by Man Hon Ming. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1990. / Bibliography: leaves 91-111. / ABSTRACT --- p.I / ACKNOWLEDGEMENT --- p.V / TABLE OF CONTENTS --- p.VI / LIST OF TABLES --- p.X / LIST OF ILLUSTRATIONS --- p.XII / Chapter CHAPTER 1 - --- INTRODUCTION --- p.1 / Chapter CHAPTER 2 - --- LITERATURE REVIEW --- p.5 / Chapter 2.1. --- "Low back pain and ""Facet joint syndrome""" --- p.5 / Chapter 2.1.1. --- Cost of low back pain --- p.5 / Chapter 2.1.2. --- Low back pain in industry --- p.5 / Chapter 2.1.3. --- Differential diagnosis of low back pain --- p.6 / Chapter 2.1. --- Lumbar facet joint syndrome --- p.8 / Chapter 2.2.1. --- Historical review --- p.8 / Chapter 2.2.2. --- Anatomy of the lumbar facet joint --- p.10 / Chapter 2.2.3. --- Functions of facet joint --- p.11 / Chapter 2.2.4. --- Pathophysiology and pathology of facet syndrome --- p.13 / Chapter 2.2.5. --- Diagnosis of facet syndrome --- p.16 / Chapter 2.2.6. --- Treatment of facet syndrome --- p.18 / Chapter 2.2.7. --- Prognosis of facet syndrome --- p.22 / Chapter 2.3. --- Articular cartilage of lumbar facet joint --- p.23 / Chapter 2.3.1. --- Function of articular cartilage --- p.24 / Chapter 2.3.2. --- Physical and mechanical properties of articular cartilage --- p.25 / Chapter 2.3.3. --- "Morphology of normal, aging and degenerated lumbar facet joint" --- p.26 / Chapter 2.3.4. --- The frequency and distribution of osteoarthritis in lumbar facet joint cartilage --- p.30 / Chapter 2.3.5. --- "Biochemistry of normal, aging and degenerated articular cartilage" --- p.32 / Chapter CHAPTER 3 - --- MATERIALS AND METHODS --- p.36 / Chapter 3.1. --- Clinical study --- p.36 / Chapter 3.1.1. --- Patients selection --- p.36 / Chapter 3.1.2. --- Initial assessment --- p.37 / Chapter 3.1.3. --- Reassessment --- p.37 / Chapter 3.1.4. --- Interpretation of the forms for the registration of related symptoms and signs --- p.38 / Chapter 3.1.5. --- Specific scoring system --- p.39 / Chapter 3.1.6. --- Methods of treatment --- p.41 / Chapter 3.1.7. --- Statistical method --- p.41 / Chapter 3.2. --- Cadaveric study of human lumbar facet joint cartilage --- p.43 / Chapter 3.2.1. --- Cadavers --- p.43 / Chapter 3.2.2. --- Procedures of dissection of the lumbar facet joint and articular cartilage --- p.44 / Chapter 3.2.3. --- "Development of ""indices"" for the observation and statistics of the articular cartilage in facet joints" --- p.44 / Chapter 3.2.4. --- Biochemical study of normal and degenerated cartilage --- p.50 / Chapter 3.2.5. --- Statistical methods --- p.54 / Chapter CHAPTER 4 - --- RESULTS / Chapter 4.1. --- Clinical study --- p.56 / Chapter 4.1.1. --- General results of the patients --- p.56 / Chapter 4.1.2. --- "Influence of various variables in predicting the ""Severity score""" --- p.62 / Chapter 4.2. --- Cadaveric study of human lumbar facet joint cartilage --- p.65 / Chapter 4.2.1. --- Sex and age --- p.65 / Chapter 4.2.2. --- The correlation between gross and histological appearance --- p.66 / Chapter 4.2.3. --- Ostoearthritic changes in the lumbar facet joints cartilage related to other factors --- p.67 / Chapter 4.2.4. --- """GMI"" and water content of the cartilage" --- p.69 / Chapter 4.2.5. --- """GMI"" and proteoglycan content of the cartilage" --- p.69 / Chapter CHAPTER 5 - --- DISCUSSION --- p.71 / Chapter APPENDIX 1 - --- Low back pain in Chinese industrial population --- p.79 / Chapter APPENDIX 2 - --- Standardized back clinic assessment sheets --- p.81 / Chapter APPENDIX 3 - --- Enzymatic method for the comparison of extraction of uronic acid from standard chondroitin 6-sulfate --- p.83 / Chapter APPENDIX 4 - --- Stability of standard chondroitin 6-sulfate in various conditions --- p.86 / Chapter APPENDIX 5 - --- "Original data of ""Gross Linear Index"" and ""Histological Linear Index""" --- p.88 / Chapter APPENDIX 6 - --- Original data of water content of various gradings --- p.89 / Chapter APPENDIX 7 - --- Original data of uronic acid content of various gradings --- p.90 / REFERENCES --- p.91

