Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2008. / lntroduction: Swimming is one of the most popular participation sports 1 as people are drawn to swimming for leisure, cardiovascular workouts, or competition 2 . As a result, the sport of swirnrninq has improved 9reatly over the past 20 years 3 . Olbjectoves: The aim of this study was to determine a profile of musculoskeletal injuries in competitive swimmers in the greater Durban area of KwaZulu-Natal, South Africa; as well as to determine whether any relationships exist between swimming injuries sustained in this study and the risk factors identified in other studies, and to compare the results with international data. Therefore; for the purpose of this study, the following information was gathered in order to build up an injury profile: o Demographics of competitive swimmers in South Africa, o The participants swimming history, o The presence of any past or current injuries and o Factors associated with current and previous injuries were also investigated. This study was a prospective, cross-sectional, questionnaire based study, investigating the profile of musculoskeletal injuries in 101 competitive swimmers in the greater Durban area. The data was collected by means of a self-administrated questionnaire, which was completed by the participants, under the supervision of the researcher, parents or coach. / M

A dissertation presented in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban University of Technology, 2007. / Objective: The aim of this study was to investigate the relative effectiveness of TENS, versus, needling, versus Electro-needling in the treatment of MTSS. First objective The first objective was to evaluate the effectiveness of TENS therapy on MTSS with respect to the patients subjective and objective responses to the treatment. Second Objective The second objective was to evaluate the effectiveness of needling therapy on MTSS, with respect to the patient’s subjective and objective responses to the treatment. Third Objective The third objective was to evaluate the effects of electro-needling on MTSS, with respect to the patients’ subjective and objective responses to the treatment. Fourth Objective The fourth objective was to integrate the subjective and objective data collected in order to determine the viability of each of the therapies in comparison to one another as treatment options of MTSS. / M

Advances in health care science are enabling greater numbers of spinal cord injured persons to live to old age. As these persons grow older, there may be additional problems in coping due to stressors such as decreasing health and income and loss of significant others. The purpose of this study was to determine those factors that contribute to the well-being of middle-aged and elderly community-residing spinal cord injured persons. One hundred spinal cord injured persons ranging in age from 40 to 73 were interviewed. Extensive data were collected in order to investigate the relationship among social support, types of social comparisons made, perceived control, health status and psychological well-being and life satisfaction. In general, respondents reported a degree of well-being that was slightly lower than that reported in studies of nondisabled populations on the same measures of psychological well-being, life satisfaction, and depression. Pearson correlations and multiple linear regressions showed that persons reporting high levels of well-being made favorable social comparisons, reported high levels of perceived control over their lives, had high levels of social support, and judged their health status to be good. They also viewed their disability more favorably and tended to have higher incomes, more education, to be employed, and to be more religious than those indicating lower levels of well-being. The severity of the spinal cord injury was not correlated highly with subjective well-being, although there was a tendency for persons with greater disabilities to report lower levels of well-being. Persons who were younger and who incurred their disability at a younger age also tended to report higher levels of well-being. A model of well-being is proposed. This model suggests that social support fosters the perception of control and the making of favorable social comparisons which, in turn, foster a sense of well-being and satisfaction with life. This model provides direction for future research and has valuable implications for clinical application.

The objective of this study was to investigate the intra-rater (within day & between days) and inter-rater reliability of foot/ankle water volumetry in healthysubjects.Study design: Repeated measures design with 2 raters.Background: Physiotherapists more often aim to reduce swelling in the acute phase of soft tissue injury. Reduction in swelling will hasten the healing process. Therefore swelling forms an important outcome measure that is worth studying during the healing process to determine the efficacy of the intervention. Though there are different methods available to measure extremity swelling, water displacement method is widely used in physiotherapy studies. Although water volumetry has been used to assess the reduction in swelling over time, there is paucity of reliability studies that have assessed the between-days reliability.Methods: Thirty normal subjects with asymptomatic ankles were measured by 2 raters. Three repeated foot volume measurements were performed by each of the rater using water volumetry during a single test session. The same procedure was repeated approximately at the same time on the 3rd day and 5th day following the 1st measurement day by the same raters on the same subjects. The raters were blinded to each other's measurements. The order for rater's volumetric measurement on each subject on each day was determined by a random chart produced by SPSS. The reliability was measured in terms of systematic bias (Paired t test & Bland & Altman's plot), absolute reliability (Limits of Agreement [LOA] & Standard Error of Measurement [SEM]) and relative reliability (Intraclass Correlation Coefficient [ICC]).Results: There was no systematic bias between any of the trials within day/between days or between raters. The intra-rater reliability within day as calculated by ICC; LOA and SEM were 0.99, ±10ml and ±3.5ml respectively and for between days reliability the values were 0.99 (ICC), ±20ml (LOA) and ±7ml (SEM) and for interrater reliability the values were 0.99 (ICC), ±13ml (LOA) and ±5ml (SEM). The results demonstrated that water volumetry method was highly reliable within day and between days for both the raters; and highly reliable between raters.Conclusion: Water volumetry is a highly reliable method for measuring foot/ankle volume repeatedly on different days. The random error range in milliliters (ml) as estimated by the absolute reliability indices provides the practical use of this method in a clinical/research setting.

