Research shows that up to 80% of recreational skiers have lower limb alignments which can impede their ability to turn their skis properly (Subotnick,1982). The most difficult of these alignment problems to control within a ski-boot is the varus alignment of the subtalar joint (Macintyre and Matheson, 1988). The use of custom molded footbeds made specifically for use inside of ski boots has been suggested as one method of compensating for a varus aligned foot. This study compared the effectiveness of one brand of custom molded ski boot footbed with that of a noncustom insole in controlling the motions of the lower limb associated with subtalar varus. Specifically these motions were those of the rearfoot and the navicular tubercle, along with the alignment of the tibial tuberosity with respect to the mid-line of the ski boot. In addition, subjects were given the opportunity to assess their subjective feelings of edge control, pain, and fatigue while skiing with both the custom molded footbeds and non-custom insoles. The subject group for this study consisted of 13 advanced level adult skiers who demonstrated more than three degrees of subtalar varus when non-weight bearing. Each subject received a pair of custom molded ski boot footbeds at the beginning of the study. Ski boots that had been cut away at the rear and the medial side were used in the laboratory in order to observe the motions of the navicular tubercle and the rearfoot as the subject transferred their weight in a simulated skiing motion. The right and left navicular tubercle, tibial tubercle, and the insertion of the Achilles at the calcaneus of each subject were located by palpation and marked. After sufficient practice of the weight transfer motion, two trials of each landmark were photographed using 35mm slide film. The subjects were first photographed while using the non-custom insoles and again using the custom molded footbeds. The slides were digitized and comparisons were made between the two types of insoles for both the start and end locations of the landmarks as well as for the ranges of motion through which the landmarks traveled. Statistical analyses of the group results indicated that there was significantly less (p=0.000) navicular motion during the shift from the start to the end positions with the use of the custom molded footbeds as compared to the non-custom insoles. The rearfoot angle was significantly less at both the start (p=0.000) and end (p=0.000) positions with the use of the custom footbeds as compared to the noncustom insoles. There was no statistical difference between the amount of rearfoot motion allowed by either type of insole. The tibial tubercle was positioned significantly (p=0.000) closer to the mid-line of the ski boot when using the custom footbeds than with the use of the non-custom insoles. These results indicate that the custom footbeds domaintain the subtalar joint in a more neutral position than do non-custom insoles. During the skiing section of the study the subjects rated the custom footbeds as providing better edge control (p=0.000) and resulting in less fatigue (p=0.000) than noncustom insoles. There was no statistical significance when comparing the ratings given by the group for the level of pain experienced with the use of either type of insole. There was a statistically significant improvement (p=0.000) in race times for the group when using the custom footbeds as compared to the non-custom insoles. The results of this study indicate that custom molded ski boot footbeds are able to control subtalar motion more effectively than a non-custom insole. It appears that this control of subtalar motion enhances the skiing experience by increasing edge control and reducing the amount of fatigue experienced. / Education, Faculty of / Curriculum and Pedagogy (EDCP), Department of / Graduate

