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Inter- and intra-examiner reliability of lumbar spine radiograph analysis by chiropractors and its impact on clinical managementMdakane, Zandile January 2017 (has links)
Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2017. / Radiographs are the most commonly used modalities for the purpose of diagnosing skeletal disorders. Radiographs are important for chiropractors to exclude any contra-indications prior to spinal manipulative therapy. If contra-indications are found treatment is modified to what best suits each patient. There is a gap in the literature regarding chiropractors reading the same set of radiographs and agreeing on findings.
Objectives
The study investigated inter- and intra-examiner reliability of lumbar spine radiograph analysis by chiropractors and its impact on clinical management.
Methods
Inter- and intra-examiner examination of radiographs occurred in two rounds separated by two weeks. Six chiropractors read the same 30 radiographs and clinical history was only available in the second round.
Results
Inter-observer agreement for categorisation for Round One was 96.78% and Round Two 89.49%. Inter-observer agreement in management was 96.45% in round one and 96.00% in Round two. Agreement between chiropractors had no statistically significant difference. Identification average improved from 0.09 to 0.89 kappa. Overall specificity was relatively high and sensitivity was relatively low.
Conclusion
Reliability/Agreement between chiropractors was strong in both rounds. Categorising of the diagnosis improved from poor to substantial from Round One to Round Two. Case history improved the accuracy of interpreting the radiographs although this change was not statistically significant. / M
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The effect of a scuba diving cylinder on static lumbar spine postureAnaniadis, Christopher January 2002 (has links)
Thesis (M.Tech.: Chiropractic) -Dept. of Chiropractic, Technikon Natal, 2002 1 v. (various pagings) / The purpose of this study was to evaluate the effect of wearing a scuba diving cylinder on static lumbar spine posture, in terms of clinical objective findings, namely radiographic changes in the lumbar lordosis, lumbosacral angle, lumbosacral disc angle, and the lumbar gravity line, during upright standing on land.
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The relationship between core stability and bowling speed in asymptomatic male indoor action cricket bowlersHilligan, Bruce Kevin January 2008 (has links)
Thesis (M.Tech.: Chiropractic)- Dept. of Chiropractic, Durban University of Technology, 2008.
x, 52 leaves, Appendices A-E, [25] leaves. / To determine whether a relationship exists between core stability and bowling speed in Action Cricket bowlers.
Methods:
Thirty asymptomatic indoor Action Cricket fast and fast-medium bowlers were divided into two groups of 15 each, with Group A having well-developed core stability and group B having poorly-developed core stability. The concept of matched pairs was used for age and cricket experience in order to maintain homogeneity between the groups. The core stability and bowling speed of each participant was measured using a pressure biofeedback unit (PBU) and speed sports radar respectively. SPSS version 15.0 was used to analyse the data.
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Thoracic and lumbar vertebrae of African hominids ancient and recent: morphological and fuctional aspects with special reference to upright postureBenade, Maria Magdalena 18 July 2016 (has links)
A Dissertation Submitted to the Faculty of Science University
of the Witwatersrand, Johannesburg for the Degree of Master
of Science
January, 1990 / This is a study of the morphological and functional aspects
of A. africanus thoracic and lumbar vertebrae in comparison
with those of modern human and anthropoid ape vertebrae. The
purpose is to determine if any derived features in the
morphology of hominids, as distinct from primitive features
shared with non-hominids, were present and if so to what
stage of attainment of full erectness such features point.
The major results of this study are as follows: (i) There is
a difference in the configuration of the lumbar articular
facets between pongids, on the one hand, and modern human and
A. africanus, on the other hand. This difference suggests
that similar stresses operate in these regions in the two
hominid groups. (ii) Bony adaptation to a developed lumbar
lordosis is present in A. africanus. (iii) Major agreement
has been found in the relative dimensions of modern human and
A. africanus lumbar vertebrae, in contrast to those of pongid
vertebrae. This indicates probable correspondence in the
pattern of weight transmission to the pelvis in modern humans
and A. africanus. (iv) The decrease of inferior lumbar
vertebral body area starts at higher levels in sts 14 (an A.
africanus partial skeleton) than in modern man, suggesting a
longer curved lower lumbar region in A. africanus.
From these results it may be concluded that the trunk was
probably carried in a fully erect posture in A. africanus.
The bony adaptation thereto, however, may not have been fully
developed as in modern man. It is proposed that, in Sts 14,
the last two lumbar vertebrae were carried at an angle
relative to each other and to the sacrum, in contrast to the
abrupt change in direction between L5 and the sacrum in
modern man.
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Application of adaptive bone remodelling theory to the motion segments of lumbar spine: a theoretical studySeenivasan, Gopi 01 May 1993 (has links)
No description available.
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Three dimensional nonlinear finite element stress analysis of a lumbar intervertebral jointShirazi-Adl, Aboulfazl January 1984 (has links)
No description available.
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Accuracy in the diagnosis of lumbar segmental mobility disordersAbbott, J. Haxby, n/a January 2005 (has links)
Background: In the clinical examination of patients with low back pain (LBP), musculoskeletal physiotherapists routinely assess lumbar spinal segmental motion by performing physical examination procedures such as observation of active range of motion and palpation of intervertebral motion. The validity of manual assessment of segmental motion, however, has not been adequately investigated.
