM therapies in the management of animal healthcare, and a growing interest in their application. Objective: The purpose of the study is to identify the current status of animal chiropractic in South Africa and to explore ways in which the integration of animal chiropractic into the animal healthcare setting of South Africa might be achieved. Method: This study is an interpretive investigation set in a post-positivistic paradigm and used a grounded theory approach. Data was collected from twelve semi-structured interviews (digitally voice recorded) with relevant stakeholders who were knowledgeable within their respective fields (animal chiropractic; veterinary health science; their respective governing bodies; and owners of animals which had received treatment from animal chiropractic). Questions addressed participants’ perceptions and experiences of animal chiropractic with regard to the role it plays, current interprofessional interactions and developmental issues facing the profession. Qualitative analysis of the data was done using NVIVO 9 software (NVivo 9, developed in Australia, copyright 2011 QSR International Pty Ltd.). The purpose of the data collection was to obtain knowledge presently available within the proposed field in order to build a credible theory which might explain the current status of animal chiropractic in South Africa and the way forward to professional integration with mainstream animal healthcare practice. iv Results: Applying a process of grounded theory methodology revealed that certain key prerequisites were needed for integration of animal chiropractic with mainstream animal healthcare to take place. Firstly, animal chiropractic practitioners had to be seen to have reached a certain level of competence, which could be achieved through a recognised educational programme and by following practising standards at the same (or similar) level as veterinary practitioners. Secondly, acceptance by the public and mainstream practitioners is vital, and requires that the need for animal chiropractic is well motivated, that the role of animal chiropractic is better defined, and that collaboration with mainstream professionals is implemented. Thirdly, animal chiropractic needs careful regulation in order for it to be controlled appropriately. This will require a suitable professional body to govern it, legislation to endorse it and guidelines to direct its actions. Lastly, resources must be available, such as enough animal chiropractors interested in entering the field, sufficient qualified instructors (i.e. experienced animal chiropractors) to provide tuition, adequate amenities, and sufficient time available for the profession to develop and the integration process to take place. Conclusion: It would appear that, with CAVM therapies becoming popular, more people are becoming interested in animal chiropractic. The study suggests that, if the animal chiropractic profession makes provision for achieving the prerequisites of competence, acceptance, regulation and resources in terms of its future development, it might be possible to achieve professional integration with mainstream animal healthcare within the next ten years.
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Lamprecht, Almay. "The epidemiology of work-related musculoskeletal injuries among chiropractors in the eThekwini municipality." Thesis, 2018. http://hdl.handle.net/10321/3079.
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Submitted in partial compliance with the requirements for a Master’s Degree in Technology, Durban University of Technology, Durban, South Africa, 2018.Background: Chiropractors are a unique group of health care professionals who are at risk for developing work-related musculoskeletal injuries. Diversity of daily practice imposes different physical demands on the chiropractor. The present study aims to determine the prevalence of work-related musculoskeletal injuries in chiropractors in eThekwini municipality and selected risk factors associated with work-related musculoskeletal injuries. There are very few studies available that look at the chiropractor holistically in terms of work-related musculoskeletal injuries. However, these existing studies suggest that chiropractors are at a greater risk for the development of work-related musculoskeletal injuries. Method: The study design was a quantitative, cross-sectional, descriptive study utilising a self- administered questionnaire, developed specifically for this research, using an expert group and pilot study. The questionnaire contained sections on personal as well as practice demographics, with questions pertaining to the single most severe work-related musculoskeletal injury, as well as the second and third most severe work-related musculoskeletal injury. Risk factors for work- related musculoskeletal injury were tested by using chi square in the case of categorical variables. In the event of violation of the expected frequencies, the Fisher’s exact test was used to obtain the p-value. Logistical regression was used to obtain odds rations in the presence of more than one explanatory variable. A p-value of <0.05 was used to indicate statistical significance. Results: Sixty-two chiropractors responded, giving a response rate of 64%. The life-time prevalence of work-related musculoskeletal injuries was 69%. A predominance of injuries to the upper extremity (50%) and lower back (28.3%) were recorded. The hand/wrist was the most common anatomical site of injury (31.5%) followed by the lower back. Number of years in practice was considered a risk factor for injury as most injuries occurred within the first five years of practice (41.6%). The likelihood of injury decreases with an increase in the number of years in practice. The majority of injuries affected the soft tissue, including ligament sprains (27.5%) and muscle strains (26.6%) and occurred while the practitioner was performing manipulation (38.2%) of the lumbosacral (80.77%) area with the patient in the side posture (61.53%). Conclusion: The results concur with other studies on work-related musculoskeletal injuries in chiropractors and add insight into risk factors predisposing this population to injury. Chiropractors need to understand the risk factors for occupational injury to implement strategies to avoid risk of injury.
