Introduction: Lumbar spine stability programs have been advocated to prevent and rehabilitate low back injury. Specifically, abdominal ‘drawing in’ has been used to train motor control deficits in individuals with low back pain. This technique requires differential activity within deep and superficial lumbar multifidus fibres, yet the ability of these fibres to act differentially has not been extensively examined. Deep fibres are hypothesized to act as spinal stabilizers while superficial fibres are hypothesized to act as global movers of the trunk. Objective: To investigate differential excitation of deep and superficial lumbar multifidus fibres during segmental indentation loads to the lumbar spine. Methods: Posterior-anterior indentation loads were applied to individual lumbar spinous processes of prone participants at three different velocities and three different indentation displacements. Indentations consisted of an initial downward displacement that was subsequently held for 500 milliseconds. Intramuscular electromyography (EMG) of deep and superficial lumbar multifidus fibres at L3, L4 and L5 was recorded. EMG was quantified by “average” root mean square (RMS), peak RMS of a sliding RMS window and time-to-peak RMS over the indentation phase and 500 millisecond hold phase. Results: Increased indentation displacement at the slowest velocity resulted in increased “average” RMS of only the L5 superficial multifidus fibres. Increased indentation velocity produced differential effects in deep and superficial multifidus fibres. “Average” RMS and peak RIVIS significantly increased with increasing indentation velocity in most deep fibre recording sites, yet superficial fibre excitation did not significantly increase. In most EMG recording sites, the time-to-peak RMS increased with increasing indentation displacement and decreased with increasing indentation velocity. Conclusion: Differential excitation of superficial and deep multifidus fibres was found with increasing indentation velocity; however, the result was opposite to that hypothesized. This result is clinically relevant because it suggests deep multifidus fibre excitation may increase in response to increased perturbation magnitude, possibly to restore vertebral body position. Differential excitation effects may also be related to different mechanical stimuli experienced by deep and superficial fibres due to vertebral body movement during indentation loads. 11

Thesis (Ph. D.)--Ohio State University, 2009. / Title from first page of PDF file. Includes bibliographical references (p. 232-256).

Introduction: Lumbar spine stability programs have been advocated to prevent and rehabilitate low back injury. Specifically, abdominal ‘drawing in’ has been used to train motor control deficits in individuals with low back pain. This technique requires differential activity within deep and superficial lumbar multifidus fibres, yet the ability of these fibres to act differentially has not been extensively examined. Deep fibres are hypothesized to act as spinal stabilizers while superficial fibres are hypothesized to act as global movers of the trunk. Objective: To investigate differential excitation of deep and superficial lumbar multifidus fibres during segmental indentation loads to the lumbar spine. Methods: Posterior-anterior indentation loads were applied to individual lumbar spinous processes of prone participants at three different velocities and three different indentation displacements. Indentations consisted of an initial downward displacement that was subsequently held for 500 milliseconds. Intramuscular electromyography (EMG) of deep and superficial lumbar multifidus fibres at L3, L4 and L5 was recorded. EMG was quantified by “average” root mean square (RMS), peak RMS of a sliding RMS window and time-to-peak RMS over the indentation phase and 500 millisecond hold phase. Results: Increased indentation displacement at the slowest velocity resulted in increased “average” RMS of only the L5 superficial multifidus fibres. Increased indentation velocity produced differential effects in deep and superficial multifidus fibres. “Average” RMS and peak RIVIS significantly increased with increasing indentation velocity in most deep fibre recording sites, yet superficial fibre excitation did not significantly increase. In most EMG recording sites, the time-to-peak RMS increased with increasing indentation displacement and decreased with increasing indentation velocity. Conclusion: Differential excitation of superficial and deep multifidus fibres was found with increasing indentation velocity; however, the result was opposite to that hypothesized. This result is clinically relevant because it suggests deep multifidus fibre excitation may increase in response to increased perturbation magnitude, possibly to restore vertebral body position. Differential excitation effects may also be related to different mechanical stimuli experienced by deep and superficial fibres due to vertebral body movement during indentation loads. 11

Traumatic lumbar punctures (TLPs) in children with acute lymphoblastic leukemia are associated with a poorer prognosis. The objective of this study was to determine risk factors for TLPs using a retrospective cohort. We compared and contrasted three different regression methods for the analysis of repeated-measures data. In the multivariable model using generalized estimating equations, variables significantly associated with TLPs were age < l year or ≥ 10 years; body mass index percentile ≥ 95; platelet counts < 100 x 103/µL; fewer days since previous LP, and a preceding TLP. The same variables, with similar estimates and confidence-intervals, were identified by the random-effects model. In a fixed-effects model where each patient was used as their own control, days since prior LP and the effect of using image-guidance were significant. Random-effects and GEE lead to similar conclusions, whereas fixed-effects discards between-subject comparisons and leads to different estimates and interpretation of results.