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Department of Chiropractic, Faculty of Health Sciences, Durban University of Technology, Durban, South Africa. 2015. / Background: Plantar fasciitis (PF) is inflammation of the plantar surface of the foot, usually at the calcaneal attachment and is most commonly due to overuse. It is the most common foot condition treated by healthcare providers. Conservative treatment using taping is one of the first lines of treatment for PF. Low-Dye taping and Kinesio taping are two types of taping techniques commonly used to treat PF. Low-Dye taping and Kinesio taping have different intrinsic tape properties as well as different mechanisms of action in the treatment of PF. Low-Dye taping involves the use of a non-stretch, rigid tape. Rigid tape is commonly used by therapists primarily for the mechanical properties the tape provides to support the injured structure as well as to protect against re-injury. Low-Dye taping shortens the distance between origin and insertion of the plantar musculature and fascia, decreasing stress and tensile forces along the plantar plate to protect the plantar fascia and allow healing to occur. Kinesio tape is an elastic tape that allows a one-way longitudinal stretch; it is applied in a specific manner to achieve its therapeutic effects and forms convolutions on the skin. The proposed mechanism of action of Kinesio tape involves improving circulation of blood and lymphatics to resolve oedema caused by the inflammatory component of PF; suppressing pain, and; relieving muscle tension to return fascia and muscle functioning to normal. Both forms of tape have shown effectiveness in the treatment of PF; however the effectiveness of one taping technique versus the other has not yet been explored. Objectives: The purpose of this study was to determine the effectiveness of Kinesio tape alone versus Low-Dye tape alone in the treatment of PF in terms of both objective and subjective measures. Methods: Thirty participants with a diagnosis of PF, between the ages of 20 and 45, were randomly allocated into two treatment groups. Both groups received treatment in the form of a taping technique, either Kinesio tape or Low-Dye tape. Assessments were made pre-treatment at each visit and at a follow up visit, with seven visits in total. Assessments included objective data measures (ultrasonography, algometer readings, weight-bearing ankle dorsiflexion measurements) and subjective measures (the visual analogue scale and the foot function index questionnaire). Data was recorded in a data collection sheet and Statistical Package for the Social Sciences version 21 was used to analyze the data with a p value of < 0.05 considered as being statistically significant. Results: Most outcomes showed a significant improvement over time regardless of which form of treatment they received. For the VAS and pain walking outside, in the disability section of the FFI, there was statistical evidence of the Kinesio tape group improving more than the Low-Dye tape group. For morning pain, in the pain section of the FFI, and pain climbing curbs, in the disability section of the FFI, there was statistical evidence of the Low-Dye tape group improving more than the Kinesio tape group. For all the other outcomes there was a non-significant trend towards the Low-Dye tape group showing a greater improvement than the Kinesio tape group. Conclusion: Kinesio taping and Low-Dye taping were both found to be effective in the treatment of PF with neither form of tape showing superiority to the other in the treatment of PF.

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2005. Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 xiv, 99 leaves / Plantar Fasciitis (PF), also called ‘the painful heel syndrome’, is a common cause of heel pain (Barrett and O’Malley, 1999:2200), accounting for between 7% and 10% of all running injuries (Batt and Tanji, 1995:77; Chandler and Kibler, 1993:345). Primarily an overuse injury, resulting from tensile overload, it involves inflammation and micro-tears of the plantar fascia at its insertion on the calcaneus (Lillegard and Rucker, 1993:168; Barrett and O’Malley, 1999:2200). The body’s attempt to heal these micro-tears leads to chronic inflammation and the formation of adhesions (Ambrosius and Kondracki, 1992:30). Transverse friction massage has been found to be beneficial in the treatment of PF (Hyde and Gengenbach, 1997:478,481; Hertling and Kessler, 1996:137). Cyriax (1984) and Prentice (1994) state the effect of frictions to include the breakdown of adhesions (scar tissue), as well as preventing the formation of further adhesions. Graston Technique Instrument-assisted Soft Tissue Mobilisation (GISTM), based on the principles of frictions, aims to break down adhesions, realign collagen fibres and aid in the completion of the inflammatory process (Carey-Loghmani, 2003:31, 51-62; Hammer, 2001). Enabling us to see changes on ultrasonography, which has been found to be an objective, non-invasive way of evaluating PF (Wall and Harkness, 1993:468; Tsai et al, 2000:259; Cardinal et al, 1996:258). These changes include decreased thickness of the fascia. The aim of the study was to see the effect of GISTM on PF in runners, in terms of ultrasonography, and identify any correlation between these findings and other objective and subjective findings. / M

The objective of this study was to investigate the intra-rater (within day & between days) and inter-rater reliability of foot/ankle water volumetry in healthysubjects.Study design: Repeated measures design with 2 raters.Background: Physiotherapists more often aim to reduce swelling in the acute phase of soft tissue injury. Reduction in swelling will hasten the healing process. Therefore swelling forms an important outcome measure that is worth studying during the healing process to determine the efficacy of the intervention. Though there are different methods available to measure extremity swelling, water displacement method is widely used in physiotherapy studies. Although water volumetry has been used to assess the reduction in swelling over time, there is paucity of reliability studies that have assessed the between-days reliability.Methods: Thirty normal subjects with asymptomatic ankles were measured by 2 raters. Three repeated foot volume measurements were performed by each of the rater using water volumetry during a single test session. The same procedure was repeated approximately at the same time on the 3rd day and 5th day following the 1st measurement day by the same raters on the same subjects. The raters were blinded to each other's measurements. The order for rater's volumetric measurement on each subject on each day was determined by a random chart produced by SPSS. The reliability was measured in terms of systematic bias (Paired t test & Bland & Altman's plot), absolute reliability (Limits of Agreement [LOA] & Standard Error of Measurement [SEM]) and relative reliability (Intraclass Correlation Coefficient [ICC]).Results: There was no systematic bias between any of the trials within day/between days or between raters. The intra-rater reliability within day as calculated by ICC; LOA and SEM were 0.99, ±10ml and ±3.5ml respectively and for between days reliability the values were 0.99 (ICC), ±20ml (LOA) and ±7ml (SEM) and for interrater reliability the values were 0.99 (ICC), ±13ml (LOA) and ±5ml (SEM). The results demonstrated that water volumetry method was highly reliable within day and between days for both the raters; and highly reliable between raters.Conclusion: Water volumetry is a highly reliable method for measuring foot/ankle volume repeatedly on different days. The random error range in milliliters (ml) as estimated by the absolute reliability indices provides the practical use of this method in a clinical/research setting.

