Made available in DSpace on 2015-06-17T19:34:04Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-03-11. Added 1 bitstream(s) on 2015-06-18T12:47:29Z : No. of bitstreams: 1 000830144.pdf: 673220 bytes, checksum: 918dda784fc3b54454589caeb53e1090 (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Objetivo: A obesidade é uma doença crônica, prevalente e comórbida com condições dolorosas como as musculoesqueléticas. A Disfunção Temporomandibular (DTM) é uma dor musculoesquelética altamente prevalente. O objetivo desse estudo foi avaliar a relação entre obesidade com a presença e gravidade de DTM dolorosa. Métodos: A amostra foi estratificada de acordo com a presença e grau de DTM dolorosa de acordo com o Research Diagnostic Criteria para Temporomandibular Disorders-Eixo I e II (RDC/TMD). A composição corporal foi determinada pelo Índice de Massa Corporal (IMC) e pelo exame de bioimpedância (BIA). As cefaleias primárias (CP) foram classificadas segundo critérios da Classificação Internacional de Cefaléia II (CIC-II). Análises uni e multivariadas avaliaram associação entre DTM dolorosa e obesidade. Resultados: A amostra foi constituída por 245 indivíduos (35,89 ± 12,61 anos), sendo 183 (74,7%) mulheres. Do total, 130 (53,25%) apresentaram DTM dolorosa. Houve associação significativa entre a presença de DTM dolorosa e sobrepeso/obesidade avaliada por BIA (RP = 1,44, IC 95% = 1,09-1,91). Associação se manteve em análise multivariada corrigido por gênero e presença de cefaleias crônicas diárias (CCD) (OR= 2,02, IC95%: 1,16-3,54). Não houve associação significativa entre a gravidade de DTM e a composição corporal segundo IMC (p= 0,06) ou BIA (p= 0,08). Conclusão: Obesidade está associada a presença de DTM dolorosa, mas não com a gravidade, após o ajuste para CCD e gênero. / Objectives: Obesity is a chronic and prevalent disorder, comorbid with painful conditions such as musculoskeletal disease. Temporomandibular disorders (TMD) are a high prevalent musculoskeletal pain. The aim of this study was to evaluate the relationship between obesity and the presence and degree of painful TMD. Methods: The sample was stratified according to the presence of painful TMD following the Research Diagnostic Criteria for Temporomandibular Disorders- Axis I and II (RDC/TMD) criteria. The body composition was assessed through Body Mass Index (BMI) and bioimpedance (BIA) analysis. The primary headaches (PH) were classified according to the International Classification for Headache Disorders II (ICHD-II). Uni and multivariate analysis assessed the association between painful TMD and obesity. Results: The sample consisted of 245 individuals (35.89 ± 12.61 years), 183 (74.70%) of them were women. Of the total, 130 (53.25%) presented painful TMD. In contrast with normal weighted individuals, those presenting overweight/obesity according to BIA were more likely to present painful TMD (PR= 1.44, 95%CI= 1.09 to 1.91). Association persisted in multivariate analysis correcting for gender and presence of chronic daily headache (CDH) (OR = 2.02, 95%CI: 1.16 to 3.54). There was no significant association between the grade of the TMD pain and body composition assessed through BMI (p= 0.06) or BIA (p= 0.08). Conclusion: Obesity is associated with the presence of painful TMD, but not with the grade of TMD pain, after adjustment for the CDH and gender. / FAPESP: 2012/10935-4

A dissertation presented in partial compliance with the requirements of the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2003. / In recent years, sacroiliac syndrome has been widely accepted by many different health professions as one of the major contributors to low back pain. Manipulation to effect the relief of the condition has thus far proven to be one of the most effective methods. Comparatively little research has however been done on the different forms of physical therapy that can be used in conjunction with a manipulation so as to maximise its affect / M

