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Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of technology, 2002. / Background: Low back pain is a common problem for which many conservative treatments are available. Spinal manipulation is considered one of the most effective of these treatments. Interferential therapy is widely used especially for pain control and often forms part of a treatment protocol. However, there is little clinical evidence to support this usage. Objective: The purpose of this investigation was to evaluate the effectiveness of interferential current therapy as an adjunct to manipulation in the treatment of acute mechanical low back pain in terms of subjective and objective measures. Methods: Sixty subjects suffering from acute mechanical low back pain were recruited through advertising and randomly divided into two groups with thirty patients each. Group A received manipulation and interferential therapy and group B received manipulation only. Both groups received 4 treatments and a follow-up consultation over a 2 week period. Subjective measurements were taken using the Numerical Rating Scale - 101and revised Oswestry low back pain questionnaire. Objective measurements were taken using an algometer and an orthopaedic rating scale. All measurements were taken before treatment on the first, third and fifth consultations. Statistical inter-group analysis was completed using the two sample unpaired t-test and the Mann-Whitney U-test. Friedman's T test was used to evaluate the intra-group information. The null hypothesis was rejected at a = 0.05 level of significance. Results: Both treatment groups A and B achieved a significant improvement in pain and disability over the treatment period. However, no significant differences in terms of pain and disability could be found between the two groups at any stage during, or at the end of the treatment period. / M

M.A. / The power of positive thinking to promote and maintain well-being has enjoyed widespread popular appeal. Spurred largely by the development of the Life Orientation Test (LOT) (Scheier & Carver, 1985), mounting evidence now attests to the apparent benefits conferred by an optimistic life outlook. Optimism, the inclination to expect favourable outcomes, has been linked to both psychological and physical well-being (Taylor, et al., 1992; Cheng & Hamid, 1997; Marshall, Wortman, Kusalas, Hervig, & Vickers, 1992; Scheier, Carver & Bridges, 1994; Scheier et al., 1989; Segerstrom, Taylor, Kemeny, & Fahey, 1998). Optimists and pessimists have been shown to differ in the manner in which they cope with the challenges in their lives. They differ in their stable coping tendencies and in the kinds of coping responses that they spontaneously generate when given hypothetical coping situations (Scheier, Weintraub, & Carver, 1986). Optimists also differ from pessimists in the manner in which they cope with serious disease and with concerns about specific health threats (Friedman, et al., 1992), and these coping mechanisms in optimists in turn have been linked to improved physical and psychological functioning. There is also a clear biological link between optimism and physical well-being and this has been noted in such areas as immune functioning (Peterson & Bossio, 2002). The current study examines these apparent benefits of optimism on health and explores the medical bases for this connection. The study also examines whether these benefits may be of use in the treatment and recovery from the unique secondary medical complications experienced by those who are spinal cord injured.

M. Tech. / It has been noted in the literature that the sensory system consists of the visual, vestibular and somatosensory systems (Guyton and Hall, 1997; Arnold and Schmitz, 1998; Murphy, 2000; Nakata and Yabe, 2001; Magee, 2002 and Gatterman, 2004). In congruence with the above authors Katz (1996), Gatterman (2004) and Murphy (2000), Morningstar, Pettibon, Schlappi, Schlapp and Ireland (2005) further stated that the postural reflexes can be subcategorised as the following: visual righting reflex, labyrinthine righting reflexes, neck righting reflexes, body on head righting reflexes and body on body righting reflexes. Each of these neurological mechanisms plays a role in balance / equilibrium. Furthermore it has been shown that spinal manipulative therapy has an effect on neurological systems. Therefore it stands to reason that spinal manipulative therapy may have an effect on balance or equilibrium.

The dimensions of the cervical spinal canal (C3 – C7) of the South African black population were measured on skeletal remains of 179 individuals (90 males and 89 females divided into age categories of 30-45; 46-60 and 61-75 years), and compared to measurements taken from CT-scans of 55 individuals divided into the same categories. There was no significant difference between measurements taken on skeletal material and CT-scans. The spinal canal is larger in males (mean = 13.96mm) than in females (mean = 13.84mm) and the Pavlov ratio is larger for females (mean = 0.89) than males (mean = 0.81). The Pavlov ratio seems to overestimate the occurrence of spinal stenosis in this population group, as almost all individuals older than 46 years are classified as stenotic according to this ratio. The shape of the cervical spinal canal was determined morphometrically by processing digital images taken of vertebrae (C3 – C7) of 60 individuals with the tps-Series of software programs and was found to be significantly different between males and females. In males the canal is congenitally triangular, whereas in females the canal assumes a more “safe”, rounded shape. The low Pavlov ratio for this population group, especially in males, can possibly be explained by these shape differences. Even slight degenerative changes affecting the spinal canal, such as osteophytosis or ossification of the posterior longitudinal ligament (OPLL), will alter the triangular-shaped male canal in such a way that the spinal cord may become compromised. Cervical vertebrae of 107 individuals were inspected for occurrence of osteophytes within the spinal canal and the incidence of OPLL. Osteophyte occurrence within the cervical spinal canal is the same for males and females and OPLL occurs frequently within this population group, especially in the cephalic region (incidence: C3 = 64.5%; C4 = 47.7%; C5 = 21%; C6 = 12.2%; C7 = 7.5%). / Dissertation (MSc (Anatomy))--University of Pretoria, 2008. / Anatomy / unrestricted

A dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic at Technikon Natal, 1998. / The absence oftested theory has resulted in the continued variation of treatment protocols in the treatment of mechanical low back pain. This study was designed to determine the relative effectiveness of specific passive mobilization versus spinal manipulation in the treatment of uncomplicated mechanical low back pain. It was hypothesized that both spinal manipulative therapy and specific passive mobilization would be effective, but that manipulation would be significantly more effective in terms of objective and subjective findings, over the same two week treatment period / M

Spinal Cord Injury (SCI) often causes cell death, demyelination, axonal degeneration and cavitation, resulting in functional motor and sensory loss below the site of injury. In an attempt to overcome SCI, the regenerating neurons require a permissive environment to promote their ability to reconnect. We report a novel thiolated hyaluronic acid (HA) hydrogel scaffold that can be used to repair the injured spinal cord. More specifically, thiolated hyaluronic acid hydrogels with varying thiol concentrations were successfully synthesized. The amount of thiol groups was measured spectrophotometrically using Ellman’s test. HA gels with different crosslinking densities were synthesized and the water content of the hydrogels was determined. The thermal behavior of the HA gels were studied by DSC. The strength of the hydrogels with varying thiol group content was evaluated by a rheometer. In addition, in vitro enzymatic degradation was performed through submerge the hydrogels in 200U/ml of hyaluronidase solution and incubate at 37°C. According to the result of the present study, this novel hydrogel shows great potential to serve as a 3D cell-patterning scaffold which can be inserted into a hollow fiber channel that could be used to promote regeneration after the SCI.

Maturation of motor control, including movements that can be autonomously generated by spinal circuits, relies on the development of key inputs to spinal circuitry. In particular, the development of supraspinal, sensory and motor fibers come together to form organized spinal circuits capable of producing skilled movements that are volitionally controlled. Primitive reflexes such as the palmar grasp reflex (PGR) are known to disappear during development; presumably giving way to more volitional control of hand grasping. However, the underlying changes to the spinal circuitry responsible for this transition remain to be determined. dI3 INs, a class of dorsal spinal interneurons, have positioned themselves as key mediators of reflexive grasping in early development and grasping in adult mice. The first aim of the study focused on determining the developmental time point at which the PGR disappeared. Our studies demonstrated that the PGR was lost by the third week of development. The second aim of this study focused on identifying changes in sensory innervation, presynaptic inhibition and supraspinal excitation to dI3 INs that might account for the loss of this reflex. Our studies demonstrated that while sensory innervation remained constant during development, presynaptic inhibitory terminals onto sensory afferents were found to increase during development. In addition, we report that dI3 INs receive decreasing corticospinal (CST) input during development. While these developmental changes do not fully account for the disappearance of the PGR, they provide valuable insights into how a reflex centered on a particular population develops.

M.Tech.

M.Tech. / Palpation is a skill taught to manual practitioners on a daily basis. This skill is used by health care professionals, including chiropractors, to examine patients complaining of spinal pain. It is the chiropractor’s responsibility to have the ability and experience to locate and identify individual spinal levels, as well as any changes in tissues affected, to accurately diagnose and treat their patients (Downey, Taylor and Niere, 1999). The inability of the therapist to have this skill, can lead to incorrect diagnosis, and in turn, incorrect treatment being provided (Downey et al, 1999). Numerous research studies have been conducted to determine how significant clinical experience is in terms of reliable palpation being achieved. Researchers such as Koran (1975) and McConnell (1980), Simmonds and Kumar (1993), McKenzie and Taylor (1997), Burton and Edwards (1990) have all been unable to support the hypothesis that experience plays a significant role in improving inter-examiner or intra-examiner reliability in their research studies. This study aims to determine the inter-examiner reliability of locating the spinous process of the seventh cervical vertebra by palpation, and to explore the role that clinical experience plays upon efficacy. Thirty participants were recruited to become part of this study. The 6 examiners chosen consisted of two 5th year and two 6th year chiropractic students as well as two qualified chiropractors. A random allocation was used which ensured that every participant was examined by 3 examiners, each from the different clinical experiences. Examiners were provided with instructions before proceeding with the study. Each participant was palpated to locate the C7 spinous processes and once located, the level was marked with a UV pen. The UV marks were located by illuminating with a UV light and these were replaced with metal markers. Each participant was then positioned to have both the AP and lateral x-ray views done. vii Once all participants were x-rayed, horizontal lines were drawn through the C7 spinous processes and metal markers on both the AP and lateral x-ray films. Distances from the lines through the spinous processes to each metal marker, were measured. The provided statistical tests were used to analyse the data. According to the Pearson Chi-square test used, there was no statistically significant difference amongst all examiners on the ability to correctly palpate, locate and mark the C7 spinous processes. Results further showed that the 6th year students correctly identified more levels on the AP x-ray films, whilst both 6th year students and the qualified chiropractors correctly located more and equal levels on the lateral x-ray films. This study showed that there were difficulties amongst all examiners across all levels of clinical experience and this important role of experience is therefore not fully understood.