Thesis supervisor: Warren G. Darling. Includes bibliographical references (p. 103-113).

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic in the Faculty of Health at Technikon Natal, 2002. / Purpose . Rotator cuff tendinitis is a common problem, however, its diagnosis and management is not completely understood. The purpose of this research project was to investigate the efficacy of the chiropractic adjustment to determine whether or not it is an effective approach in the treatment of rotator cuff tendinitis. Methods This randomized controlled trial consisted of two groups. Each group consisted of thirty subjects, of any age, selected from the general population and randomly allocated to Group 1 or 2, participation in this trial was voluntary. Group 1 received chiropractic adjustment of the glenohumeral or acromioclavicular joint according to the fixations found on motion palpation and group 2 received placebo laser. Subjects in both groups had to comply with certain inclusion criteria before being allowed to participate in the study. Goniometer readings were taken to measure range of motion, algometer readings to measure pain threshold and the Numerical Pain Rating Scale was answered at the initial consultation, and on the third and sixth consultations. The Unpaired and Friedman's T- tests were used to assess the intra and intergroup information from the first, third and sixth consultations. Groups 1 and 2 were compared in terms of age, gender, race and clinical severity prior to onset. / M

Thesis (M.App.Sc. in Physiotherapy)--University of South Australia, 1997

Thesis (MAppSc in Physiotherapy)--University of South Australia, 1995

Thesis (M.App.Sc. in Physiotherapy)--University of South Australia, 1997

[Truncated abstract] Normal and pathological upper limb movement assessments rely on the valid and reliable identification of the glenohumeral joint centre of rotation (GHJ). However, clarifying the most suitable techniques to identify and reference this location has proved a challenge, and performing a variety of methods that lack validation is commonplace. This may not only be erroneous, but also prevents the standardised collection of upper limb biomechanical information. The principle aim of this research was to clarify the accuracy and reliability of various methods of GHJ identification, including both predictive and functional techniques, as well as the error associated with referencing the GHJ location during dynamic movement trials. Predictive methods of GHJ identification rely on a generic relationship between the GHJ position and predetermined anatomical distances or locations. The ISB recommended predictive method was developed and validated using cadavers, and it appears that a number of convenient, yet to be validated methods are routinely performed in preference of this recommended technique. In the present study, magnetic resonance imaging (MRI) was utilised to validate, in vivo, the accuracy of various predictive approaches; the ISB recommended method and a representative sample of commonly used techniques. A new multiple linear regression model and simple 3D offset method, were developed from the MRI identified locations of the GHJ and the surface markers. The results indicated that the new multiple linear regression model (13 ±4.6) mm and simple 3D offset (12 ±4.6 mm) found an average GHJ location closer to the MRI determined location than any of the established predictive methods (14-50 mm), including the ISB recommended method (32 ±8.2 mm), and a recently publicised amended 2nd version (16 ±8.4 mm). ... For instance when the optimal algorithm (geometric sphere fit), marker set and movement trial were used in the functional approach, average in vivo accuracy errors of 27 ±8.6 mm were reported, around half the error reported by the most accurate and reliable predictive method (13 ±4.6 mm). A further investigation aimed to determine the most suitable location to reference the GHJ during dynamic motion analysis trials. The GHJ was referenced in a number of upper arm and acromion technical coordinate systems (TCSs) in a series of static MRIs. This permitted the error associated with each set of markers to be calculated in vivo. The results indicated that a combination of TCSs defined from two sets of markers; one placed on the acromial plateau and one located proximally on the upper arm, produced the most accurate results, recording an average of 18 ±4 mm of error following a large humeral elevation (up to 180°). Furthermore, a distal upper arm set of markers proved to be inappropriate for GHJ referencing, reporting average errors greater than 30 cm in two large humeral elevations. Therefore, following the identification of the GHJ, its 3D location should be referenced in the average of two TCSs determined from respective sets of markers placed on the acromion and proximal upper arm, during dynamic trials.

The purpose of this study was to characterize glenohumeral joint laxity and stiffness using instrumented arthrometry. To evaluate the validity of an instrumented measurement system we compared cutaneous and bone-pinned measures of laxity and stiffness that replicate previously reported in vivo methodology. Characterization of capsular laxity was achieved through determination of the sagittal plane translational area at increasing levels of quantified force. Finally, a method for increasing the objectivity of the standard manual laxity examination was developed for the orthopaedic clinician to quantify humeral head translation and capsular volume in vivo. We hypothesized that: 1) cutaneous measures could accurately predict bone-pinned measures, 2) capsular laxity would increase with increasing levels of applied force, and 3) manual cutaneous, manual bone-pinned, and force-displacement bone-pinned measures of translation would be equal. Thirty fresh frozen cadaveric shoulder specimens (mean age=70��14 years) were tested. The shoulders were thawed and mounted to a custom-made shoulder-testing apparatus. Displacement was measured using an electromagnetic tracking system. Sensors were secured cutaneously and with bone-pins to the scapula and humerus. Force-displacement testing was performed using a load applicator and manual displacement testing utilized the anterior/posterior drawer and inferior sulcus tests. A comparison of cutaneous and bone-pinned measures of laxity and stiffness revealed good to excellent criterion validity (r=0.68 to 0.79). Examination of displacement measures at increasing levels of force revealed increasing capsular laxity with symmetric directional compliance. No significant difference was observed between anterior and posterior translation (0.4 mm, p=.55), with significant differences between inferior and anterior (4.6 mm, p<.0001) and between inferior and posterior (5.1 mm, p<.0001). A comparison of manual cutaneous to bone-pinned manual and kinetic measures of translation revealed a significant difference between methods (p=.0024) and between directions (p<.0001) with no significant interaction (p=.0948). Estimations of the force required to achieve clinical end-point suggest that greater force is required in the anterior (173 N) direction compared to posterior (123 N) and inferior (121 N). We have developed two new methods to measure glenohumeral joint kinematics and reported new information regarding normal kinematics of the glenohumeral joint. / Graduation date: 2001

Thesis (Ph. D.)--University of Chicago, Committee on Evolutionary Biology, August 2003. / Includes bibliographical references. Also available on the Internet.

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

Thesis (MAppSc in Physiotherapy)--University of South Australia, 1995