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Logtenberg, Jana. "An assessment of chiropractic adjustment beds as reservoirs for normal flora and infectious bacterial pathogens at a chiropractic teaching clinic." Thesis, 2009. http://hdl.handle.net/10321/458.
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Submitted in partial compliance with the requirements for a Master Degree in Technology: Chiropractic at the Durban University of Technology, 2009.Background: Research has indicated the majority of bacteria on chiropractic adjustment beds (beds), can persist on dry inanimate surfaces for months. Thus, insufficient disinfection procedures create continuous sources of pathogens endangering patients and healthcare workers alike. This research study aimed to assess the beds as reservoirs for micro-organisms, at a chiropractic teaching clinic (clinic) in South Africa. Method: A selection of samples obtained from the headrests and armrests of the beds were serially diluted, plated in duplicate (using the spread plate technique) and incubated for 24-48 hours at 37°C. After inspection for the presence of micro-organisms, those present were enumerated to determine their quantities, the microbial build-up throughout the day, as well as the degree of the transmission from the patients to the beds during treatment. The incidence of the micro-organisms was established, along with their identities, using microscopic and macroscopic characteristics. These micro-organisms were also used to assess the efficacy of the disinfectant currently in use by the clinic. Results: Microbial growth was present on 89.4% of the beds sampled. The quantities of the micro-organisms increased significantly (p=0,027) from 7:30 am to 16:30 pm, with the median increasing from 25 colony forming units (cfu) / cm2 to 714 792 cfu/ cm2. The microbial build-up was highly significant (p<0.001), with a median of 346 cfu/ cm2 at 7:30 am and 10:30 am; increasing to 162 291 cfu/ cm2 by 13:30 pm and 250 million cfu/ cm2 by 16:30 pm. There was also a significant increase (p<0.001) in the quantity of micro-organisms during treatment with a median of 0 cfu/ cm2 before treatment that rose to 23 479 cfu/cm2 after treatment, indicating that the micro-organisms present on the beds were being deposited by the patient`s skin during the treatment. The most prevalent micro-organisms identified were Staphylococci and Serratia, with an average of 59% and 40% of colonies; while Micrococci and Bacilli were relatively uncommon. No growth was evident after 5 minutes of exposure to the disinfectant during the growth inhibition test. For the Kirby Bauer test, the average size of the zone of inhibition increased as the dilution decreased. The disinfectant is effective but more so against the Gram-positive than the Gram-negative bacteria. The disinfectant was 5,0, 5,5 and 5,6 times more effective than phenol in eradicating Staphylococci, Serratia and Bacilli, respectively. Conclusions and Recommendations: This study showed that micro-organisms were present on the beds. Staphylococci and Serratia have been implicated in many healthcare associated infections. The present disinfectant is effective, but should be used in between every patient. A different or additional disinfectant that is more effective against the Gram-negative bacteria should be considered for future use.
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Richardson, Grant Walter. "The effect of differing clinical settings on chiropractic patients suffering from mechanical low back pain." Thesis, 2007. http://hdl.handle.net/10321/157.
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Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban University of Technology, 2007
xviii, 140 leavesEach healing encounter, and every treatment, has specific and non-specific treatment effects. Non – specific effects, or placebo effects, are the benefits felt by the patients because of the nature of the healing encounter. Although difficult to quantify and control, a number of authors recognize that the non-specific component of management has an additive effect on the overall clinical outcome. It has been reported that due to the physical interaction and social nature of chiropractic, there is a strong non-specific component in the management process, but to what extent it facilitates in the healing encounter is unknown. It has also been shown that spinal manipulation has a clinical effect which exceeds that of placebo; therefore it is possible for its effect to be muted or amplified, depending on the presence or absence of non-specific effects. For the above reasons this study was conducted in an attempt to map the size of the non-specific effect in the healing encounter by manipulating the practice setting in which the patients were treated.
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Maartens, Kirsten. "The efficacy of the Graston technique instrument-assisted soft tissue mobilisation (GISTM) in the treatment of plantar fasciitis in runners." Thesis, 2005. http://hdl.handle.net/10321/192.
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Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005
12, xiii, 84 leavesPlantar Fasciitis (PF) or “painful heel syndrome” is an inflammation of the plantar fascia at its insertion on the medial calcaneal tubercle. Accounting for 7-9% of total sports injuries, this condition is predominantly due to overuse and is notoriously difficult to treat. Traditionally treatment focused on the resolution of the inflammation with the application of such modalities cross frictions / transverse frictions being the modality of choice. With such modalities there are however limitations which include the detection of the appropriate areas in which treatment should be given as well as the treatment depth achieved. The GISTM, however is an advanced form of soft tissue mobilisation that employs the use of specifically designed stainless steel instruments that, when manually brushed over the skin of the affected area, are thought to detect and release scar tissue, adhesions and fascial restrictions. This complementary technique is hypothesized to work in the same manner as cross friction massage, and is thought to achieve quicker and improved outcomes by its detection of the treatment area(s) as well as improving the depth of treatment application. This assertion was however untested. Therefore the purpose of this study was to determine the efficacy of the Graston Technique Instrument-assisted Soft Tissue Mobilisation (GISTM) in the treatment of Plantar Fasciitis in runners.