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 6 uppsatser.

Diss. Stockholm : Karol. inst.

A dissertation submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Master of Science in Occupational Therapy. Johannesburg, October 2011 / Background: Numerous factors influence work status in employees with chronic back pain. The objective of this study was to identify those factors which were most significantly associated with long term absence from work. Methods: The design entailed a sample of employees diagnosed with chronic back pain referred for functional capacity evaluation. Quantitative, descriptive, cross sectional and multivariate correlation study design was used. Fifty-seven Clients participated. Outcomes were defined using self-report questionnaires, two lifting tasks and a dynamic and static posturing assessment. This study was performed within an occupational therapy private practice setting in South Africa. Results: Multivariate logistic regression analysis indicated significant adjusted odds ratios (OR) for kneeling (OR 7.6; CI 1.27-45.29), waist to floor lift (OR 3.8 CI 0.99-14.9) and depression (OR 2.7; CI 0.71-10.4). Conclusion: This study supported current views that work status in employees with chronic back pain was affected by both physical and psychological factors. Kneeling, lifting from floor to waist and depression were factors most significantly associated with employees with chronic back pain not being at work. Occupational therapists taking referrals for FCEs need to integrate these factors into their assessment in order to make informed recommendations regarding capacity for work in clients with chronic back pain.

Musculoskeletal physiotherapy is the most common intervention for chronic low back disorder. Any observation on clinical practice or investigation into the clinical and scientific literature indicates that musculoskeletal physiotherapy encompasses a plethora of treatment modalities and approaches. The aim of the present investigation was to determine the most common intervention(s) that comprise musculoskeletal physiotherapy and to critically explore their empirical therapeutic basis. Two components were highlighted as the most frequently employed interventions; namely manually applied therapy (manual therapy) and exercise(s) to rehabilitate the lumbar spine's stabilising system. In the course of an extensive literature search, work was uncovered that suggested that the mechanisms required for spinal stability could be better facilitated using methods other than those in current clinical use. These discoveries culminated in the creation of a ten-week rehabilitation programme which was primarily developed to facilitate rehabilitation of spinal stabilisation but also permitted an empirical analysis of this component of musculoskeletal physiotherapy. The efficacy of the regime was then assessed in comparison to manual therapy and to a control (an education booklet) in a randomised controlled trial. Following a series of pilot studies, 300 patients with chronic low back disorder were randomly assigned to groups and completed their respective management programmes. Data were collected on pain, disability, handicap, impairment and quality of life prior to entry and at three, six, twelve and twenty-four months post intervention. The results indicated a consistent trend for greater improvement in the spinal stabilisation group in the pain, handicap, impairment, disability, dysfunction and medication variables. These trends reached statistical significance at the three-month follow-up stage as evidenced by quality of life (P = 0.025), at the six-month follow-up stage in pain (P = 0.009) and dysfunction (P = 0.042) and at the one-year follow-up stage in medication (P = 0.007), dysfunction (P = 0.048), disability (P = 0.0098) and quality of life (P = 0.003). It was therefore concluded that the spinal stabilisation programme was a more effective component of musculoskeletal physiotherapy (when analysed in isolation) than manually applied therapy or an education booklet in the management of chronic low back disorder. Various sub-analyses of the data were conducted. Subjects who entered the study with high levels of low back pain (greater than 50 numerical rating scale) demonstrated a statistically Significant reduction in pain levels (P = 0.04) in both the manual therapy group and the spinal stabilisation group in comparison to the education control group at the three-month follow-up stage. These data provide empirical evidence towards the efficacy of these two musculoskeletal physiotherapy management regimes as being effective in pain reduction in comparison to an active control intervention. This has not hitherto been demonstrated on patients with chronic low back disorder.