This study placed specific emphasis on the motor-skills and practice strategies employed by piano players when practising and performing in relation to playing-related musculoskeletal disorders (PRMDs). The survey questionnaire-instrument was designed by the researcher to investigate the prevalence of PRMDs among both professional and non-professional piano players. Five hundred and five respondents completed the self-administered survey questionnaire. Out of the total 505 participants, 42% of the players reported PRMDs. The professional players (72%) reported a significantly higher incidence (p < 0.05) of PRMDs in comparison with the non-professional group. The professional players with piano as their major instrument, using predominantly neutral wrist posture (i.e., open-kinetic chain playing technique), reported a significantly higher incidence of PRMDs. Although the present study showed a greater number of years of playing was associated with greater risk of PRMDs, the result also showed that the years of playing had no significant effect on the incidence of PRMDs (p > .05) when it was analyzed with the practice hours within seven days. Moreover, analyzing the practice hours over seven days with the piano major/non-major instrument, the various grade levels and PRMDs; the results showed that the practice hours had no significant effect on the groups with and without PRMDs (p > .05). Although women reported a significantly higher percentage of PRMDs (p < 0.05) than men, there was no significant association between the groups with and without PRMDs when analyzing practice hours over seven days by grade levels and gender. The PRMDs seem to arise when overuse is compounded by misuse and/or adverse playing conditions. The best and safest practice would be to minimize consumption of musculoskeletal force production and combine this with effective practice-breaks between sessions to achieve the optimum goal of daily practice. Keywords: hand injury, PRMDs, wrist pain, hand-span size, playing-technique, and piano player.

[Truncated abstract] Autologous Chondrocyte Implantation (ACI) has shown early clinical success as a repair procedure to address focal articular cartilage defects in the knee, and involves isolating and culturing a patient's own chondrocytes in vitro and re-implantation of those cells into the cartilage defect. Over time, repair tissue can develop and remodel into hyaline-like cartilage. A progressive partial weight bearing (PWB) program becomes the critical factor in applying protection and progressive stimulation of the implanted cells, to promote best chondrocyte differentiation and development, without overloading the graft. The aim of this thesis was to investigate whether patients could replicate this theoretical load bearing model to possibly render the best quality tissue development. In addition, this proposed external load progression is only a means to loading the articular surface. Several factors, including those that may result from pathology, have the potential to influence gait patterns, and therefore, articular loading. The association between increasing external loads (ground reaction forces - GRF) and knee joint kinetics during partial and full weight bearing gait was, therefore, investigated in the ACI patient group, as was the contribution of other gait variables to these knee joint kinetics which may be modified by the clinician. Finally, current weight bearing (WB) protocols have been based on early ACI surgical techniques. With advancement in the surgical procedure and ongoing clinical experience, we employed a randomised controlled clinical trial to assess the effectiveness of an 'accelerated' load bearing program, compared with the traditionally 'conservative' post-operative protocol. ... Although similar spatio-temporal, knee kinematic and external loading parameters were observed between the traditional and accelerated rehabilitation groups, the accelerated group was 'more comparable' to the controls in their external knee adduction and flexion moments, where the traditional group had lower knee moments. Knee moments greatly affect knee articular loading, and large adduction moments have been related to poor clinical outcomes after surgery. Therefore, the return of normal levels may be ideal for graft stimulation, however, may overload the immature chondrocytes. Acceleration of the intensive rehabilitation program will enable the patient to return to normal activities earlier, whilst reducing time and expenses associated with the rehabilitative process, and may enhance long-term tissue development. However, continued follow-up is required to determine if there are any detrimental effects that may emerge as a result of the accelerated load bearing program, and assess the recovery of normal gait patterns and whether longer term graft outcomes are affected by the recovery time course of normal gait function, and/or abnormal loading mechanics in gait. Furthermore, analysis at all levels of PWB is needed to identify a more complete set of variables attributing to the magnitude of external knee joint kinetics and, therefore, knee articular loading, while the influence muscle activation patterns may have on articular loading needs to be investigated. This becomes critical when you consider loads experienced by the articular surface throughout the early post-operative period following ACI may be important to short- and long-term graft development.

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No description available.

