Thesis (Ph. D.)--University of Oregon, 2005. / Typescript. Includes vita and abstract. Includes bibliographical references (leaves 115-119). Also available for download via the World Wide Web; free to University of Oregon users.

Thesis (Sc. D.)--Louisiana Tech University, 2003. / Includes bibliographical references (leaves 246-257).

Thesis (Ph. D.)--Hong Kong Polytechnic University, 2003. / Includes bibliographical references (leaves 199-216).

Thesis (Ph. D.)--University of Oregon, 2005. / Includes bibliographical references (leaves 115-119)

M.Tech. (Chiropractic) / Mechanical neck pain is the most common type of cervical spine pain encountered. It is also referred to as simple or non-specific neck pain and is common in all groups of people (Plaugher, 1993). A majority of individuals with neck pain do not experience a resolution in their pain and disability and this thus results in chronicity (Cote, Cassidy, Carrol and Kristman, 2004). Chiropractic manipulative therapy (CMT) is a specific form of articular manipulation, especially of the vertebral column. This is performed either manually, mechanically, actively or passively in order to restore normal articular alignment and function (Gatterman, 2005). Proprioceptive neck exercises are designed to retrain the cervical musculature to regain its position sense in space. Specific exercises are designed to locate the head to a neutral position and then to do a series of movements in other planes, and then to return the head to the neutral position (Revel, Minguet, Gergoy, Valliant and Manuel, 1994). Chiropractic manipulative therapy does have documented positive effects on the proprioceptive system within the cervical spine (Palmgren, 2006) as does proprioceptive exercises (Sarig-Bahat, 2003; Revel, Minguet, Gergoy, Vaillant, Manuel, 1994). The desired effects of combining both these treatments would be to increase the response rate in patients suffering from chronic mechanical neck pain. The aim of this study was to compare the effects of Chiropractic manipulative therapy (CMT) and proprioceptive neck exercises as stand-alone treatment protocols, as well as a combination treatment protocol with regards to neck pain, disability, cervical spine range of motion and Head Repositioning Accuracy (HRA). Participants were recruited from the University of Johannesburg Chiropractic Day Clinic. They were eligible to participate in the study once they met the inclusion and exclusion criteria. Participants were recruited by means of advertisements that were placed around the respective campuses of the University of Johannesburg as well as by word of mouth. Thirty participants, who presented with chronic mechanical neck pain, volunteered for this randomised comparative clinical study. The participants, aged between 18 - 40, were randomly divided into three groups of ten, with a half female to male ratio. Group 1 received Chiropractic manipulative therapy to the restricted joints in the cervical spine, Group 2 received proprioceptive neck exercises and Group 3 received a combination of both treatments. Participants were treated for a total of 6 visits over a three week period. Subjective and objective measurements were taken at the beginning of visits 1, 4 and at a final visit 7 during which only measurements were taken. Subjective measurements consisted of the Vernon-Mior Neck Pain and Disability Index (VMNPDI) and the Numerical Pain Rating Scale (NPRS) to assess the participants‟ neck pain and disability as well as their perception of pain. Objective measurements were obtained by using the Cervical Range of Motion device (CROM) as well as measuring the Head Repositioning Accuracy (HRA) as described by Revel, Andre-Deshays and Minguet (1991). Based on the results of the study, it could be concluded that both Group 1 (Chiropractic manipulative therapy to the restricted joints in the cervical spine) and Group 3 (a combination of cervical spine manipulation and proprioceptive neck exercises) can be used effectively to treat chronic mechanical neck pain and improve HRA. Group 1, 2 and 3 showed statistical improvements in certain areas and clinical improvements in all areas over time. It could not be statistically concluded whether one treatment is superior to the other, although clinically, Group 1 and Group 3 seemed to be more effective. Considering that Group 3 is a combination of cervical spine manipulation and proprioceptive neck exercises, it could be considered as a valid treatment protocol for chronic mechanical neck pain and improving HRA and could thus be used in a clinical setting.

