Thesis (M.S.)--University of Toledo, 2009. / Typescript. "Submitted as partial fulfillment of the requirements for the Master of Science Degree in Mechanical Engineering." "A thesis entitled"--at head of title. Bibliography: leaves 92-98.

Thesis--University of Turku, Finland, 1991. / Includes bibliographical references.

Thesis (Ph. D.)--Michigan State University, 2005. / Includes bibliographical references (leaves 307-322). Also available online (PDF file) by a subscription to the set or by purchasing the individual file.

Thesis--University of Turku, Finland, 1991. / Includes bibliographical references.

Thesis (Ph. D.)--Michigan State University, 2005. / Includes bibliographical references (leaves 307-322)

M.Tech. / Manual medicine practitioners rely on clinical skills to diagnose and treat patients with musculoskeletal complaints. Palpatory analysis of a patient is used to identify their problem, treat the problems found and evaluate the result of the treatment (Ward 1996). Despite this reliance on palpation as a clinical tool, the reliability of palpation remains to be proven (O'Haire & Gibbons 2000). Chiropractors' and other manual medicine practitioners' ability to accurately identify bony anatomical landmarks needs to be validated as static palpation, followed by motion palpation are based on the assumption of this ability (O'Haire & Gibbons 2000). The most common method of identifying lumbar interspaces is to use the intercrestal line, which is drawn between the two iliac crests (Reynolds 2000). The intercrestal line is reported to most frequently cross the vertebral column at the L4-5 disc (Mac Gibbon & Farfan 1979; Quinelle & Stockdale 1983), L4 spinous process (Cunningham & Romanes 1979; Nimmo et al 1994), or L4-5 interspinous space (Render 1996). From this it is clear that no clear consensus exists, at least not in the literature, as to where exactly the intercrestal line intersects the spine. This study aimed to determine whether palpation of the superior aspect of the iliac crest is a reliable, accurate and/or valid method of determining the location of the spinous process of the fourth lumbar vertebra in the standing, seated and prone positions. Thirty participants were marked by three examiners in the standing, seated and prone positions, using the iliac crests to locate the fourth lumbar vertebra. An X-ray was taken of each participant in each of the three positions, after being marked by all three examiners. Measurements were then made on the x-rays, as well as visual assessments by examiners to assess the location of the markers on the lumbar anatomy. The results demonstrated consistent inter-examiner reliability, however the accuracy of using the iliac crest to locate the fourth lumbar vertebra was poor. This is disappointing as the ability to palpate spinal levels is a basic skill and a pre-requisite to more complex palpatory tasks within manual medicine. As for the validity aspect of using the iliac crests to locate the fourth lumbar vertebra, this method was found to be valid in locating the spinous process of the fourth lumbar vertebra. However, it is not a very reliable method, considering that there is only a 53.3% chance of locating the spinous process of L4 once in three attempts in the standing and seated positions and only a 46.7% in the prone position. The reliability of palpation of anatomical landmarks needs to be validated further in future studies as motion palpation and the palpatory assessment of effectiveness of treatment applied to correct motion restriction are predicted upon accurate localization of anatomical landmarks The large variation in intersection points of the intercrestal line does however possibly explain the different opinions found in the literature, and it can be said that to a certain degree all of them are correct.