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No description available.

No description available.

Introduction Various authors have proposed that there may be altered hip rotation range of motion (ROM) in patients with low back pain (LBP). However, limited studies have been conducted to investigate the association between hip rotation ROM and LBP specifically in distance runners. The aim of this study was to determine whether there is an association between hip rotation ROM and non-specific LBP in distance runners. Methods A cross-sectional design was used to look at the relationship between hip rotation ROM and LBP. Thirty five runners with LBP (24 males, 11 females) and 51 runners without LBP (29 males, 22 females) participated in the study. A questionnaire was used to divide participants into LBP and no LBP groups and to evaluate certain factors specific to LBP. Passive rotation ROM was measured in prone position using a hand-held inclinometer. Results Results showed no statistically significant difference (p>0.05) in hip rotation ROM between the two groups. Furthermore, no statistically significant difference (p>0.05) was found for factors specific to running, between the two groups. Conclusion Although no association was found between hip rotation ROM and LBP in distance runners, further research is needed into other possible causative factors of LBP in distance runners. Keywords Low back pain, hip biomechanics, hip mobility, hip rotation, sports and running Operational definitions  Low back pain (LBP): pain and discomfort located below the costal margins and above the gluteal folds, with or without associated leg pain (Van Tulder et al 2006).  Non-specific LBP: pain not attributable to a clearly recognisable pathology (Koes et al 2006).  Healthy distance runner: a runner who has had no LBP symptoms within the last 6 months.  Time trial: an unofficial road running race in which participants are timed individually over a set distance, in this case, 4km.

The research reported in this dissertation centered around the prevalence and factors associated with low back pain (LBP) among the undergraduate physiotherapy students at the University of the Witwatersrand. Physiotherapy students are prone to LBP due to a flexion posture while studying, lifting patients and working. After pathology, muscle activity is influenced, affecting optimal function of the spine. Preventative strategies can minimise recurrences of LBP. Physiotherapy students enrolled for 2010 at the University of the Witwatersrand participated in a cross-sectional prevalence study. A questionnaire, multi-stage fitness test and physical assessment were completed. Statistical analysis was done with univariate analysis for associations with LBP. The study revealed that the lifetime LBP prevalence was 35.6% among all four physiotherapy year groups. The prevalence increased from first year to third year but unexpectedly decreased in the fourth year group. Significant associations with LBP were posterior-anterior mobilisations on L4 (p=0.003) and L5 (p≤0.001) centrally, left lumbar multifidus (LM) cross-sectional area (p=0.02), right obliquus internus abdominis (p=0.02) and transversus abdominis (TrA) thickness at rest (p=0.03), both TrA during contraction, left (p=0.02) and right (p=0.01), as well as the pull of the TrA during contraction on the left (p=0.03). The present work is the first study to show measurements with ultrasound imaging of LM and TrA on physiotherapy students. The prevalence of LBP might be reduced if students are more aware of LBP and consequential muscle imbalances that might perpetuate the problem. The dissertation concludes with a discussion of future research avenues. It is suggested that an intervention to make students aware of LBP and risk assessments in South Africa will help to identify and address hazards in the workplace.