No description available.

<p>Background: Increased physical activity has a modest effect on the spatial distribution of bone mineral. The risks and benefits of exercise for women with osteoporosis at high risk to fracture are not known. The decompression of aquatic exercise is an option to increase exercise compliance. The dual energy absorptiometry (DXA) vertebral fracture assessment (VFA) images 2D bone geometry however measurement properties have not been established for this outcome.</p> <p>Purpose: To determine relative and absolute intra-rater reliability of DXA-based vertebral height (VH) measures and to assess the feasibility of investigating bone outcomes in women with established osteoporosis before and after a 6 month aquatic exercise program.</p> <p>Methods: DXA VFA scans of 32 women over 60 years old were analyzed on 2 occasions, 4 weeks apart. Relative reliability, intraclass correlation coefficient (95% CI) and absolute reliability, standard error of measurement (95% CI) were estimated for visible anterior, middle and posterior VHs from T4 to L4. Women with osteoporosis at high risk to fracture (clinical practice guidelines used) were recruited from two osteoporosis clinics. Feasibility of recruitment, adherence to the exercise, adherence to the assessment protocols (DXA, pQCT, physical performance measures), safety and retention were assessed.</p> <p>Results: Intra-rater reliability ICC >0.87 (0.74, 0.94) and SEM <1.17 from T10 to L4. Recruitment of 9 women in 10 weeks; average adherence 68%; pQCT data loss 46%; 1 fracture after class; retention 89% at 12 months.</p> <p>Conclusion: Further study of measurement properties of VH and protocols for recruitment, data management and safety are required.</p> / Master of Science Rehabilitation Science (MSc)

<p>Radial head arthroplasty (RHAP) is proposed as the treatment of choice of complex radial head fractures not amenable to reconstruction. With advances in the understanding of elbow biomechanics and subsequently implant designs, low morbidity, few complications and good success has been reported with RHAP compared to internal fixation. Much of the success/complication post RHAP has been attributed to the fracture pattern and presence of associated injuries. While these are important parameters to reflect on, however, the outcome of surgery cannot be solely attributed to the methods of dealing with the radial head fracture. Importantly, the outcomes of RHAP are also influenced by patient factors. Hence, the purpose of this thesis was to assess the existing knowledge of functional outcomes post RHAP and explore the role of acute post surgical pain as a predictor of those outcomes.</p> <p>The first manuscript in the thesis systematically examines the current available English literature regarding the functional outcomes of metal RHAP. Studies reviewed revealed significant heterogeneity in the study and patient characteristics. Likewise, the method of reporting fracture classification, clinician and patient reported outcomes are inconsistent. Based on the level 4 evidence studies in the review, we concluded that RHAP provides good to excellent outcomes in short-midterm follow up, with no evidence regarding the superiority of one implant over another.</p> <p>The second manuscript explored the role of acute post surgical pain in development of chronic functional impairment post RHAP using the EVOLVE (Wright Medical Technology, Arlington, Tennessee) implant at 2 years post surgery. A total of 59 adults with complex radial head fractures treated with EVOLVE metal radial head implant were followed for a period of two years. Demographics, American Shoulder and Elbow Surgeon's-Elbow (ASES-e) pain subscale and Disability of Arm, Hand and Shoulder Questionnaire (DASH) data were collected at baseline and two years. Regression analyses revealed that acute post operative pain post RHAP is significantly related to the functional outcome at 2 years post RHAP. An ASES-e pain cut off score of 32/50 predicted the development of chronic functional impairment two years post RHAP.</p> <p>The results of this thesis highlight the need for prospective longitudinal studies, comparative analyses and standardized methods of reporting concerning effectiveness of RHAP. It also emphasizes the significance of quantifying pain levels in the immediate post operative period and classifying the patient in high/low risk groups for developing chronic functional impairment based on the pain level.</p> / Master of Science (MSc)

No description available.

Abstract available through Journal of Neurologic Physical Therapy.