The objective of this study was to investigate the intra-rater (within day & between days) and inter-rater reliability of foot/ankle water volumetry in healthysubjects.Study design: Repeated measures design with 2 raters.Background: Physiotherapists more often aim to reduce swelling in the acute phase of soft tissue injury. Reduction in swelling will hasten the healing process. Therefore swelling forms an important outcome measure that is worth studying during the healing process to determine the efficacy of the intervention. Though there are different methods available to measure extremity swelling, water displacement method is widely used in physiotherapy studies. Although water volumetry has been used to assess the reduction in swelling over time, there is paucity of reliability studies that have assessed the between-days reliability.Methods: Thirty normal subjects with asymptomatic ankles were measured by 2 raters. Three repeated foot volume measurements were performed by each of the rater using water volumetry during a single test session. The same procedure was repeated approximately at the same time on the 3rd day and 5th day following the 1st measurement day by the same raters on the same subjects. The raters were blinded to each other's measurements. The order for rater's volumetric measurement on each subject on each day was determined by a random chart produced by SPSS. The reliability was measured in terms of systematic bias (Paired t test & Bland & Altman's plot), absolute reliability (Limits of Agreement [LOA] & Standard Error of Measurement [SEM]) and relative reliability (Intraclass Correlation Coefficient [ICC]).Results: There was no systematic bias between any of the trials within day/between days or between raters. The intra-rater reliability within day as calculated by ICC; LOA and SEM were 0.99, ±10ml and ±3.5ml respectively and for between days reliability the values were 0.99 (ICC), ±20ml (LOA) and ±7ml (SEM) and for interrater reliability the values were 0.99 (ICC), ±13ml (LOA) and ±5ml (SEM). The results demonstrated that water volumetry method was highly reliable within day and between days for both the raters; and highly reliable between raters.Conclusion: Water volumetry is a highly reliable method for measuring foot/ankle volume repeatedly on different days. The random error range in milliliters (ml) as estimated by the absolute reliability indices provides the practical use of this method in a clinical/research setting.

Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 xiv, 99 leaves / Plantar Fasciitis (PF), also called ‘the painful heel syndrome’, is a common cause of heel pain (Barrett and O’Malley, 1999:2200), accounting for between 7% and 10% of all running injuries (Batt and Tanji, 1995:77; Chandler and Kibler, 1993:345). Primarily an overuse injury, resulting from tensile overload, it involves inflammation and micro-tears of the plantar fascia at its insertion on the calcaneus (Lillegard and Rucker, 1993:168; Barrett and O’Malley, 1999:2200). The body’s attempt to heal these micro-tears leads to chronic inflammation and the formation of adhesions (Ambrosius and Kondracki, 1992:30). Transverse friction massage has been found to be beneficial in the treatment of PF (Hyde and Gengenbach, 1997:478,481; Hertling and Kessler, 1996:137). Cyriax (1984) and Prentice (1994) state the effect of frictions to include the breakdown of adhesions (scar tissue), as well as preventing the formation of further adhesions. Graston Technique Instrument-assisted Soft Tissue Mobilisation (GISTM), based on the principles of frictions, aims to break down adhesions, realign collagen fibres and aid in the completion of the inflammatory process (Carey-Loghmani, 2003:31, 51-62; Hammer, 2001). Enabling us to see changes on ultrasonography, which has been found to be an objective, non-invasive way of evaluating PF (Wall and Harkness, 1993:468; Tsai et al, 2000:259; Cardinal et al, 1996:258). These changes include decreased thickness of the fascia. The aim of the study was to see the effect of GISTM on PF in runners, in terms of ultrasonography, and identify any correlation between these findings and other objective and subjective findings.