The primary objective of this study was to determine the acceleration characteristics of spinal manipulative therapy (SMT) and whether patient anthropometric parameters correlated with the SMT kinematic parameters. For this, a wireless tri-axial accelerometer was taped to the dorsum of a clinician’s hand to record the accelerations generated during clinical treatment of 95 symptomatic patients. Peak acceleration magnitudes differed significantly between spinal levels (p<0.0001; lumbar > cervical > thoracic = sacroiliac). The latencies of these peaks were also significantly different (p<0.0001; lumbar < cervical = thoracic < sacroiliac). Within a given spinal level, acceleration amplitudes varied over a wide range with temporal parameters remaining relatively constant. Overall, anthropometric parameters were poorly correlated with SMT parameters. In summary, distinct acceleration amplitudes were observed across spinal levels with relatively constant temporal factors. Thus, clinicians appear to vary the magnitude rather than the duration of the SMT thrust.

This thesis examined two aspects of information processing by the feline spinal cord during centrally-evoked motor activity: 1) the modification of transmission from different sensory afferents and 2) the neuronal elements of reflex pathways from group II muscle afferents during fictive motor behaviours (i.e motoneuron activity under neuromuscular blockade). Fictive locomotion was evoked by electrical stimulation in the midbrain and fictive scratch was triggered by stimulation of the skin covering the ears following curare application to cervical dorsal roots in decerebrate in vivo feline preparations. Both monosynaptic and longer latency components of muscle and cutaneous afferent-evoked field potentials were reduced in amplitude during fictive locomotion and scratch, but field potentials evoked by muscle group II afferents were suppressed more than those evoked by cutaneous and group I muscle afferents recorded at the same spinal locations. The novel finding, that field potentials evoked at the same spinal locations by muscle and cutaneous afferents are suprressed differently, suggests that there is a preferential and non-uniform control of transmission from muscle and cutaneous fibres during motor activity. Extracellular recordings from neurons within the lumbar spinal segments showed that suppression of group II afferent input during fictive motor activity results in a powerful reduction of the activation of neurons with input from muscle group II afferents in 93% of the examined neurons after short trains of stimuli were delivered to peripheral nerves. However, more neurons remained recruitable by group II intensity stimulation if train duration was sufficiently long with only 33% showing a reduction in sensory-evoked firing. The majority of the neurons that remained responsive to muscle group II afferent input during fictive locomotion had axonal projections to supralumbar, or supraspinal areas and showed spontaneous, often rhythmic, firing activity. Overall, the studies presented in this thesis provide insights into the mechanisms by which the mammalian spinal cord processes sensory information and on how sensory input is able to control motor activity in spite of suppressive control provided by the nervous system.

The primary objective of this study was to determine the acceleration characteristics of spinal manipulative therapy (SMT) and whether patient anthropometric parameters correlated with the SMT kinematic parameters. For this, a wireless tri-axial accelerometer was taped to the dorsum of a clinician’s hand to record the accelerations generated during clinical treatment of 95 symptomatic patients. Peak acceleration magnitudes differed significantly between spinal levels (p<0.0001; lumbar > cervical > thoracic = sacroiliac). The latencies of these peaks were also significantly different (p<0.0001; lumbar < cervical = thoracic < sacroiliac). Within a given spinal level, acceleration amplitudes varied over a wide range with temporal parameters remaining relatively constant. Overall, anthropometric parameters were poorly correlated with SMT parameters. In summary, distinct acceleration amplitudes were observed across spinal levels with relatively constant temporal factors. Thus, clinicians appear to vary the magnitude rather than the duration of the SMT thrust.

This thesis investigated the relationship between the three-dimensional kinematics of the human back and spinal pathology. This required the development of a system capable of the in vivo measurement of spinal movement non-invasively and in three-dimensions. The opto-electronic CODA-3 Scanner proved unsatisfactory in this respect. The electro-magnetic 3SPACE Isotrak, however, was found to be an accurate and reliable system during a study of twisting in flexed postures. Available axial rotation was significantly increased in some degree of sagittal flexion suggesting that this may be a mechanism for intervertebral disc injury. At high degrees of sagittal flexion a reduction in available axial rotation was noted. In vitro tests on isolated lumbar motion segments confirmed the increase in axial rotation available in flexed postures shown in vivo, this was presumed to be due to an opening of the lumbar zygapophysial joints. Mechanical testing of lumbar interspinous and supraspinous ligaments showed them to be active only in the extremes of sagittal flexion and hence that they could be responsible for the reduction in axial rotation seen in vivo. The 3SPACE Isotrak was used in a clinical study of 80 normal and 43 pathologic subjects. In the normals ranges of motion were, in general, reduced with increasing age in both males and females although a significant increase in sagittal flexion occurred with increasing age in females. Male mobility significantly exceeded female in sagittal flexion but female tended to exceed male in extension, lateral bend and axial rotation. Opposite axial rotation occurred consistently upon lateral bend and vice versa, flexion also occurred on lateral bend but not axial rotation. There was widespread disruption to the primary and coupled movements of the back pain patients when compared to normal movement patterns but there was no clear distinction between the kinematic movement patterns of discrete patient groups. The small numbers in these patient groups warrant a further, more detailed, clinical study.

