Dissertations / Theses on the topic 'Fasciae (anatomy)'

Résumé

Ce travail de thèse contribue à déterminer chez l’humain, le rôle de différentes structures fasciales (expansions aponévrotiques, tissu conjonctif aréolaire, fascia profond et paratendon) disposées en parallèle ou en série avec leur tendon respectif.

La première partie de ce travail est consacrée à l’étude de l’expansion aponévrotique du biceps brachial. Deux protocoles ont été développés sur spécimens cadavériques frais. Un premier, anatomique, a permis de mettre en évidence des caractéristiques individuelles telles que la longueur et la largeur sans lien avec le sexe et la latéralité. D’autre part, une partie profonde de l’expansion aponévrotique du biceps brachial a été observée de façon constante.

Le second, biomécanique, nous a permis d’étudier les mouvements de flexion du coude et de supination de l’avant-bras ainsi que les bras de leviers instantanés du muscle biceps brachial avec et sans la présence de son expansion aponévrotique. Les résultats nous indiquent que cette structure limite la flexion du coude ainsi que la supination de l’avant-bras, tout en maintenant une rythmicité entre la flexion et la supination. D’autre part, elle permet d’augmenter le bras de levier musculaire du muscle biceps brachial en flexion et en supination.

Dans la seconde partie de ce travail, notre étude in-vitro s’est intéressée à la contribution relative des structures tendineuses et fasciales sur l'avantage mécanique musculaire lors d’une plastie du ligament croisé antérieur aux tendons des muscles droit interne et demi-tendineux. Les résultats suggèrent que la voie myofasciale des muscles droit interne et du demi-tendineux semble cruciale pour la transmission de force permettant le déplacement du segment jambier.

Malgré les limitations inhérentes aux études sur préparations anatomiques, ce travail contribue à une meilleure connaissance de certaines structures fasciales, dont les implications cliniques devraient être prises en considération.

Doctorat en Sciences biomédicales et pharmaceutiques
info:eu-repo/semantics/nonPublished