M.Tech. (Chiropractic) / Purpose: This study aims to determine the effect of Bruegger’s exercise on chronic low back pain in association with lower crossed syndrome and compare it to spinal manipulation alone or a combination of Bruegger’s exercise and spinal manipulation with regards to pain and disability, hip and lumbar range of motion as well as degree of lumbar lordosis. Method: Thirty participants who met the inclusion criteria were randomly allocated to one of three different groups of ten participants each. Group one was only instructed on how to perform Bruegger’s exercise. Group two only received a spinal manipulation/s over the restricted joint/s in the lumbar spine. Group three received a spinal manipulation/s over the restricted joint/s in the lumbar spine in conjunction to being instructed on how to perform Bruegger’s exercise. All participants were assessed over a four week period. All groups attended six treatment sessions over three weeks of which Bruegger’s exercise and/or spinal manipulation were performed. The participants who needed to perform Bruegger’s exercise were also advised to continue doing the exercise out of the treatment session where applicable. In the fourth week only measurements were taken and no treatment was administered. Procedure: Subjective data was collected at the first and fourth consultations prior to treatment, as well as on the seventh consultation by means of a Numerical Pain Rating Scale and Oswestry Low Back Pain Disability Questionnaire to assess pain and disability. Objective data was collected at the first and fourth consultations prior to treatment, as well as on the seventh consultation by means of a universal goniometer for assessing passive hip flexion and extension, a digital inclinometer for assessing active lumbar range of motion and a flexible ruler for measuring the degree of lumbar lordosis. Analysis of collected data was performed by a statician. Results: Clinically significant improvements in group 1, group 2 and group 3 were noted over the duration of the study with regards to pain, disability, hip and lumbar range of motion as well as degree of lumbar lordosis. Statistically significant changes were noted in group 1 and group 2 with regards to pain, disability, hip and lumbar range of motion as well as degree of lumbar lordosis, and in group 3 with regards to hip and lumbar range of motion as well as degree of lumbar lordosis. Conclusion: The results show that Bruegger’s exercise, spinal manipulation and the combination of Bruegger’s exercise and spinal manipulation are effective treatment protocols both clinically and significantly in decreasing pain and disability (not statistically for the combination of Bruegger’s exercise and spinal manipulation), increasing hip and lumbar range of motion as well as decreasing the degree of lumbar lordosis. However, there was no treatment protocol that proved to be preferential over the other. Because spinal manipulation alone showed the greatest overall clinical improvements, it may be suggested that spinal manipulation alone is the most effective in the treatment of chronic low back pain associated with lower crossed syndrome with regards to pain and disability, hip and lumbar range of motion as well as degree of lumbar lordosis. Also, the addition of Bruegger’s exercise may help in some instances to further assist in treatment once the full effects of the spinal manipulation has occurred and allowed for the muscles to be in their optimum state for exercise.

Ergonomics aims to improve worker health and enhance productivity and quality. Knowledge and practical evidence of this relationship would be instrumental for optimising organisational performance particularly in industrially developing countries where the discipline is still in its developmental stages. Therefore this thesis set out to analyse the relationship between ergonomics deficiencies and performance. A survey was first conducted to establish the severity of quality problems in the South African manufacturing industry and to determine if these were related to Ergonomic deficiencies. The results indicated that quality problems continue to plague industry, a challenge associated with huge cost implications. Furthermore organisations were not cognisant of the fact that ergonomics deficiencies such as poor workstation design and awkward or constrained working postures are a major contributing factor to poor quality and performance decrements. This demonstrates that much is yet to be done in raising awareness about the benefits of ergonomics in South Africa and other industrially developing countries. However, for this to be effective, tangible evidence of these purported benefits is required. In lieu of this, a laboratory study was then conducted to establish the relationship between awkward working postures and the performance of precision tasks. Acknowledging that the task and the worker are interrelated elements, the impact of precision task demands on the postural strain experienced by the human was also investigated. A high and low precision task quantified positional precision while a force task (combination of pushing and pulling) was utilised to assess the ability to maintain a precise force over time. These three tasks were performed in eight different postures; namely seated, standing, stooping 300 and 600, working overhead, lying supine, and twisting to either side. A combination of the tasks and postures resulted in 24 experimental conditions that were tested on forty eight healthy male and female participants. The performance related dependent variables were movement time, deviation from the centre of the target, and the trend/slope followed by the force exerted. Muscle activity of eight arm, shoulder and back muscles, iii supplemented with heart rate and local ratings of perceived exertion, were utilised to quantify the impact of the tasks and the postures on the individual. The results revealed that awkward working postures do in fact influence performance outcomes. In this regard, awkward working postures (such as overhead work and lying supine and stooping) were evidenced to significantly affect movement time, deviations from the target and the ability to maintain a constant force over time. These variables have a direct relationship with organisational priorities such as productivity and quality. Furthermore, the results indicated that high precision demands augment postural strain elicited through high muscle activity responses and may have negative implications for the precipitation of musculoskeletal disorders. Essentially, the work done on this thesis reflected the complex nature of ergonomics by drawing on both macro and micro-ergonomics approaches. In so doing, challenges perceived to be relevant to industry as reported by organisations formed the foundation for further laboratory studies. Therefore, more collaborative research and knowledge transfer between industry and ergonomics researchers is a necessity particularly in industrially developing countries where ergonomics is still in its developmental stages.