Thesis (MAppSc in Physiotherapy)--University of South Australia, 1993

Thesis (M.S.B.)--University of Toledo, 2004. / Typescript. "A thesis [submitted] as partial fulfillment of the requirements of the Master of Science degree in Bioengineering." Bibliography: leaves 4-11.

Thesis (D.PT.)--Sage Colleges, 2009. / "May 2009." "A Capstone project for PTY 768 presented to the Faculty of the Department of Physical Therapy Sage Graduate School in partial fulfillment of the requirements for the degree of Doctor of Physical Therapy." Includes bibliographical references.

Thesis (D.PT.)--Sage Colleges, 2010. / "May 2010." "A Capstone project for PTY 768 presented to the faculty of The Department of Physical Therapy Sage Graduate School in partial fulfillment of the requirements for the degree of Doctor of Physical Therapy." Includes bibliographical references.

Introduction: Lumbar spine stability programs have been advocated to prevent and rehabilitate low back injury. Specifically, abdominal ‘drawing in’ has been used to train motor control deficits in individuals with low back pain. This technique requires differential activity within deep and superficial lumbar multifidus fibres, yet the ability of these fibres to act differentially has not been extensively examined. Deep fibres are hypothesized to act as spinal stabilizers while superficial fibres are hypothesized to act as global movers of the trunk. Objective: To investigate differential excitation of deep and superficial lumbar multifidus fibres during segmental indentation loads to the lumbar spine. Methods: Posterior-anterior indentation loads were applied to individual lumbar spinous processes of prone participants at three different velocities and three different indentation displacements. Indentations consisted of an initial downward displacement that was subsequently held for 500 milliseconds. Intramuscular electromyography (EMG) of deep and superficial lumbar multifidus fibres at L3, L4 and L5 was recorded. EMG was quantified by “average” root mean square (RMS), peak RMS of a sliding RMS window and time-to-peak RMS over the indentation phase and 500 millisecond hold phase. Results: Increased indentation displacement at the slowest velocity resulted in increased “average” RMS of only the L5 superficial multifidus fibres. Increased indentation velocity produced differential effects in deep and superficial multifidus fibres. “Average” RMS and peak RIVIS significantly increased with increasing indentation velocity in most deep fibre recording sites, yet superficial fibre excitation did not significantly increase. In most EMG recording sites, the time-to-peak RMS increased with increasing indentation displacement and decreased with increasing indentation velocity. Conclusion: Differential excitation of superficial and deep multifidus fibres was found with increasing indentation velocity; however, the result was opposite to that hypothesized. This result is clinically relevant because it suggests deep multifidus fibre excitation may increase in response to increased perturbation magnitude, possibly to restore vertebral body position. Differential excitation effects may also be related to different mechanical stimuli experienced by deep and superficial fibres due to vertebral body movement during indentation loads. 11 / Education, Faculty of / Kinesiology, School of / Graduate

M. Tech. / Low back pain is experienced by approximately 60-90% of the population and is one of the most expensive public health problems today (Shin and Slipman, 2005). Lumbar facet joint syndrome is a common condition, involving about 79% of patients suffering from low back pain (Schleifer, et al., 1994). The aim of this study was to determine the effectiveness of treatment for lumbar facet syndrome with the homeopathic injectable Discus compositum® by using the pressure algometer, Helbig and Lee scorecard system and the Oswestry low back pain questionnaire. This double-blind placebo-control trial, with matched pairs, was conducted at the University of Johannesburg and participants were recruited with posters and by word of mouth. Thirty-two participants that met the inclusion criteria, and were not outside of treatment parameters, were included in the study. These participants were then randomly divided into two groups: Group A was treated with Discus compositum® injectables and Group B was treated with placebo injectables. In addition, participants were matched according to activity levels of more than 3 times per week and activity levels of less than 3 times per week. Participants in both groups were treated four times over a period of two weeks; two treatments per week. A one month post-injection follow-up consultation was carried out in order to determine if the treatment had a lasting effect. The subjective and objective data was analysed by using non-parametric tests in order to establish statistical significance between visits and between groups. The subjective data was obtained by using the Oswestry low back pain and disability questionnaire. The objective data was gathered by using the Helbig and Lee scorecard system as well as the algometer readings. The two sample groups did exhibit statistical differences. The results showed that there was a significant decrease in the pain experienced by the participants, as well as a significant change in the participant’s pain pressure threshold, for both groups. With regards to the diagnostic criteria a higher percentage of participants that were treated with Discus compositum® injections were no longer diagnosed with lumbar facet syndrome according to the Helbig and Lee scorecard system, than those participants that were treated with the placebo injections. In addition, it was determined that a combination of Discus compositum® injections and activity levels of more than 3 times per week proved to be beneficial. Based on the results of this study, one can determine that Discus compositum® is effective in the treatment of lumbar facet syndrome.