M.Tech. / The aim of this research study was to determine the most effective way of treating sacroiliac joint dysfunction with associated gluteus medius trigger points, using adjusting of the sacroiliac joint or needling of the gluteus medius muscle or both. The participants were recruited randomly and placed in 3 different groups. Participants in group 1 were treated with an adjustment of the sacroiliac joint, as well as needling of the most prominent gluteus medius trigger point. Participants in group 2 were adjusted only and participants in group 3 were needled only. The treatment of the participants took place at the University of Johannesburg’s chiropractic day clinic. The objective data was acquired using a Digital Inclinometer to measure the ranges of motion at the spinal levels of the 5th lumbar vertebra and the first sacral vertebra (L5/ S1). An Algometer was used to measure the amount of pressure required to evoke pain, within the most prominent trigger point being treated. The subjective data was acquired using the Oswestry Pain and Disability Questionnaire, as well as the Numerical Pain Rating Scale. The results of the trial were of no statistical significance, but clinical improvement in both objective and subjective data was found. Group 2’s mean value percentage improvement was the greatest, when looking at range of motion. Group 1’s mean value percentage improvement was the greatest, with the Algometer and the subjective readings. The outcome of this study was that overall all three treatment protocols had a positive effect on the participants. Group 1 and group 2 had a slightly greater overall improvement. Thus it is suggested that when treating sacroiliac joint dysfunction with associated gluteus medius trigger points, the doctor can use an adjustment or adjusting with needling, both are effective. It is important to take the patients preference into account in order to make them feel at ease with the treatment they are receiving.

M. Tech. / Purpose: Trigger points in the paraspinal muscles are commonly associated with lameness or stiffness in horses, and unless they are “released”, muscle power and flexibility are impaired and athletic performance is reduced (Rogers, Fischer, Pontinen, and Janssens, 1996). The aim of this study was to determine the immediate and the prolonged effects of Sacroiliac mobilization on spot tenderness within the Erector spinae muscles of performance horses. Method: Horses from a selected stable yard underwent a screening process under the supervision of a qualified Chiropractor and Veterinarian to identify horses suitable for the study. Thirty horses were selected for the study based on the inclusion and exclusion criteria. The sample was divided into two groups of fifteen horses. The experiment group received mobilization therapy for SI joint restrictions, while the control group did not receive any treatment intervention. Procedure: Horses received an initial treatment and two follow ups, totaling three treatments. The first follow up treatment was two days after the initial and the second was four days post initial treatment. During these treatment sessions, trigger points in the Erector spinae muscles were located in each horse and algometer measurements were taken. Sacroiliac restrictions were then identified using motion palpation and passive range of motion as indicators. The researcher performed a mobilization technique on the Sacroiliac joints of horses in the experiment group only, and thereafter both groups were reassessed two minutes later, via an algometer, for spot tenderness within the same trigger points. The Sacroiliac restrictions and trigger points were re-assessed without treatment two weeks later. Conclusion: The results indicated that low-velocity Sacroiliac mobilization was effective in increasing the pain-pressure tolerance within the Erector spinae muscles of performance horses immediately and over the treatment period of two weeks.

No description available.