The purpose of this study was to determine the reliability of two new alternative portable methods for measuring maximal isometric force measures while performing the standard mid-thigh pull. One method, the bar grip method, required the use of the trunk and upper extremity muscles, while the second method, the pelvic belt method, did not. Both methods demonstrated good test-retest reliability via randomized repeated measures over 24-36 hours. Interestingly, the pelvic belt method generally demonstrated average maximal forces up to 65% higher than the bar method. There was a good relationship between both methods. These new alternative methods could provide strength coaches an option for a more efficient, cost-effective, portable means for the mid-thigh pull test.

No description available.

Abstract available through Physical Therapy.

Dissertation submitted to the Faculty of Health at the Durban University of Technology in partial compliance with the requirements for the Master‟s Degree in Technology: Chiropractic, 2009. / The prevalence of neck pain in musculoskeletal practice is second only to that of low back pain (Vernon et al., 2007). There is a growing interest in neck pain research due to the escalating disability burden and compensation costs associated with neck pain (Côte et al., 2003). Manual therapies are commonly used in the treatment of neck pain (Côte et al., 2003). After an extensive literature review by Haldeman et al. (2008) they found that manual therapy techniques have some benefit but no one technique was clearly superior to the next. Therefore, the purpose of this study is to compare three commonly used manual therapy techniques in the treatment of chronic mechanical neck pain. OBJECTIVES The purpose of this study was to compare three different manual therapy techniques (SMT, MET and PNF) which are commonly used in the treatment of chronic MNP in terms of range of motion, pain and disability. METHOD Forty-five patients with chronic mechanical neck pain were obtained through non-probability convenience sampling and assigned into one of three treatment groups (15 per group) using a computer generated randomized table. The three different treatment groups were: Spinal Manipulative Therapy (SMT), Muscle Energy Technique (MET) and Proprioceptive Neuromuscular Facilitation (PNF). Each group received six treatments over a period of three weeks with a follow-up consultation. Measurements were taken at the first, third and sixth treatment and at the follow-up consultation. SPSS version 15.0 was used to analyse the data. A p value of <0.05 was considered as statistically significant. An intra-group analysis was done using repeated measures ANOVA testing to assess the time effect for each outcome separately. For inter-group analyses the time x group interaction effect was assessed using repeated measures ANOVA testing, and profile plots were used to assess the trend and direction of the effects. RESULTS Intra-group analysis of the results revealed that all three groups improved significantly between the first and the final consultation, for all measures. Inter-group analysis of the data did not show any difference between the three groups by the end of the final consultation. However, extension range of motion appeared to improve slightly faster in the PNF group iv but it was not significant when compared to the other two groups. Therefore, there was no statistical significance between the three groups. CONCLUSION It was concluded that all three treatment groups responded equally to the treatment, thus, suggesting that MET or PNF techniques can be used if SMT is contra-indicated.

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban University of Technology, 2011. / Background: Wong and Deyo (2001) believe that 98% of the LBP cases are musculoskeletal (mechanical) in origin and 51,7% of these individuals are chronic sufferers (Andersson, 1999). Weak spinal stability muscles have shown to be an aetiological cause (Chok, Lee and Latimer, 1999). Wolff, Weinik and Maitin (2003) agree a combination of brace aided pelvic stabilization combined with a spinal stability programme may be the best treatment intervention for chronic low back pain (CLBP). Objective: The purpose of this research was to determine the relative effectiveness of three treatment protocols with (Group A-Groovi-SI-Belt®; Group B-standard SI belt) and without (Group C-control) brace aided pelvic stabilization in patients with CLBP. Method: Forty-six patients suffering from CLBP were randomly allocated to one of the three treatment groups. A spinal stability programme was progressively taught and enforced in all three groups. Weekly follow-up consultations were required to assess subjective and objective outcomes of the three treatment interventions. Outcomes were obtained by using the Numerical Pain Rating Scale (NRS); Quebec disability scale; Active straight leg raiser test; Biofeedback device and the static trunk extensor endurance test. Results: Data was analysed using the SPSS version 15.0 (SPSS Inc. Chicago, Ill, USA).Comparing pre and post outcome measurements using a p value <0.05 which was considered to be statistically significant. All three treatments improved most outcomes significantly over time. The Groovi-SI-Belt® showed non significant trends of quicker rates of improvement. . Conclusion: This study revealed that brace aided pelvic stabilization combined with a spinal stability programme was a beneficial treatment intervention with the Group A being superior to Group B.