Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2005. / Damage to the proprioceptive organs, as well as lack of proprioceptive retraining, after an inversion ankle sprain, has been shown to contribute to the problem of recurring ankle joint injuries, which has the highest incidence of sports related injuries. The proprioceptive organs are important as afferent pathways in reflexes and for the adjustment of posture and muscle tone (Miller and Narson, 1995 and Jerosch and Bischof, 1996). Manipulation is thought to cause a change in the afferent pathways of the manipulated joints and it is proposed that this change may restore normal proprioceptive input, in a previously injured joint (Wyke, 1981 and Slosberg 1988). This however is unproven as indicated in a study by Lephart and Fu, (1995), where techniques to improve proprioception remain untested and according to Brynin and Farrar (1995), screening for proprioceptive and neuromuscular co-ordination should be carried out as part of a chiropractor's physical examination and injury evaluation. This was a qualitative pre-post clinical study. Forty (40) subjects between the ages of 25 and 45, who had been diagnosed with chronic ankle instability syndrome, were recruited. The only treatment they received was a single mortise separation adjustment and all participants received the same treatment. Clinical outcomes were measured before and after the adjustment on both ankles using a Dualer Electronic Inclinometer and algometer. Only the affected ankle received an adjustment, but both ankles were measured. The participants were evaluated by the examiner at an initial consultation during which diagnosis of chronic ankle instability syndrome was made based on case history, physical examination and foot and ankle regional examination. Participants presented with at least four of the following (Kessler and Hertling 1983) / M

A dissertation presented in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban Institute of Technology, 2005. / Following an inversion ankle joint sprain, damage to the proprioceptive organs can occur, which is made worse by lack of proprioceptive retraining and will increase the chances of re-injury (Hoffman and Payne 1995:144 and Anderson, 2002). Pellow and Brantingham (2001) indicated that patients who received multiple manipulations improved more rapidly than patients in the placebo group. Therefore it is proposed that manipulation provokes changes in afferent input that may restore normal proprioceptive input (Slosberg, 1988). However, Pellow and Brantingham (2001) were not able to establish what effect multiple manipulations had, as opposed to a single manipulation, on the proprioception on the foot and ankle complex and how this may influence the clinical outcome of the patient’s treatment. Therefore, it was hypothesized that multiple manipulations of the foot and ankle complex would have a greater effect on chronic ankle instability syndrome than a single treatment in terms of overall improvement subjectively and objectively. In addition to this the following was also hypothesized: • That multiple manipulations of the foot and ankle complex would increase the ROM to a greater extent than single manipulations. • That multiple manipulations would decrease point tenderness more effectively than a single manipulation. / M

M.P.H., Faculty of health Sciences, University of the Witwatersrand, 2011 / Background: The hospital as an organisation employs many people who may be at risk for Injuries on Duty (IOD). Although IOD occur across the hospital and impact on staff morale and quality of care, no formal study has been conducted within the public hospitals in South Africa on the profile of employees who have sustained these injuries. This study was aimed at comprehensively describing the IOD and related factors at Klerksdorp/Tshepong/Potchefstroom (K/T/P) Hospital Complex in order to better understand and plan appropriate preventive strategies. Methodology: The study was based on a cross-sectional design involving retrospective record review obtained from the hospital information system. No primary data was collected. The study setting was K/T/P Hospital complex. All records of employees who sustained IOD during the study period were reviewed. Data was collected on relevant variables such as employee profile, type of IOD during the study period. Descriptive statistics was used to analyse the data. Results: The study found that the total number of IOD during this period was 152. The annual prevalence rate was 2.3% (Klerksdorp-Tshepong Hospital Complex) and 2.8% (Potchefstroom Hospital). . The category of employees who experienced injuries were administration (5.3%), support (18.8%), medical (34.9%), nursing (36.2%), professional (4.6%). The types of the injuries sustained were cut (8.6%), fall (19.7%), minor injuries (9.2%), needle prick (49.3%), patient related (1.3%), splash (11.8%). With regard to PEP costs, Klerksdorp Hospital incurred the highest costs of R31 231 34, followed by Potchefstroom Hospital with R23 714 83 and Tshepong Hospital with R19 305 57 during the study period