People with severe trunk impairments cannot maintain or control upright posture during sitting or reaching out with the upper body. Passive orthoses are clinically available to support the trunk and promote the use of upper extremities in this population. However, these orthoses only rigidly position the torso on a wheelchair but do not facilitate movement of the trunk. In this dissertation, we introduce a novel active-assistive torso brace system for upperbody movements by a subject while seated. We have named this system as Wheelchair Robot for Active Postural Support (WRAPS). We propose designs of two robots, one for the pelvis and the other for the trunk. Each of the two devices has a parallel chain architecture to accommodate the range of motion (ROM), respectively for the pelvic and thoracic segments. The first thoracic robot was designed for the upper trunk motion relative to the pelvis. It has a 2[RP]S-2UPS architecture which provides four degrees-of-freedom (DOFs) to the end-effector placed on the upper trunk. The second is a pelvic robot which is designed to orient the pelvic segment relative to the seat. It has a 3-DOF [RRR]U-2[RR]S architecture, coupled with translation to accommodate pelvic movements relative to the seat. These robot architectures are synthesized based on human movement data. WRAPS can modulate the displacement of both the pelvic and the thoracic segments. Additionally, the forces can be applied on the torso through the end-effectors of these robots. Each of the robot prototypes was evaluated with able-bodied subjects to assess the device wearability, kinematic performances, and control system.

Postural control is essential for maintaining an upright sitting position. However, children with Cerebral Palsy (CP) Gross Motor Function Classification System (GMFCS) IV-V present with impaired postural control, often limiting their daily function and environmental interaction. Most interventions targeting postural dysfunction in CP consider the trunk as a single biomechanical segment and are challenging to use in the GMFCS IV-V population. The aim of this study was to develop the Segmental Intensive Trunk Training (SITT), which uses the segmental model of trunk control. The motor learning framework was chosen for structuring SITT to be an intensive approach, with a dosage of 2hrs/day, 3days/week for 4 weeks (24 hours). The development process included the test of feasibility and the initial evidence of effects, using a single subject research design (SSRD). An A-B-A design was used, where the first phase A included 4 baseline assessments, and phase B included the 4 weeks of SITT intervention. The second phase A was the withdrawal period including an immediate posttest, post 1 week test and a 3 month follow up evaluation. Postural control and reaching behavior were assessed during all 3 phases, using the Segmental Assessment of Trunk Control (SATCO) and Seated Postural and Reaching Control Test (SP&R-co). Hand dexterity and function was measured using the Box and Block test, and ABILHAND-kids questionnaire. Gross motor function was measured using the Gross Motor Function Measure Item Set (GMFM-IS). Performance on functional goals was assessed using the Canadian Occupational Performance Measure (COPM). Data analysis was descriptive, including visual analysis and the two standard deviation band method. One participant (11 years, GMFCS V) participated in the study with a 100% completion rate and 88% participation rate. SITT was a feasible approach for training segmental postural control and reaching behavior in children with CP GMFCS V. The improvements in postural control were associated with an improvement in manual dexterity, gross motor function, functional goal performance, and performance-related satisfaction. The gains in static control and COPM performance and satisfaction were retained at 3 months. These improvements were seen in the areas of body structure and function, and activity domains. Progress in motor performance in response to SITT was established at an individual level; however, more evidence is needed to establish the external validity of the approach.

This dissertation aimed to spotlight a prevalent issue in lifespan development and learning that is under-appreciated in educational research and practice. Many children in the United States and abroad learn to coordinate fundamental motor actions with maladaptive postural deviations that impose excessive stress and strain on musculoskeletal structures. The stabilization of maladaptive movement patterns during a critical period of psychomotor development produces non-structural sagittal misalignments of the spine, including Forward Head Posture (FHP) and Postural Thoracic Hyperkyphosis. Moreover, the reproduction of maladaptive movement patterns may be associated with the development of musculoskeletal disorders and associated chronic pain conditions that impact the global public. The researcher employed philosophical synthesis to describe and explain the adverse effects of maladaptive postural coordination on lifespan human development while amplifying its origins in early childhood. Principles from the traditions of Pragmatism and Dynamical Systems Theory are applied to develop a positive model of adaptive psychomotor learning and development that is seamlessly integrated into Early Childhood Education curriculum and learning formats. To this end, Early Childhood Education should structure learning experiences to guide the discovery and stabilization of adaptive movement patterns that (1) accomplish fundamental action goals in the here-and-now and (2) support the health of the changing neuromuscular-skeletal system across its lifetime. Therefore, the researcher proposes a model of early learning in which the study of the body-self is seamlessly woven into all aspects of the general ECE curriculum.