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Uys, Lizette. "An investigation into the effect of a high velocity low amplitude manipulation on core muscle strength in patients with chronic mechanical lower back pain." Thesis, 2006. http://hdl.handle.net/10321/170.
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Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2006
xvii, 148 leaves, Annexures A-LBrunarski (1984) says that philosophically and historically, chiropractic has been uniquely orientated toward an emphasis on preventative care and health maintenance with a mechanistic and hands-on model for treatment. Instead of reductionism, chiropractors focus on holism, non-invasiveness and the sharing of the responsibilities for healing between doctor and patient. As stated in a Canadian report by Manga et al. (1993), lower back pain is a ubiquitous problem and there are many epidemiological and statistical studies documenting the high incidence and prevalence of lower back pain (Manga et al., 1993). Evans and Oldreive (2000) revealed in a study of the transversus abdominis that low back pain patients had reduced endurance of the transverses abdominis and that its protective ability was decreased. In addition, it was noted that wasting and inhibition of the other core stabiliser and co-contractor, multifidus, was present (Hides et al.,1994), both of which have been linked to the presence of low back pain (Evans and Oldreive, 2000 and Hides et al., 1994). Thus, it stands to reason that manipulation, as an effective treatment for low back pain (Di Fabio, 1992), could be effective in restoring the strength and endurance of the core stability muscles. This is theoretically supported by the fact that a restriction in motion and pain due to mechanical derangement in the low back can be effectively treated by manipulation (Sandoz, 1976; Korr (Leach, 1994); Herzog et al., 1999; Homewood, 1979; Vernon and Mrozek, 2005 and Wyke (Leach, 1994)). Homewood (1979) described that a subluxation may interfere with the nerve supply and result in a decrease in muscular activity. He hypothesized that removal of the subluxation could restore: normal physiological processes, increase muscle activity and; improve functional ability and normalize the torque ratios (Herzog et al., 1999; Korr (Leach, 1994); Nansel et al., 1993 and Rebechini-Zasadny et al., 1981). In terms of an intervention, Rebechini-Zasadny et al. (1981) and Naidoo (2002) demonstrated and inferred that manipulation to the cervical spine could affect the muscular activity supplied by those levels. They, however, suggested further studies of manipulation-induced peripheral changes in the muscles are needed, due to unaccounted for variables and small sample sizes in their respective studies This research aims to address the questions posed by the above literature, hence by investigating a high velocity low amplitude manipulation as a possible added intervention for improving local core stabilizer muscle strength, a management protocol for the chronic mechanical lower back pain could be developed.
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Rampersad, Rekha. "Chiropractic effectiveness in the treatment of primary dysmenorrhoea." Thesis, 2009. http://hdl.handle.net/10210/2830.
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Thomson, Deborah Anne. "A clinical trial to investigate the relative effectiveness of acetaminophen with caffeine as opposed to cervical manipulation in the treatment of tension-type headache." Thesis, 2000. http://hdl.handle.net/10321/2820.
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A dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic at Technikon Natal, 2002.Tension-type headache is generally accepted as the most common form of headache and has been shown to have a great impact on work and social activities (Shwartz et al. 1998). Tension-type headache occurs in 39% of people who suffer from headache symptoms with a higher incidence among females, and a peak in the 25-44 year old age group (Wong et al. 1995). The purpose of this study was to investigate the relative effectiveness of 1000mg acetaminophen (paracetamol) combined with 130mg caffeine as opposed to cervical manipulation as a treatment for tension-type headache.
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Perkin, Jonathan Charles. "The effect of stretching the hamstring muscles on low back pain in cyclists." Thesis, 1999. http://hdl.handle.net/10321/2064.
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A dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 1999.There have been few studies conducted to determine the effects of stretching as a therapy on its own in the treatment of low back pain. In response to this, the objective of this study was to evaluate the relative effectiveness of stretching the hamstring muscles on low back pain experienced by cyclists. Thirty two cyclists with low back pain were screened for lumbar facet syndrome, sacroiliac syndrome and myofascial pain syndrome of the quadratus Iumborum, gluteus medius and gluteus maximus muscles and randomly divided into two groups of sixteen. Detuned ultrasound was applied to the hamstring muscles of the patients in the placebo group twice a week for three weeks. Patients in the experimental group were involved in a stretching program whereby the hamstring muscles were passively stretched for three sets of thirty seconds duration, two days a week for three weeks. Both groups were evaluated in terms of subjective clinical findings by utilising the Oswestry Low Back Pain Disability Questionnaire, the Numerical Pain Rating Scale-101, and theti
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