M.Tech. / OBJECTIVE: The aim of this study was to determine the electromyographic effect of flexion distraction therapy of the lumbar spine on the Erector Spinae muscles in participants with lumbar facet dysfunction. STUDY DESIGN: Thirty participants with lumbar facet dysfunction underwent 6 flexion distraction therapy treatments on alternate days over a 2-week period (excluding weekends) to test the electromyographic effect on the Erector Spinae muscle. SETTING: University of Johannesburg Chiropractic Clinic, Johannesburg, South Africa. SUBJECTS: Thirty participants with lumbar facet dysfunction participated in this study. The participants were divided into two groups of fifteen participants each and matched according to age and gender. Group 1, the study group, received flexion distraction therapy to the restricted segments in the lumbar spine. Group 2, the control group, did not receive any flexion distraction therapy and rested during the duration of the treatment. METHODS: Lumbar Erector Spinae muscle electrical activity was tested before and after treatment one, three and six using surface electromyography (sEMG). One pair of bipolar electrodes was placed bilaterally over the Erector Spinae muscles at the level of L3. Participants were asked to lie down in a prone position with their arms next to their sides. They were then instructed to perform five maximum voluntary lower back extension exercises by lifting their chests and shoulders as high off the plinth as possible. Each contraction lasted five seconds, with a rest period of ten seconds between each contraction. The average rest and work surface electromyography readings were recorded, analysed and compared for reference. Information regarding the intensity of the pain experienced by the vii subjects was also collected at the start of treatment one, three and five using the Numerical Pain Rating Scale. RESULTS: Comparison of the results indicated a statistically significant difference between the two groups and their responses to the treatments. Subjectively, a statistically significant improvement was observed in Group 1 between the third and the sixth treatments and the first and the sixth treatments, with an overall 80% improvement in pain, thus demonstrating the medium to long term effects of flexion distraction therapy. Objectively, Group 1 demonstrated a statistically significant medium to long term improvement in the resting rate of the Erector Spinae muscles as observed between the first and sixth treatments. Statistically, the two groups responded differently over time with regards to the contraction ability of the Erector Spinae muscle. A statistically significant and immediate improvement was observed in the sixth treatment in Group 1, thus further supporting the long term effects and benefits of flexion distraction therapy. CONCLUSION: In light of these findings it can be concluded that flexion distraction therapy, as represented by Group 1, demonstrated favourable treatment results in terms of the pain experienced by the subjects, the resting rate and contraction ability of the Erector Spinae muscles. The trends observed in this study should be used and tested in future research studies of a similar nature incorporating larger sample groups.

M. Tech. / It has been noted in the literature that the sensory system consists of the visual, vestibular and somatosensory systems (Guyton and Hall, 1997; Arnold and Schmitz, 1998; Murphy, 2000; Nakata and Yabe, 2001; Magee, 2002 and Gatterman, 2004). In congruence with the above authors Katz (1996), Gatterman (2004) and Murphy (2000), Morningstar, Pettibon, Schlappi, Schlapp and Ireland (2005) further stated that the postural reflexes can be subcategorised as the following: visual righting reflex, labyrinthine righting reflexes, neck righting reflexes, body on head righting reflexes and body on body righting reflexes. Each of these neurological mechanisms plays a role in balance / equilibrium. Furthermore it has been shown that spinal manipulative therapy has an effect on neurological systems. Therefore it stands to reason that spinal manipulative therapy may have an effect on balance or equilibrium.

A dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic at Technikon Natal, 1998. / The absence oftested theory has resulted in the continued variation of treatment protocols in the treatment of mechanical low back pain. This study was designed to determine the relative effectiveness of specific passive mobilization versus spinal manipulation in the treatment of uncomplicated mechanical low back pain. It was hypothesized that both spinal manipulative therapy and specific passive mobilization would be effective, but that manipulation would be significantly more effective in terms of objective and subjective findings, over the same two week treatment period / M