This thesis focuses on the effects of pharmacological and environmental interventions following perinatal prefrontal cortex lesions. Rats given postnatal day 3 medial prefrontal cortex lesions were provided with one of the following treatments: basic fibroblast growth factor (bFGF), complex-housing, tactile stimulation, or a combined treatment of both bFGF and tactile stimulation or bFGF and complex-housing. Rats given postnatal day 3 orbital prefrontal cortex lesions were housed in a complex environment. The findings of these studies suggest that bFGF, complex-housing or tactile stimulation are beneficial after early brain injury. The combined treatment of bFGF with complex-housing provides a synergistic effect, as the combined condition is more advantageous than bFGF alone. In contrast, the combined treatment of bFGF with tactile stimulation produced adverse effects. These results suggest that pharmacological and environmental manipulations change cortical plasticity and therefore functional recovery after neonatal cortical injury. / xv, 177 leaves : ill. (some col.) ; 29 cm.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic Faculty: Health Sciences, Durban University of Technology, 2009 / Aim To determine the profile of traumatic cervical spine fractures with respect to the epidemiology, clinical presentation, types of fractures, conservative and surgical intervention, short-term post-intervention (i.e. post-conservative and post-surgical) complications and short-term post-surgical rehabilitation of patients presenting at the Spinal Unit of King George V Hospital over a 12-week period. Methods Patients who presented to the King George V Hospital Spinal Unit from surrounding hospitals with traumatic cervical spine fractures were evaluated by the medical staff. Data concerning the epidemiology, clinical presentation, types of fractures, conservative and surgical intervention, short-term post-intervention (i.e. post-conservative and postsurgical) complications and short-term post-surgical rehabilitation data were recorded by the researcher. A p-value of <0.05 was considered as statistically significant. Appropriate statistical tests were applied to the hypothesis-testing objectives. These involved the Pearson’s Chi Square Tests for categorical variables or Fisher’s Exact Tests as appropriate where sample sizes were small. Paired t-tests were done to compare preand- post-surgical Frankel grading and Norton Pressure Sore Assessment scores. Results The number of patients who presented to the Spinal Unit over a 12-week period was 20, of this number 17 were males, three were females and all were black. Eleven patients were treated surgically while nine patients were treated conservatively. The most frequent aetiology of cervical spine fractures was motor vehicle accidents (n = 10) followed by falls (n = 9). The most common co-existing medical conditions were smoking (n = 7), HIV (n = 5), alcohol abuse (n = 3) and obesity (n = 3). The most frequent locations of cervical spine fractures were C2 (n = 6), C1 (n = 4) and the posterior column of C6 (n = 3), while dislocations occurred primarily at the C5-C6 levels (n = 5) of the lower cervical spine. Odontoid fractures (n = 6), Jefferson’s fractures (n = 4) and unilateral facet dislocations (n = 6) were the most common fractures and dislocations v observed. Head injuries (n = 4) and lower limb fractures (n = 3) were the most common extra-spinal fractures. All subjects who sustained head injuries also had associated C1 or C2 fractures. Neurological complications most frequently involved the upper limb where loss of motor function (n = 8) and weakness (n = 4) were observed. The majority of the patients (n = 8) reported a Frankel Grading of E. There were no significant associations between types of fracture and gender with the exception of fracture/dislocation observed in two females. There was a statistically significant difference in the NPSA score (p = 0.004). Conservative care utilized included soft collar (n = 6), cones calipers (n = 6), physiotherapy (n = 4), Minerva jacket (n = 4) and SOMI (sterno-occipital mandibular immobilization) brace (n = 1) while surgical intervention included anterior decompression (n = 8), anterior fusion (n = 8), allograft strut (n = 8), discectomy (n = 8), anterior cervical plating (n = 8), anterior screw fixation (n = 2), a transoral approach (n = 1) and a corpectomy (n = 1). The short-term post-conservative care complications observed in this study were an occipital pressure sore (n = 1), severe discomfort (n = 1) as well as severe neck pain (n = 1), while the short-term post-surgical complications were severe neck pain (n = 2), oral thrush (n = 1), pneumonia (n = 1), odynophagia (n = 1) and hoarseness (n = 1). Of the 11 patients who underwent cervical spine surgery, ten were sent for physiotherapy and one for occupational therapy. No significant associations were seen between the type of cervical spine fracture and the age of the subject. There was a significant association between fracture/dislocation and the female gender (p = 0.016). There was significant negative association between odontoid fracture and: anterior decompression, anterior fusion, allograft strut, discectomy and anterior cervical plating (p = 0.006). Conclusion The results of this study reflect the presentation and management of cervical spine fractures at a referral spinal unit of a public hospital in KwaZulu Natal. The impact of HIV and other co-existing medical conditions were not determined due to the small sample size in this study. Further epidemiological studies are required to be conducted in the Spinal Units of all South African public hospitals in order to confirm or refute the observation of this study.