Methods: In this pragmatic, multi-centre, criterion-related validity study, 138 consecutive patients with LBP were recruited and examined by physiotherapists with postgraduate training in musculoskeletal manual therapy. Clinicians examined each patient�s spine for the presence of segmental motion abnormalities, described as lumbar segmental rigidity (LSR) and lumbar segmental instability (LSI), then referred the patients for flexion-extension (FE) radiographs. The physical examination procedures of interest were: 1) assessment of forward-bending (FB) active range of motion (AROM); 2) FB and backward-bending (BB) passive physiological intervertebral motion testing (PPIVMs) in the sagittal plane; and 3) central postero-anterior passive accessory intervertebral motion testing (PAIVMs). Sagittal displacement kinematics of the lumbar spinal segments were measured from the FE radiographs, and served as the criterion standard against which the clinical assessment results were compared. The kinematic parameters measured were sagittal rotation, sagittal translation, ratio of translation per degree of rotation (TRR), instantaneous axis of rotation (IAR), and centre of reaction (CR). Reference ranges for normal motion were calculated from the analysis of FE radiographs of 30 asymptomatic volunteers. The accuracy and validity of the clinical examination procedures were then calculated, and reported as sensitivity, specificity, and likelihood ratios for a positive test (LR+) and a negative test (LR-).
Results: In patients with LBP, sagittal rotation LSR and sagittal translation LSR had a prevalence of approximately 5.7% (p <0.0005) in this cohort. Sagittal rotation LSI was not found in statistically significant numbers. Sagittal translation LSI was found at a prevalence of 3.6% (p <0.05). Abnormal TRR (23.3%), IAR (17.7%), and CR (16.5%) were more prevalent findings (all p <0.0005). Observation of the quantity of AROM, during FB, is not valid for the assessment of either total lumbar segmental sagittal rotation, or detection of individual segments with abnormal segmental motion. PPIVMs and PAIVMs are specific, but not sensitive, for the detection of rotation LSI and translation LSI. A positive test (grade 4 on a scale from 0 to 4) with BB PPIVMs may have some utility for the diagnosis of rotation LSI or translation LSI, with LR+ of 8.4 and 7.1 respectively (and 95% CIs from around 1.7 to 38). Likelihood ratio statistics for FB PPIVMs were not statistically significant. A positive test (grade 2 on a scale from 0 to 2) with PAIVMs may have some utility for the diagnosis of rotation LSI or translation LSI, with LR+ of 2.7 and 2.5 respectively (and 95% CIs from around 1.01 to 7.5). Neither PPIVMs nor PAIVMs were useful for the detection of LSR, or abnormal quality of motion as measured by TRR, CR, and IAR.
Conclusions: Abnormal spinal segmental motion is associated with the symptom of LBP, in patients presenting to physiotherapists with a new episode of recurrent or chronic LBP, however prevalence is low due to highly variable lumbar segmental motion among asymptomatic individuals. Manual physical examination has moderate validity, but limited utility on its own, for the detection of translation LSI. Further research should investigate the utility of other clinical examination findings for the detection of lumbar segmental mobility disorders.
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Three dimensional nonlinear finite element stress analysis of a lumbar intervertebral joint / 3-D nonlinear finite element stress analysis of a lumbar intervertebral joint.Shirazi-Adl, Aboulfazl January 1984 (has links)
The need for the development of a rigorous analytical model of the lumbar spine to clarify the role of mechanical factors in low-back disorders has long been recognized. In response to this need, a general three dimensional nonlinear finite element program has been developed as part of this work and has been applied to the analysis of a lumbar L(,2-3) joint including the posterior elements. The analysis accounts for both the material and geometric nonlinearities and is based on a representation of the nucleus as an incompressible inviscid fluid and of the annulus as a composite of collagenous fibres embedded in a matrix of ground substance. The facet articulation has been accounted for by treating it as a general moving contact problem. The ligaments have been modelled as a collection of nonlinear axial elements. The geometry of the finite element model is based on in-vitro measurements. / The response of the joint under single compression, single flexion, single extension and also under flexion or extension combined with compression and sagittal shear has been analyzed for both the normal and degenerated states of the nucleus. Validity of the model has then been established by a comparison of those predictions which are also amenable to direct measurements. The states of strain and stress in different components of the lumbar joint have been thoroughly studied under all the foregoing loading conditions. / Those elements of the joint predicted to be vulnerable to mechanical failure or damage under the above types of loading have been identified. These results have been correlated with the lumbar joint injuries reported clinically. Furthermore, some joint injury mechanisms and degeneration processes have been proposed and the supporting clinical evidences have been presented.
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The effect of a scuba diving cylinder on static lumbar spine postureAnaniadis, Christopher January 2002 (has links)
Thesis (M.Tech.: Chiropractic) -Dept. of Chiropractic, Technikon Natal, 2002 1 v. (various pagings) / The purpose of this study was to evaluate the effect of wearing a scuba diving cylinder on static lumbar spine posture, in terms of clinical objective findings, namely radiographic changes in the lumbar lordosis, lumbosacral angle, lumbosacral disc angle, and the lumbar gravity line, during upright standing on land.
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The relationship between core stability and bowling speed in asymptomatic male indoor action cricket bowlersHilligan, Bruce Kevin January 2008 (has links)
Thesis (M.Tech.: Chiropractic)- Dept. of Chiropractic, Durban University of Technology, 2008.
x, 52 leaves, Appendices A-E, [25] leaves. / To determine whether a relationship exists between core stability and bowling speed in Action Cricket bowlers.
Methods:
Thirty asymptomatic indoor Action Cricket fast and fast-medium bowlers were divided into two groups of 15 each, with Group A having well-developed core stability and group B having poorly-developed core stability. The concept of matched pairs was used for age and cricket experience in order to maintain homogeneity between the groups. The core stability and bowling speed of each participant was measured using a pressure biofeedback unit (PBU) and speed sports radar respectively. SPSS version 15.0 was used to analyse the data.
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