M.Tech. / It has been well documented in literature that at least 80% of the general population will suffer from lower back pain or dysfunction at one stage in their lives. Recent literature suggests Sacroiliac joint dysfunction to be a common cause of lower back pain. Clinical interest in the dysfunction and the consequences of this joint being a major cause of lower back pain is growing, as more biomechanical clinicians are finding Sacroiliac joint disorders to be a common occurrence in clinical practice (Pool-Goudzwaard, Vleeming, Stoekart, Snijders and Mens, 1998). Sacroiliac syndrome is characterised by loss of joint play or altered mobility in the Sacroiliac joint‟s range of motion, and is usually associated with altered structural relationships in the region of the Sacroiliac joint (Grieve, 2001). This loss of normal movement is often adjusted by Chiropractors to regain normal mobility, however the correct diagnosis of the loss of mobility is required to induce the correct treatment. Motion palpation has been scrutinised by many researchers who widely questioned its inter-tester reliability. As yet there has been no consensus as to a „gold standard‟ for motion palpation of the Sacroiliac joint. This study aims to reconfirm the inter-examiner reliability of two such motion palpation tests, i.e. Gillet‟s motion palpation and the Standing Flexion test. One hundred participants underwent a double blind experimental study where the results from eight different examiners were recorded to obtain the reliability of the tests. Four examiners tested the participants using Gillet‟s motion palpation and four examiners used the Standing Flexion test. The results were recorded as either right, left or no restriction. The results were then compared and correlated. There was no statistically significant reliability found in either of the two tests. The mean reliability for the Standing Flexion test was found to be 59.31% while the Gillet‟s Motion Palpation produced a mean reliability of 56.38%. These two values are considerably lower than the expected 80% indicating low reliability between the two tests.

Joint disorders significantly affect quality of life and present unique challenges for tissue engineering. In the craniofacial space, and especially for the temporomandibular joint (TMJ), there is an unmet need for anatomically precise and mechanically robust cartilage and bone tissues to recapitulate native function. Current surgical reconstruction methods, whether using autologous or synthetic options, suffer from imprecision, comorbidities, complications, and frequently require subsequent operations. Furthermore, many craniofacial graft efforts have focused on improving bone without addressing cartilage, which is essential to proper TMJ function. Thus, there is a compelling need to engineer a human-sized, biologically and anatomically matched cartilage-bone TMJ replacement. This dissertation demonstrates the ability to generate such a graft with native-like properties in a human-sized large animal model by focusing on two aims: (i) establish methods to fabricate and culture anatomically specific, autologous cartilage-bone grafts (Aim 1), and (ii) show improvement of graft performance after six months implantation in vivo compared to previous methods, controls, and native tissue (Aim 2). Using Yucatan mini-pigs as a human-sized model, the ramus-condyle unit (RCU), a geometrically intricate portion of the mandible and primary load bearing section of the TMJ, was targeted for reconstruction. Scaffolds were created using computer tomography (CT) image-guided micromilling of decellularized bone matrix, then infused with autologous adipose-derived chondrogenic and osteogenic progenitors. These biological constructs were then cultured in vitro in a novel dual-perfusion bioreactor before in vivo implantation. Similar in vitro culture of representative constructs done in parallel demonstrated cell attachment and some differentiation. After six months implantation, the dual cartilage-bone RCU grafts maintained their predefined anatomical structure and regenerated full-thickness, stratified, and mechanically robust cartilage over the underlying bone, to a significantly greater extent than either bone-only grafts or acellular scaffolds, and showed remarkable similarity to native tissue. Furthermore, tracking of implanted cells enabled additional insights into the progression of cartilage and bone regeneration. The methods and results established in this dissertation form a promising basis for the next evolution in engineering full-sized, patient-specific, and biologically and mechanically robust TMJ replacements.

Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2006 18, xvii, 157, 14 leaves, Annexures A-K / The aim of this study was to assess the inter-examiner reliability of motion palpation of the patella, in both pathological (osteoarthritis) as well as functional (patellofemoral pain syndrome) conditions, in order to assess the validity of this assessment tool, which is commonly used as a method in identifying restricted patella motion.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2012. / Background: Hamstring muscle strains are a common musculoskeletal injury amongst athletes, with a high rate of recurrence that suggests room for improvement in the treatment and management of these injuries. Cibulka et al. (1986) suggest a possible link between injuries of the hamstring muscles and dysfunction of the sacroiliac joint. A study by Fyfer (2005) found that sacroiliac manipulation alone had a positive effect in the treatment of recurrent hamstring strains, but this was not combined with or compared to conventional treatment for muscle strain. Fox (2006) found that sacroiliac manipulation added to hamstring stretching increased the resultant flexibility of uninjured hamstring muscles. Objective: The purpose of this study was to determine the relative effectiveness that manipulation may have when combined with and compared to a regime of hamstring stretching and strengthening in the treatment of chronic hamstring strains. Method: Thirty two participants suffering from chronic hamstring injuries and concomitant dysfunction of the sacroiliac joint were randomly allocated into two treatment groups. Both groups attended six consultations over a period of three weeks. Group one received treatment in the form of proprioceptive neuromuscular feedback (PNF) stretching and resisted isometric exercises of the hamstring, and were taught a home routine consisting of static stretching of the hamstring and Theraband® exercises directed at the hamstring. Group two received the same treatment and home routine as those in Group one, with the addition of Chiropractic manipulation of the dysfunctional sacroiliac joint. Outcomes were obtained by using the Numerical Pain Rating Scale (NRS-101), inclinometer testing of passive straight leg raiser test, and algometer assessment of pain threshold in the injured hamstring muscle and ipsilateral sacroiliac joint. Results: Data was analysed using the SPSS version 18.0 (SPSS Inc. Chicago, Ill, USA). Subjective and objectives outcomes were measured quantitatively. The effect of the intervention was measured using repeated measures ANOVA testing. The time versus treatment group interaction effect assessed whether the effect of the different treatment over time is the same, with a p value of <0.05 being v considered significant. Both treatment groups showed improvement of outcomes, and manipulation showed a marginally non-significant trend of greater improvement with regards to sacroiliac joint algometry. Conclusion: This study did not provide conclusive evidence of either a benefit or no benefit of manipulation, but where non-significant trends were shown, it is likely that this was due to lack of statistical power and that with an appropriate a priori analysis being done a greater sample size may have shown the same effect to be statistically significant.

published_or_final_version / Dentistry / Doctoral / Doctor of Philosophy

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2006. / The aim of this study was to assess the inter-examiner reliability of motion palpation of the patella, in both pathological (osteoarthritis) as well as functional (patellofemoral pain syndrome) conditions, in order to assess the validity of this assessment tool, which is commonly used as a method in identifying restricted patella motion. / M

M.Tech. (Chiropractic) / Purpose: According to Jonhagen, Nemeth and Erikson (1994), hamstring muscle injury as a result of weakness is prevalent. Hoskins and Pollard (2005) states that a previous or recent hamstring muscle injury is the most recognized risk factor for future injury. Given the high reoccurrence rate, hamstring injuries provide a significant challenge to the treating clinician. Knowledge surrounding the optimal treatment is critical to improve hamstring muscle strength in preventing these injuries. The aim of this study is to determine the most effective treatment method, when comparing sacroiliac joint manipulation with or without dry needling and the effect it has on hamstring strength. Design: Thirty participants between the ages of 18 and 35 years old presenting with SI joint dysfunction and hamstring trigger points, were considered for this study. The participants were randomly divided into two groups of 15 participants each (group A and B). Group A received manipulation to the sacroiliac joint and group B received manipulation to the sacroiliac joint, as well as dry needling of the active myofascial trigger points in the semimembranosus muscles. Each participant was treated six times over a period of three weeks. Measurements: All measurements were collected at the first, third and fifth consultation prior to treatment and on the seventh consultation where no treatment was performed. Subjective measurements included the McGill questionnaire and a visual analogue pain scale. Objective measurements included algometer, readings of pressure pain threshold of the hamstring muscle trigger points and hamstring muscle strength recorded using a dynamometer instrument. Results and Conclusion: Group A and group B proved to have a statistical and clinical improvement overall. Group A had a better improvement in both subjective tests and in the objective tests. In comparing the statistically significant data for hamstring muscle strength in this study, it would appear that Group A responded better to treatment than Group B. Although both groups did improve, it suggests that Group A achieved the greatest overall improvement. Therefore it can be suggested that myofascial dry needling of the hamstring muscle was found not to have an additive effect for improving vii hamstring muscle strength, it actually appears to have done worse. The reason for this might be due to the post treatment soreness after needling. This may cause muscle inhibition and decreased muscle contraction, due to the pain or tenderness, which could have affected the muscle strength. In conclusion, the results in this study show that chiropractic manipulation combined with dry needling did not have better results in improving hamstring strength.

Diss. (sammanfattning) Uppsala : Sveriges lantbruksuniversitet, 2004. / Härtill 4 uppsatser.