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Department of Chiropractic, Durban University of Technology, Durban, South Africa, 2016. / Aim: To determine the intra- and inter-examiner reliability of the radiographic assessment of the cervical lordosis of asymptomatic adult males. Participants: Eighty lateral plain film radiographs of the cervical spine of asymptomatic males aged 18-45 years (taken in a previous study) were utilised for this study. However, due to the obstruction of the C7 vertebral body by the trapezius muscle, the examiners were unable to assess the CL on all 80 plain film radiographs. Three examiners took part in the study viz. Examiner One who was a qualified chiropractor with three years of clinical experience, Examiner Two who was a qualified chiropractor with six years of clinical experience and Examiner Three who was a chiropractic master’s student. Methodology: The initial set of assessments of the CL using the C1-C7 and C2-C7 modified Cobb methods was completed by Examiner One and captured on an Excel spread sheet for Round One. The procedure was then repeated for Examiners Two and Three. The process was repeated for the second set of assessments (Round Two). Each examiner was given a maximum of two weeks to complete their assessments for each round. The data was statistically analysed using SPSS 22.0 and Stata 13. Descriptive data was presented in tables as mean and standard deviation at a 95% confidence interval while intra- and inter-examiner reliability was determined using the Kappa coefficient. Results: The mean (± SD) CL values obtained by each examiner using the C1-C7 modified Cobb method for Round One was: Examiner One: 45.6˚ (± 10.4˚) (n = 70), Examiner Two: 44.0˚ (± 11.0˚) (n = 75) and Examiner Three: 43.8˚ (± 12.0˚) (n = 72). The mean (± SD) CL values obtained by each examiner using the C1-C7 modified Cobb method for Round Two was: Examiner One: 46.7˚ (± 10.7˚) (n = 72), Examiner Two: 43.3˚ (± 11.1˚) (n = 74) and Examiner Three: 43.8˚ (± 11.5˚) (n = 72). The mean (± SD) CL values obtained by each examiner using the C2-C7 modified Cobb method for Round One was: Examiner One: 15.9˚ (± 9.2˚) (n = 72), Examiner Two: 22.6˚ (± 9.7˚) (n = 75) and Examiner Three: 17.2˚ (± 9.7˚) (n = 72). The mean (± SD) CL values obtained by each examiner using the C2-C7 modified Cobb method for Round Two was: Examiner One: 16.3˚ (± 9.4˚) (n = 72), Examiner Two: 20.5˚ (± 9.0˚) (n = 74) and Examiner Three: 16.9˚ (± 9.2˚) (n = 72). The intra-examiner reliability obtained by each examiner using the C1-C7 modified Cobb method for Round One and Round Two was: Examiner One: K = 0.16, Examiner Two: K = 0.11 and Examiner Three: K = 0.16. The intra-examiner reliability obtained by each examiner using the C2-C7 modified Cobb method for Round One and Round Two was: Examiner One: K = 0.21, Examiner Two: K = 0.04, Examiner Three: K = 0.22. The inter-examiner reliability obtained by each examiner using the C1-C7 modified Cobb method for Round One and Round Two respectively was: Examiner One vs Examiner Two: K = 0.03; K = 0.09, Examiner One vs Examiner Three: K = 0.19; K = 0.15, Examiner Two vs Examiner Three: K = 0.03; K = 0.08. The inter-examiner reliability obtained by each examiner using the C2-C7 modified Cobb method for Round One and Round Two respectively was: Examiner One vs Examiner Two: K = 0.00; K = 0.01, Examiner One vs Examiner Three: K = 0.19; K = 0.11, Examiner Two vs Examiner Three: K = 0.02; K = 0.05. There was a significant difference in the intra-examiner findings for both the modified Cobb methods (p < 0.05). Using the C1-C7 modified Cobb method, there was a significant difference in the inter-examiner reliability findings between all three examiners for both rounds (p < 0.05). There was no significant difference in the inter-examiner findings of the CL using the C2-C7 modified method between Examiner One versus Examiner Two for Round One (p = 0.33) and Round Two (p = 0.23) but there was a significant difference in the findings between Examiner One versus Examiner Three (p < 0.05) and between Examiner Two versus Examiner Three (p < 0.05) for Round Two only. Conclusion: The results of this study are in agreement with those of a previous study which reported that the C1-C7 modified Cobb method over-valued the magnitude of the curve while the C2-C7 modified Cobb method under-valued the curve. A significant difference in the intra-examiner findings suggests that recall bias did not significantly affect the assessments while inter-examiner findings suggest that experience and skill of the examiners as well as assessments that require drawing of lines and measuring of angles might lead to differences in the results obtained. Further studies which would utilise a large number of digitised radiographic images from both asymptomatic and symptomatic individuals are required to confirm the findings of this study. / M