M.Tech. / aim of this unblinded randomized control study was to compare Chiropractic Adjustive Therapy (CAT) to Interferential Current Therapy (IFC) as treatment for Painful Minor Intervertebral Dysfunction (PMID) in the lumbar spine. The effects of CAT and IFC on lumbar spine range of motion (ROM) and pain relief from PMID were also examined. The participants of the trials were treated at the Chiropractic Day Clinic at the University of Johannesburg. Thirty participants presenting with Low Back Pain (LBP) and PMID on segmental intervertebral examination were used for this study and divided into two groups of fifteen. Group A participants were treated with CAT applied to the painful intervertebral segment. Group B participants were treated with IFC over the painful intervertebral segment. The objective data for this research was recorded by the readings obtained from the application of transverse pressure by a Pressure Algometer to the lateral aspect of a painful spinous process. Further objective readings were taken using a Digital Inclinometer to measure the participants Range of Motion (ROM). Subjective data was obtained by an Oswestry Pain and Disability Index (ODI). The subjective and the objective data were both recorded at the first, fourth and seventh visit which took place over a three week period. The results of the study showed that Group A had a statistically significant decrease in Pressure Algometer Readings and ODI scores. Group A also showed a statistically significant improvement in ROM readings for Left Lateral Flexion, Left Rotation and Right Rotation. Group B did not show any statistical significance in either the subjective or objective data. Importantly, an Inter-group comparison for the Pressure Algometer Readings also revealed an increasing statistically significant difference between Group A and Group B from the first to the fourth and seventh visit. The pain elicited by transverse pressure to a spinous process is core to the diagnosis of PMID, which can result in many pain syndromes of vertebral origin (Maigne, 2006). This research provides evidence that CAT is more beneficial than IFC for the treatment of PMID in the lumbar spine over a short and longer period of time.

Low back syndrome affects 20% of people, and it is estimated that 30% of patients are unable to return to work after surgery. The monitoring of health care outcomes could improve the delivery of health services. The health performance conceptual framework, derived from the Donabedian model, was used to evaluate the functional outcome, clinical recovery, response to surgery, and physician performance of the surgical management of lumbar spine degeneration. A quantitative study (n=685) was undertaken using an administrative database in a repeated-measures design. The clinical and functional outcome improvements were analyzed using t tests. Surgical complexity on health outcome was examined with ANOVA. Predictors of patient satisfaction was explored using Pearson's correlation and regression analyses. The results demonstrated highly significant improvements in functional (mean change 30%; ODI=16.79 -± SD 19.92) and clinical recovery (mean change 50%; modified-JOA=6.983 -± SD 2.613) with surgery at 3 months; a >50% positive response to surgery; and a > 90% patient satisfaction, sustained over a 2 year period. Complexity of surgery did not impact health performance. Strong correlations between the health performance metrics were detected up to 6-months from surgery. Poor clinical recovery and persistent functional disability were predictive of patient dissatisfaction. The social change implications for health policy are that a constellation of health performance metrics could predict the potential for functional and clinical recovery based on presurgery disability while avoiding medical expenditures for procedures with no health benefit; aid in health quality monitoring, peer comparisons, revision of practice guidelines, and cost benefit analysis by payers.

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Title Cervicogenic headache Objectives The aim of this master thesis is to present a comprehensive overview of the topic of cervicogenic headache. It focuses on the prevalence of this disease in the general population and on the cervical spine segment where the dysfunction in patients with cervical headache occurs the most frequently. It also focuses on the link between suboccipital muscles, cervical dura mater spinalis and headache on the effectiveness of different therapies for this diagnosis. Method The thesis is conceived as a scientific literature research. In order to obtain sources professional database such as Pubmed, PEDro, Medline, HighWire, Science direct were used. The thesis is divided into a theoretical and an analytical part. There have been 4 questions and 4 hypotheses set for the purposes of work the thesis. Results Based on the analysis of available studies, the thesis confirmed that the incidence of cervicogenic headache in the general population is not negligible. It has also been proved that the diagnosis is quite frequent in patients suffering from headache, which may represent up to 35 % of patients. The results of available studies indicate that the dysfunction of the cervical spine causes 15-20 % of cervicogenic headaches. In most of the cases, it is the influence of the...

Title Cervicogenic headache Objectives It focuses on the prevalence of this disease in the general population and on the cervical spine segment where the dysfunction in patients with cervical headache occurs the most frequently. It also focuses on the effectiveness of manipulative therapies for this diagnosis. Method The thesis is conceived as a scientific literature research. In order to obtain sources professio- nal database such as Pubmed, PEDro, Medline, HighWire, Science direct were used. The thesis is divided into a theoretical and an analytical part. There have been 3 research questions set for the purposes of the thesis. Results Based on the analysis of available studies, the thesis confirmed that the incidence of cervico- genic headache in the general population is not negligible. It has been proved that the diagno- sis is quite frequent in patients suffering from headache, which may represent up to 35 % of patients. The results of available studies indicate that the dysfunction of the cervical spine causes 15-20 % of cervicogenic headaches. In most of the cases, it is the influence of the C1- C2, which is in more than 60 % of the cases. On the other hand, the influence of the AO joint is not very frequent. It only occurs in approximately 7 % of the cases. Due to the fact that the...