Calcium channel blockers (CCB) was studied extensively in cardiology for their tissue protective effect following myocardial infarction; we hypothesized that administration of a CCB would interfere with the processes that result in exercise-induced muscle damage (EIMD) and delayed onset muscle soreness. To investigate the effects of a CCB on a development and recovery from EIMD, we used a double blind, placebo controlled protocol to administer CARDIZEM CD, 240 mg/day, for 6 days to 30 college age males and females. To induce EIMD, subjects performed 4 sets of 10 repetitions of squat, leg press, leg extension, and leg curl. We observed no treatment related difference in CPK or DOMS levels. Overall, peak quadriceps force (PQF) were not different between the Placebo and Diltiazem groups, but PQF was significantly greater in the Diltiazem groups immediately after the weight lifting bout. Average quadriceps force (AQF) values decreased in both groups following the exercise bout; however, no difference existed between the groups (p>.05). The Diltiazem group PQF and AQF values returned to the pre-exercise levels 24 hours earlier than did the Placebo group. Neutrophils decreased by 21% in the Diltiazem group compare with a 1.4% increase in the Placebo group, due to large variability in the neutrophil count at the baseline, this difference was not significant. Lymphocytes were not affected by CCB treatment. Administration of diltiazem did not interfere with the development of EIMD as measured by CPK release and the DOMS scores. Diltiazem appeared to affect quadriceps force generation immediately following the weight lifting bout and to speed the recovery of muscle force to pre-exercise level in our sample of college age adults. Heart rate was significantly lower in the Diltiazem group after the administration. There was no difference in either systolic or diastolic blood pressure after the administration between the Diltiazem and Placebo groups. The incidence of side effects was very low and similar in both groups. The administration of this dose and preparation of diltiazem does not change heart rate or blood pressure in a clinically significant fashion, and was well tolerated in our sample of college age adults. / Graduation date: 1997

published_or_final_version / Nursing Studies / Master / Master of Nursing

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It has been well documented that providing informal care for a person with a traumatic brain injury can be burdensome. The goal of this research was to discover the effects of two stressors, severity of daily hassles and distress caused by the behavioral problems exhibited by the person with the brain injury, and two supports, social support and income, on the caregiver burden and quality of life felt by caregivers.Data were collected using questionnaires sent via postal mail to members of the Brain Injury Associations of Ohio, Michigan, and Indiana. Each packet contained a demographic questionnaire, the Social Provisions Scale, the Head Injury Behavior Scale, the Daily Hassles Scale, the Caregiver Burden Scale and the Satisfaction with Life Scale. Ninety-one respondents returned usable protocols. Hierarchical regressions were utilized to analyze the data.When controlling for demographic variables, stressors were found to account for a statistically significant proportion of the variance in subjective caregiver burden but not in satisfaction with life. When controlling for both demographic variables and stressors, supports were not found to significantly predict either subjective burden or satisfaction with life. Upon further investigation, it was found that behavioral distress was most predictive of caregiver burden and the severity of daily hassles was the next most predictive variable of burden.This research was limited by the Midwest location of the participants and their lack of ethnic and gender diversity. Additionally, each respondent had access to support groups and they all had time to fill out the questionnaires. It is likely the case that many caregivers do not have this kind of support or the time to complete unnecessary paperwork. Finally, all of the factors affecting burden and quality of life for caregivers could not possibly be accounted for. Future research should account for a more diverse group of caregivers and assess some of the less frequently researched predictors. Scales more specific to caring for a person with a brain injury could be developed and utilized to explore sources of satisfaction for caregivers. Finally, more attention could be paid to the overall quality of life of caregivers. / Department of Counseling Psychology and Guidance Services

In the aftermath of an acquired brain injury, many survivors and their family members struggle to maintain their preferred identities. This is particularly so given the relational nature of storytelling and the numerous power relations functioning to silence and restrict certain stories, while others are allowed to be told. This study employs a qualitative methodology, narrative constructionist inquiry, in order to examine the stories of three participants following their involvement in a multi-family outdoor adventure program for brain injury survivors. The aims of the program were to provide opportunities for families to engage in outdoor adventure activities together, such as hiking, sea kayaking and challenge courses, so they could strengthen their relationships with themselves, each other, and their communities. Through an exploration of their stories, valuable insights regarding the shifts in narrative identity that occurred following brain injury are illuminated. Further, reflections pertaining to the importance of social contexts, nature and adventure, and the value of hope in the construction of preferred identities are discussed. Finally, recommendations for future research and practice are offered. / Graduate