Thesis (Ph. D.)--University of Washington, 2000. / Vita. Includes bibliographical references (leaves 96-103).

Thesis Ph.D.) - University of Queensland, 2005. / Includes bibliography.

Thesis (M.Phil.) - University of Queensland, 2005. / Includes bibliography.

Thesis (Ph. D.)--Oregon State University, 2007. / Printout. Includes bibliographical references (leaves 89-97). Also available on the World Wide Web.

Thesis (M.Sc.)--University of Alberta, 1997. / Submitted to the Faculty of Graduate Studies and Research in partial fulfilment of the requirements for the degree of Master of Science, Department of Physical Therapy. Also available online.

Low back pain (LBP) affects many individuals worldwide. The established association between LBP and spine motor control has led to the development of many control assessment techniques. To understand the association between motor control and LBP, it is essential to understand the relationship between separate assessment techniques. Systems identification (SI) and local dynamic stability (LDS) are two methods commonly used to quantify spine control. SI provides a detailed description of control but uses linear assumptions, whereas LDS provides a “black box” non-linear assessment and can be quantified during dynamic movements. Although both SI and LDS techniques aim to measure the control of the spine, each employs different experimental setups and data processing strategies. Therefore, the purpose of this thesis was to compare the motor behaviour outcomes of SI and LDS quantification techniques. To do this, 15 participants completed two tasks (SI and LDS) in a random order. For the SI task, participants were seated and ventrally perturbed at the level of the 10th thoracic vertebrae (T10). They completed this task under instructions to resist the perturbations (resist condition) or relax and remain upright (relax condition). Admittance was represented using frequency response functions, and a validated neuromuscular control model quantified lumbar stiffness, damping and muscle spindle feedback gains. The LDS task involved participants completing three repetitive movement blocks consisting of flexion/extension, axial rotation, and complex movements. In each block, the maximum finite-time Lyapunov exponent (λmax) was estimated. A stepwise linear regression determined that λmax during the rotation task was best predicted by SI outcomes in the relax condition (adjusted R square = 0.65). Many conditions demonstrated no significant relationship between λmax and SI outcomes. These findings outline the importance of a consistent framework for the assessment of spine control. This could improve clinical assessment efficiency as well as the understanding of the association between LBP and motor control.

M.Tech. / Purpose: This study aims to compare the effects of chiropractic adjustment to the lumbar spine and/or pelvis, and chiropractic adjustment to the lumbar spine and/or pelvis in conjunction with a muscle stability exercise programme in the treatment of chronic low back pain in former ballet and modern dancers with regards to pain, disability and lumbar spine and pelvic range of motion. These effects were based on a questionnaire consisting of a Numerical Pain Rating Scale, and an Oswestry Low Back Pain and Disability Index, and on lumbar spine range of motion (ROM) readings taken using a digital inclinometer. The questionnaire was completed and the ROM readings taken prior to treatment on the first, fourth and seventh visits. Method: Thirty participants who met the inclusion criteria were randomly allocated to one of two different groups of fifteen participants each. One group received chiropractic adjustments to the lumbar spine and/or sacroiliac joints, with an added muscle stability exercise programme. The second group received chiropractic adjustments to the lumbar spine and/or sacroiliac joints alone. Treatment took place over a period of three weeks, and participants were treated six times out of a total of seven visits. Procedure: Subjective data was collected at the first and fourth consultations prior to treatment, as well as on the seventh consultation by means of a Numerical Pain Rating Scale (NPRS) as well as an Oswestry Low Back Pain and Disability Index to assess pain and disability levels. Objective data was collected at the first and fourth consultations prior to treatment, and at the seventh consultation by means of a digital inclinometer for assessing lumbar spine range of motion (ROM). Data collected was analysed by a statistician. Results: Clinically and statistically significant improvements in group 1 and group 2 were noted over the duration of the study with regards to pain and disability, however the lumbar spine range of motion results were inconsistent with regards to the expected outcome of increased range of motion. Conclusion: The results show that both chiropractic adjustment, as well as chiropractic adjustment in conjunction with a muscle stability exercise programme, are effective treatment protocols both clinically and statistically in decreasing pain and disability in former ballet and modern dancers with chronic low back pain, however, neither treatment protocol proved to be preferential over the other. The results also showed a larger decrease in lumbar spine range of motion than the expected increase in lumbar spine range of motion.

M.Tech. / Purpose: This study aims to compare the effects of a manual high velocity, low amplitude spinal manipulation and a mechanical force, manually assisted spinal manipulation in the treatment of sub acute lumbar facet syndrome with regards to pain, disability, lumbar spine range of motion and pressure pain threshold. These effects were based on two questionnaires, the McGill Pain Questionnaire and the Oswestry Low Back Pain and Disability Questionnaire, lumbar spine range of motion readings using a digital inclinometer and pressure pain threshold readings taken with an algometer. Method: Thirty participants who met the inclusion criteria were randomly allocated to one of two groups. One group received a manual lumbar spine manipulation using the Diversified Technique. The second group received lumbar spine manipulative therapy with the use of the Activator Adjusting Instrument. Treatment occurred over a three week period, with participants receiving treatment six times out of a total of seven consultations. Procedure: Subjective data was collected using both the McGill Pain Questionnaire and the Oswestry Low Back Pain and Disability Questionnaire. Objective data was collected using a digital inclinometer to measure lumbar spine range of motion, and an algometer to measure pressure pain threshold. The questionnaires and all readings were recorded prior to treatment on the first, fourth and seventh visits. The data was then analysed by a statistician. Results: Clinical improvements in both groups were noted over the duration of the study with regards to pain, disability, left rotation and left and right lateral flexion. The group receiving a spinal manipulation with the Activator Adjusting Instrument also showed clinical improvement for flexion and right rotation and only the manual manipulation group improved in algometer measurements. Both groups displayed a decrease in lumbar extension readings over time. Statistical significance was observed for subjective measurements only. Conclusion: The results show that both spinal manipulative therapies are effective in the treatment of sub acute lumbar facet syndrome, however neither proved to be preferential over the other for subjective and objective measurements.