Objetivo: Avaliar a função da coluna cervical, utilizando testes clínicos cervicais em indivíduos com e sem Disfunção Temporomandibular (DTM) associados ou não ao relato de dor de cabeça. Métodos: Estudo Transversal. Foram avaliadas 57 mulheres com idade de 18 a 60 anos, divididas em dois grupos: DTM (n=40), e controle (n=17). Dada a alta frequência de relato de dor de cabeça a amostra de DTM foi estratificada em DTM com cefaleia (n=25) e DTM sem cefaleia (n=15). A incapacidade cervical foi avaliada pelo Índice de Incapacidade Cervical (NDI) e a dor na ATM pela Escala Visual Analógica de dor (EVA). A avaliação funcional da coluna cervical foi conduzida uma única avaliação por um examinador fisioterapeuta experiente e foi constituída pelos testes clínicos: análise da Amplitude de Movimento Ativa da Coluna Cervical (ADM); realização do Flexion-Rotation Test (FRT) e Cranio-Cervical Flexion Test (CCFT). Os sujeitos com DTM que relataram a presença de dores de cabeça foram instruídos a responder um questionário sobre as principais características da cefaleia referida. Para comparações entre os grupos foram aplicados ANOVA one way seguida por teste Post Hoc de Tukey ou por Teste Kruskall Wallis quando necessário. Para a análise de associação entre as variáveis categóricas foram aplicados Teste chi-quadrado ou Teste Exato de Fisher quando apropriado e para a análise de associação entre variáveis ordinais/contínua foram aplicados Testes de Correlação de Spearman. Resultados: Os indivíduos com DTM independente do relato de dor de cabeça apresentaram menor mobilidade no plano sagital, menores valores no FRT e apresentaram pior performance dos flexores profundos cervicais comparados aos controles (p<0.05). Além disso, os dados de ADM, FRT e CCFT foram associados com a intensidade de dor na ATM e a incapacidade cervical (p<0.01). Conclusão: Pacientes com DTM independente do relato de cefaleia apresentaram limitação na amplitude de flexão/extensão e do segmento C1-C2 da coluna cervical, além do menor desempenho dos músculos flexores profundos. Adicionalmente, a incapacidade cervical e a dor na ATM apresentaram correlação moderada com os testes funcionais cervicais nos indivíduos com DTM. / Objective: To evaluate the function of the cervical spine, using cervical clinical tests in individuals with and without Temporomandibular Disorders (TMD)associated or not to the report of headache. Methods: Were analyzed 57 women with age between 18 and 60 years, divided in two groups: TMD (n=40) and control (n=17). Given the high frequency of headache report, the TMD sample was stratified into TMD with headache (n=25) and TMD without headache (n=15). Cervical disability was assessed by the Neck Disability Index (NDI) and TMJ pain by the Visual Analogue Scale of pain (VAS). The functional evaluation of the cervical spine was conducted by a physiotherapeutic examiner with 10 years of experience and was constituted by the clinical tests: Analysis of the Cervical Range of Motion (CROM); Flexion-Rotation Test (FRT) and Craniocervical Flexion Test (CCFT). Subjects with TMD who reported the presence of headaches were instructed to answer 11 questions that contained the main characteristics of referred headache. For comparisons between control groups, TMD with Headache and TMD without Headache, ANOVA was applied one way followed by Tukey\'s Post Hoc test or by Kruskall Wallis test when necessary. For the analysis of association between the categorical variables, chi-square test or Fisher\'s exact test were applied when appropriate and for analysis of association between ordinal / continuous variables, Spearman\'s Correlation Tests were applied. Results: Individuals with TMD independent of headache report showed less mobility in the sagittal plane, lower values in FRT and showed worse performance of the deep cervical flexors compared to Controls (p<0.05). In addition, CROM, FRT and CCFT were associated with an intensity of TMJ pain and cervical disability (p <0.01). Conclusion: Patients with TMD independently of the headache report showed limited flexion / extension range and C1-C2 segment of the cervical spine, as well as deficits in the performance of the deep flexor muscles. In addition, a cervical disability and TMJ pain report showed a moderate correlation with the functional tests of FRT and CCFT in individuals with TMD.

Title: Influence of pilates method on the stabilizing system of the spine Objectives: The main aim of this diploma thesis was to confirm or refute the claim that a six-week motion program using the pilates method positively affects the stabilizing system of the spine. The partial aims of the work were to determine whether the a six-week motion program using the pilates method had a positive effect on the posture, spinal mobility, shortened muscles and standing stabilization. Methods: As a method of research, a case study was selected involving two adult persons (males). The motion program was preceded by an initial examination. In particular, static examination of the standing position, dynamic examination of standing position (flexion, extension, lateroflexion), examination of stabilization (Véle test, stand on 1 LL, standing on 2 scales), examinations of spinal distances (Schober's, Otto's and Čepojev's distance, lateroflexion), goniometry of rotation of thoracic and lumbar spine, examination of shortened muscles according to Janda (hip flexors, knee flexors, pectoralis major and minor, m.trapezius and paravertebral muscles) examination of postural stabilization by Kolář (extension test, trunk flexion test, diaphragm test, hip flexion test). Participants then underwent a six-week motion program...

In the present work we compare the effectiveness of therapy in patients with chronic non-specific low back pain (CNLBP) using classical analytical strengthening and strengthening program based on principles of physiotherapy techniques that focus on the stabilization of the spine and are used in the treatment CNLBP. The experiment included a total of 14 patients diagnosed with CNLBP who were divided into two groups (n = 7), each of who underwent a 12-week training either classical or physiotherapy conceived strengthening. As for the evaluated parameters, we chose the size and quality of pain (visual analogue scale and Short Form McGill Pain Questionnaire), restrictions in daily life in relation to LBP (Oswestry Disability Index); we tried to capture a change in the stabilizing muscle function by using a collection of tests according to Kolar (2006). The evaluation took place at the beginning and after the program and then at intervals of six months. The results showed that there was a statistically significant improvement in both groups in the monitored parameters. The difference in results in pain intensity and functional limitations in life when comparing the two groups showed statistically insignificant. Both the groups of patients improved their score in the evaluation of the stabilizing functions of...