This thesis examined two aspects of information processing by the feline spinal cord during centrally-evoked motor activity: 1) the modification of transmission from different sensory afferents and 2) the neuronal elements of reflex pathways from group II muscle afferents during fictive motor behaviours (i.e motoneuron activity under neuromuscular blockade). Fictive locomotion was evoked by electrical stimulation in the midbrain and fictive scratch was triggered by stimulation of the skin covering the ears following curare application to cervical dorsal roots in decerebrate in vivo feline preparations. Both monosynaptic and longer latency components of muscle and cutaneous afferent-evoked field potentials were reduced in amplitude during fictive locomotion and scratch, but field potentials evoked by muscle group II afferents were suppressed more than those evoked by cutaneous and group I muscle afferents recorded at the same spinal locations. The novel finding, that field potentials evoked at the same spinal locations by muscle and cutaneous afferents are suprressed differently, suggests that there is a preferential and non-uniform control of transmission from muscle and cutaneous fibres during motor activity. Extracellular recordings from neurons within the lumbar spinal segments showed that suppression of group II afferent input during fictive motor activity results in a powerful reduction of the activation of neurons with input from muscle group II afferents in 93% of the examined neurons after short trains of stimuli were delivered to peripheral nerves. However, more neurons remained recruitable by group II intensity stimulation if train duration was sufficiently long with only 33% showing a reduction in sensory-evoked firing. The majority of the neurons that remained responsive to muscle group II afferent input during fictive locomotion had axonal projections to supralumbar, or supraspinal areas and showed spontaneous, often rhythmic, firing activity. Overall, the studies presented in this thesis provide insights into the mechanisms by which the mammalian spinal cord processes sensory information and on how sensory input is able to control motor activity in spite of suppressive control provided by the nervous system.

Wheelchair prescription is a highly complex clinical practice. Evidence exists that long term success of wheelchair prescription is not always achieved and that rehabilitation professionals are experiencing increasing pressure to demonstrate accountability and cost containment in this area of service delivery. Occupational therapists within a spinal injury unit in South Australia conducted a quality activity to evaluate their wheelchair prescription practice. The quality activity involved consecutive sampling techniques to collect data on 128 wheelchair users who had a wheelchair prescribed between November 1993 and January 1996. / Demographic data related to the wheelchair user, the technology and the environment were collected at the time of the wheelchair prescription. Outcome measures were used at the time of wheelchair prescription and repeated at 3 months and again at 12 months post prescription. Outcome measures included 5 point self-rating scales for satisfaction with the wheelchair and sitting comfort. Rating scales were also used to measure postural symmetry, wheelchair skills and wheelchair maintenance knowledge. / In 1999, a 5 year follow-up was commenced to investigate what factors influence wheelchair prescription outcome after five years. Wheelchair users involved in the quality activity were invited to participate in this 5 year follow-up. Of these, 94 people agreed to participate in the 5 year follow-up. A repeated-measures study design was employed with outcome measures used during the quality activity repeated in an identical fashion. Additional measures were used to gain information regarding wheelchair abandonment. / Analysis involved Multiple Regression techniques for the prediction of outcomes where rating scales were used and Logistic Regression techniques where dichotomous variables were used. The possibility of early predictors of a successful long-term outcome was explored. / This study found wheelchair prescription outcomes changed significantly over 5 years with all outcomes except for wheelchair skills demonstrating a significant decrease over time. Significant positive associations were found between wheelchair user's satisfaction and comfort and between postural symmetry and wheelchair maintenance knowledge. / Reported level of comfort at 3 months post wheelchair prescription was found to be an early predictor of a successful long-term outcome. Abandonment rates were found to be lower than general assistive technology rates reported elsewhere. / Findings from this research support the importance of the direct relationship or 'fit' between the wheelchair user and the technology as a key factor in the achievement of successful short and long-term wheelchair prescription outcomes. Wheelchair prescription outcomes changed over time as a result of a change in this relationship. That is, as the condition of the wheelchair deteriorated or the person's needs changed, the 'fit' between the person and the wheelchair changed affecting important outcomes such as wheelchair user satisfaction comfort and posture. / Findings from this study provide valuable information an a little researched area. In this way, these findings may be useful in informing prescription practices which promote the provision of wheelchairs that meet the unique needs of the wheelchair user at the time of prescription and into the future. / Thesis (MApSc(OccupationalTherapy))--University of South Australia, 2004

Thesis (MPhysio)--University of South Australia, 1998

Thesis (M.E.)--University of Canterbury, 2007. / Typescript (photocopy). Includes bibliographical references. Also available via the World Wide Web.

Thesis (M.D.)--University of Melbourne, 1986. / Spine title: Risk factors in traumatic spinal cord paralysis. "An analysis of 124 consecutive admissions to the Victorian Spinal Injuries Unit, Austin Hospital from 1st March, 1983 to 28th December, 1984." Typescript (photocopy). Includes bibliographical references (v. 4, leaves 745-754).

Diss. (sammanfattning) Stockholm : Karol. inst. / Undertitel på omsl.: experimental studies of neorochemistry and behaviour. Härtill 9 uppsatser.