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2017. / Sacroiliac joint syndrome is diagnosed in patients who complain of various painful symptoms associated to their lower back, for example: hip and groin pain, sciatica pain, and / or a need to frequently urinate. They further report that their pain is further intensified when standing from sitting, stair walking, bending forward or from sitting or standing too long. Sacroiliac joint syndrome has been widely accepted by health professions as a contributor to low back pain. Spinal manipulation has shown to be an effective method for pain relief of this condition. Studies have been done using physical therapy in conjunction with manipulation in treating sacroiliac joint syndrome. However, little research has been done on the effects of static stretching and manipulation combined. The posterior oblique sling group of muscles is created by the biceps femoris, gluteus maximus, erector spinae and latissimus dorsi muscles. The sacroiliac joint can be affected by the functional relationship of the posterior oblique sling muscles. These muscles are involved in forces across the sacroiliac joint. Tightness of muscles can affect the sacroiliac joint. Flexibility is an essential element of normal biomechanical functioning. Flexibility of muscles, tendons and ligaments can influence a joints range of motion. There is evidence that suggests that stretching could increase a joint’s range of motion which was evident one or more days after the stretching protocol in people without clinically significant contractures. Upon review of the related literature, it appears that there is insufficient literature assessing the clinical effectiveness of static stretching of the posterior oblique muscle sling group with respect to sacroiliac joint syndrome. Therefore this study is aimed at providing insight into the role of the posterior oblique muscle sling group in participants with and chronic sacroiliac joint syndrome. It is hypothesized that effective treatment of these muscles will allow for a more effective outcome of symptoms. The study design chosen was a randomised, clinical trial consisting of thirty voluntary participants’ between the ages 18 to 45 years suffering from chronic sacroiliac joint syndrome. There were two groups of fifteen participants, who received four treatment consultations within a two week period. Participants placed into Group One received sacroiliac joint manipulation only, while participants in Group Two received static stretching of the posterior oblique muscle sling and sacroiliac joint manipulation. Subjective and objective readings were taken at the first, third and fourth (final) consultations. The Numerical Pain Rating Scale (NRS) and the Oswestry Low Back Pain Disability Index (OSW) questionnaires were used to assess the subjective findings whilst the objective measurements were collected from results of algometer and inclinometer readings. The intra-group analysis revealed there was a statistically significant improvement within both groups for NRS, OSW, and inclinometer results. It appeared that Group Two fared better in terms of the algometer (pressure) results. The inter-group analysis revealed that all comparisons apart from the algometer readings had no statistically significant improvement between the two groups. From the intra-group comparisons of the objective data, participants in both groups experienced a statistically significant improvement. However, Group Two fared better in terms of the algometric pressure readings (p = 0.001). This study confirms that both treatment protocols were effective in reducing the signs and symptoms associated with sacroiliac joint syndrome. Although the readings were not statistically significant, there is evidence that Group Two responded better than Group One in terms of the algometer readings (Figure 4.13). There is insufficient literature on studies related to the posterior oblique sling muscles, and therefore, comparisons are needed with respect to the posterior oblique muscle sling group and its effects on the sacroiliac joint. This study concludes that overall there was no statistically significant difference between the two groups and recommends that further studies be undertaken with a greater number of participants to gauge if a more significant result can be achieved. / M

京都大学 / 0048 / 新制・課程博士 / 博士(人間健康科学) / 甲第21703号 / 人健博第69号 / 新制||人健||5(附属図書館) / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 山田 重人, 教授 古田 真里枝, 教授 万代 昌紀 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

Transition analysis transforms skeletal traits with an invariant, unidirectional series of stages into a likelihood function with a maximum likelihood value and a 95% confidence interval. Boldsen et al. used transition analysis to develop an adult age estimation method employing components of the cranial sutures, pubic symphysis and ilial portion of the sacroiliac joint, used either in combination or individually. This validation study aimed to use the 36 transition analysis numerical, categorical scores for the anatomical features in conjunction with the ADBOU computer program to assess the accuracy and precision of the age estimates for 149 black individuals from the Pretoria Bone Collection. In addition, the effect of observer variability in scoring of these traits was assessed. Six age estimations were generated by the ADBOU computer program using 1) the cranial sutures only, 2) the pubic symphysis only, 3) the auricular surface of the ilium only, 4) all three features combined, 5) all three features combined and modified by a forensic prior distribution and 6) all three features combined and modified by an archaeological prior distribution. The six point estimate categories, calculated from the maximum likelihood values, were evaluated for accuracy using mean absolute values. The 95% confidence intervals were evaluated for range width and accuracy. Cohen’s Kappa statistics were used to analyse repeatability of the scoring procedure through inter- and intra-observer agreement and Kruskal-Wallis ANOVA statistics to determine the effect of observer differences on the final age estimates. The usefulness of the age ranges were diminished by large widths encompassing up to 95 years. The accuracy for the point estimates fared better for the combined skeletal indicators and overall accuracy was improved by using the archaeological prior distribution. The archaeological prior distribution was also responsible for narrowing the age ranges, especially in the older ages (over 70 years). Age estimates did not differ significantly when using inter- and intra-observer scores, but experience with the method did seem to improve results. Overall, age ranges were too wide, but accuracy could potentially be improved by adding more skeletal components to the method and using a population-specific prior distribution. The method would need considerable adjustments to make it usable in a South African setting. / Dissertation (MSc)--University of Pretoria, 2014. / tm2015 / Anatomy / MSc / Unrestricted

Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 120 leaves / Low back pain has been shown to be associated with inhibition of the lower limb musculature. This inhibition is called arthrogenic muscle inhibition (AMI). Sacroiliac joint dysfunction has been linked with AMI of the ipsilateral and contralateral quadriceps and hamstring muscles. Sacroiliac manipulation has been shown to significantly reduce ipsilateral AMI, however no studies have been conducted to illustrate the effect of sacroiliac manipulation on contralateral AMI. Neither have their been studies to show the presence or extent of spinal dysfunction between the levels of L2-L5 and its significance on muscle inhibition in the quadriceps and hamstring muscles, nor the effect of manipulation of these levels on AMI of the quadriceps and hamstring muscles. The purpose of this study was therefore to determine whether spinal manipulation has an effect on AMI of the contralateral limb as well as that of the ipsilateral limb.

Objective : Low back pain (LBP), and in particular sacroiliac joint syndrome, is a significant health concern for both patient and their chiropractor with regards to quality of life and work related musculoskeletal disorders. Therefore, chiropractors often utilise mechanical aids to reduce the impact on the chiropractor’s health. It is, however, important to establish whether these mechanical aids are indeed clinically effective, therefore, this study evaluated the Activator Adjusting Instrument (AAI) against an AAI placebo to determine whether this adjusting instrument is an effective aid for both the chiropractor and the patient. Method : This randomised, placebo controlled clinical trial consisted of 40 patients (20 per group), screened by stringent inclusion criteria assessed through a telephonic and clinical assessment screen. Post receipt of informed consent from the patients, measurements (NRS, Revised Oswestry Disability Questionnaire, algometer) were taken at baseline, prior to consultation three and at the follow consultation. This procedure occurred with four interventions over a two week period. Results: The AAI group showed clinical significance for all clinical measures as compared to the AAI placebo group which attained clinical significance only for the Revised Oswestry Disability Questionnaire. By comparison there was only a statistically significant difference between the groups in terms of the algometer readings (p= 0.037). Conclusion : Therefore, it is evident that the AAI seems to have clinical benefit beyond a placebo. However this is not reflected in the statistical analysis. It is, therefore, suggested that this study be repeated with a larger sample size in order to verify the effect on the statistical analysis outcomes.

Submitted in partial compliance with the requirements for the Masters’ Degree in Technology: Chiropractic, Department of Chiropractic, Durban University of Technology, Durban, South Africa, 2014. / Background: Spinal manipulation has been shown to result in neurophysiological changes, most often noted in the paraspinal muscles. These effects have been associated with an increase in paraspinal muscle contractibility; it is unclear if this leads to an increase in paraspinal muscle endurance. Objectives: To determine the effect of sacroiliac joint (SIJ) manipulation compared to a placebo treatment of the SIJ on lumbar extensor muscle endurance time. Method: A randomised, placebo-controlled pre-test post-test experimental trial, involving 40 asymptomatic male participants divided into an intervention group receiving SIJ manipulation using an impulse adjusting instrument and a placebo group receiving a pre-load force without the delivery of an impulse thrust. Outcome measures were lumbar extensor muscle endurance time, surface electromyographic (SEMG) readings, lumbar spinal range of motion, paraspinal muscle length assessment and a subjective pain measurement. Results: There was a significant difference between the groups (p=0.004) with the SIJ manipulation group showing an increase in endurance time compared to the placebo group which showed a decrease. SEMG readings increased for both groups with no statistically significant difference between the groups (p>0.05). Only extension lumbar spinal range of motion significantly improved in both groups (p=˂0.001) with no significant differences between groups (p=0.876). Only one participant reported pain during the research procedure. Conclusions: SIJ manipulation may enhance the endurance of the paraspinal muscles. This study should be conducted in a larger sample to validate the findings.

The sacroiliac joint (SIJ) is frequently involved in low back and pelvic girdle pain. However, morphometrical and functional characteristics related to SIJ pain are poorly defined. Pelvic belts represent one treatment option, but evidence still lacks as to their pain-reducing effects and the mechanisms involved. Addressing these two issues, this case-controlled study compares morphometric, functional and clinical data in SIJ patients and healthy controls and evaluates the effects of short-term pelvic belt application.