M.Tech. / This unblinded, randomised pilot study was performed to determine and compare the effect of innervation specific lumbar spine adjustments and stretching on the flexibility of the rectus femoris muscles in asymptomatic subjects. Twelve asymptomatic subjects between the ages of 20 and 30 years were recruited by the use of advertisements placed around the University of Johannesburg, Doornfontein Campus. The inclusion criteria required that the patient had decreased rectus femoris muscle flexibility (testing positive on the rectus femoris contracture test) and no history of, or any current osteoarthritis or pathology of the hips or knees. The patients were randomly placed into one of three groups by drawing a group number from a closed bag. Group 1 consisted of four subjects receiving a single lumbar spine adjustment per treatment relating to the most restricted segment in the L2-L4 area as well as bilateral proprioceptive neuromuscular facilitation (PNF) of the rectus femoris muscles; Group 2 consisted of four subjects receiving bilateral rectus femoris muscle stretches (PNF); and Group 3 consisted of four subjects who received a single lumbar spine adjustment at the L2-L4 area to the most restricted segment found. One adjustment per treatment was performed. With the subject in the rectus femoris contracture test position, a goniometer was used to measure the knee range of motion bilaterally before and after treatments. These measurements were used as objective data. Each subject was treated twelve times over a four to six week period. The objective results indicated that there was a statistically significant improvement in rectus femoris muscle flexibility in both Group 1 and Group 3. In conclusion, it was shown that specific adjustments at the spinal level of the nerve innervation for the rectus femoris muscle resulted in an improvement of the flexibility of the rectus femoris muscle and with a greater effect on the leg ipsilateral to the side of the spinal adjustment. This gives support for the effectiveness of innervation specific spinal adjustments.

M.Tech. (Chiropractic) / OBJECTIVE: The aim of this study was to determine the effectiveness of a single treatment approach of flexion distraction or diversified lumbar adjustments, compared to the combined treatment of flexion distraction in conjunction with diversified lumbar adjustments. STUDY DESIGN: A total of 30 participants were used, they all presented with chronic low back pain (LBP) of mechanical origin. SETTING: University of Johannesburg Chiropractic Clinic, Johannesburg, South Africa. SUBJECTS: The participants were divided randomly into one of 3 groups: Group 1 was treated with diversified lumbar adjustments. Group 2 was treated with flexion distraction directed at the lumbar spine. Group 3 was treated with a combination of diversified lumbar adjustments and flexion distraction. Each participant was treated 6 times over a 3 week period, with a 7th consultation where subjective and objective measurements were taken with no treatment. METHODS: Group 1 was adjusted on a chiropractic table in a seated or side lying posture. Group 2 was treated lying prone on the Cox Flexion Distraction Table. Group 3 was treated with a combination of the above treatments. Flexion distraction was applied to all participants in group 2. It was applied over the segments that were found to be restricted during motion palpation. One set of 10 repetitions was performed under distraction in each range of motion (ROM). Mobilisation of the restricted joints was executed until full and complete ROM was detected. To ensure that the participant was comfortable and received the best treatment possible Velcro straps were used to secure them onto the flexion distraction table. Diversified chiropractic adjustments were done on the flexion distraction bed or the chiropractic tables in the University of Johannesburg Chiropractic Day Clinic. Spinous Hook (Pull), Thigh-Transverso-Deltoid, Transverso-Deltoid and Push-Pull Technique were the names of the adjustments used to treat participants in group 1 or group 3. PROCEDURE: Subjective data was collected using the Oswestry Low Back Pain and Disability Questionnaire (ODQ) and the Numerical Pain Rating Scale (NPRS), which were completed by the participants prior to the 1st and 4th consultations and then again on the 7th consultation. Objective data was collected using the Digital Inclinometer. The ROMs measured were forward flexion, extension, left lateral flexion, right lateral flexion left rotation and right rotation of the lumbar spine. This data was collected by the researcher prior to the 1st and 4th consultations and then again on the 7th consultation. RESULTS: This study was done to try and establish the most effective approach in the management of chronic mechanical LBP using the different treatment approaches. When comparing the results obtained from the study it can be seen that all 3 groups were effective at reducing pain levels using the NPRS. There was a significant change that occurred on the 7th consultation when looking at the NPRS values. The statistics were then further analysed and a statistically significant difference was shown to have occurred between groups 1 and 3. This indicates that the chiropractic adjustment used alone, was the best treatment protocol compared to groups 2 and 3. The ODQ values showed that the treatments for all 3 groups were effective at getting the participants back to normal activities of daily living over the treatment protocol, with no preference between any of the treatment protocols. Statistically significant changes were found to have occurred in only some ranges of motion of the lumbar spine within certain groups. Clinical improvements regarding ROM were evident in group 1 concerning flexion, left rotation and right rotation. A clinical decrease was found in extension, left and right lateral flexion with group 1. Clinical improvements concerning group 2 were found in extension, left rotation and right rotation. Flexion showed a clinical decrease in ROM values of group 2. Statistically significant improvements were found with left and right lateral flexion in group 2. Group 3 showed positive clinical results with left and right rotation. Flexion and left and right lateral flexion ROM showed decreased values clinically in group in group 3. Extension showed a statistically significant decrease in group 3. These results indicate that chiropractic adjustments used alone, were the best treatment protocol compared to group 2 and 3 when using the NPRS. The ODQ values showed that there was no preference between either of the treatment protocols with regards to normal activities of daily living.