Current understanding concerning the human deep cervical fascia (DCF) differs between anatomists, surgeons, and radiologists. One reason has been the varying methodologies used to examine the DCF and the terminology assigned to each layer or potential space formed. Previous knowledge concerning the DCF originally came from cadaveric studies. However, such findings were highly subjective, reliant on the dissectionist�s skill with a scalpel. With the recent advent of radiological imaging and sheet plastination, there has been a re-examination of the fascial layers (investing, pretracheal, and prevertebral) that constitute the DCF. Although there is general consensus regarding the existence of the three layers, there is continuing conjecture over the concise anatomical description of these fascial structures. Recently, the investing (superficial) fascia, as a separate fibrous structure, has been questioned with a small number of plastination studies reporting its absence in the postereolateral regions of the neck. Within the suboccipital region (SOS) it is widely reported that the nuchal ligament, extending from the investing layer, directly connects with the spinal dura mater. However, a recent plastination study by Johnson et al. (2000b) found these fibres to dissipate in the SOS.The question remains as to what fibres directly communicate with the spinal dura? The fibrous connective bridge is reported in some clinical studies to originate from the rectus capitis posterior minor (RCPm) via the SOS. The origin of the connective fibrous bridge is essential in understanding the mechanism in the prevention of the phenomenon of 'infolding' and cervicogenic neck pain? Anteriorly, the investing fascia is regarded as a continuance of a 'fibrous collar' that encapsulates the entire neck, yet if it does not truly exist in the posterior neck region, does it actually exist as a tangible structure in the anterior neck? With regard to the deep midline fascial structures that arise from the pretracheal fascia, the presence of two separate spaces, the retropharyngeal and danger space, divided by the alar fascia in the posterior pharyngeal region, is still debated and is yet resolved in the clinical literature. The aims of this qualitative study were to: 1. determine the dural ligamentous and tendinous connections in the posterior atlanto-occipital (PAO) interspace region, and establish the morphology of the PAO membrane, 2. determine whether the investing layer of the DCF is a distinct fibrous structure in the anterior neck and examine the relationship with the subcutaneous platysma muscle, and 3. determine the relationship between the RPS and DS in the posterior pharynx region and identify the configuration of the alar fascia. Twenty-seven cadavers were examined at the gross, macro- and, microscopic level. Blunt and sharp dissections were conducted on 12 specimens. Fifteen cadavers were prepared as epoxy sheet plastinates. Light, fluorescent and confocal microscopy was conducted on the sheet plastinations.The findings of the first study demonstrated that small discrete bundles from medial tendinous fibres of RCPm formed a fibrous connective tissue bridge directly with the spinal dura in the SOS (in all 6 median-sectioned plastinated specimens), not the nuchal ligament as commonly reported. The RCPm fascia, in conjunction with lateral contributions from the perivascular sheath, formed the PAO membrane (ligamentum flavum) which was not continuous with the neural arch of C1 as often cited in anatomical texts. The cerebrospinal junction was also demonstrated to be a naturally formed multi-layered structure in all plastinates and not the result of pathological change as widely reported in clinical literature.The Gross dissection findings of the second study supported the traditional view that the investing layer formed a covering over the anterior triangle neck region. However, findings from plastinations, in conjunction with confocal microscopy, demonstrated clearly that the investing layer is formed from the epimysium of superficial muscles in the anterior neck. In the suprahyoid neck, it appeared disjointed with the fascia of the sternocleidomastoid (SCM) fascia isolated from the neighbouring submandibular fascia. In the infrahyoid neck, it was formed by medial fascial extensions from the omohyoid fascia, SCM fascia, and fused at the midline to the infrahyoid fascia, (pretracheal layer) resulting in two ipsilateral compartments. Distal 'finger-like' fascicles of platysma presented with individual epimysial fascia, which gave the false appearance of a thickened investing layer. These findings contravene those of the traditional view that the investing fascia is continuous at the mid-line.The findings of the third study agreed with both those reported in radiological and cadaveric studies respectively, in that the alar fascia was not present above the level of C1 as purported by radiologists, but became more apparent below this level. The alar fascia was observed to be formed from medial extensions of the carotid sheath, with some minor contributions from the lateral slips of the prevertebral fascia posteriorly, and was visible within transverse plastinated slices to the level of C7. However, at the levels of C4 and C6, the alar fascia appeared to fuse with the buccopharyngeal fascia, (posterior pretracheal layer of the DCF), a finding not previously reported. This study demonstrated, through E12 sheeted plastinated sections, that the morphology and topography of the DCF is complex, and a more precise understanding of the anatomy of the DCF and associated potential spaces is paramount clinically in otolaryngology, concerning the cervical fascial pathways of potentially life-threatening commutative pathologies.

The aim of this thesis is to evaluate the short and long term effectiveness of foot orthoses in the treatment of plantar fasciitis.Three studies were undertaken, the first two informing the third. The aim of the first study was to establish prescription habits of Australian and New Zealand podiatrists in order to ascertain the most commonly prescribed foot orthoses. The second study was conducted to establish the most appropriate outcome measure to assess the effectiveness of foot orthoses in the treatment of plantar faciitis. The main study, a pragmatic single-blind randomised control trial, was conducted to evaluate the effectiveness of three types of foot orthoses in the treatment of plantar fasciitis. The research concluded that provision of appropriate foot orthoses produces small short-term benefits in function for people with plantar fasciitis, but no effect is apparent at twelve months.

The aim of this thesis is to evaluate the short and long term effectiveness of foot orthoses in the treatment of plantar fasciitis.Three studies were undertaken, the first two informing the third. The aim of the first study was to establish prescription habits of Australian and New Zealand podiatrists in order to ascertain the most commonly prescribed foot orthoses. The second study was conducted to establish the most appropriate outcome measure to assess the effectiveness of foot orthoses in the treatment of plantar faciitis. The main study, a pragmatic single-blind randomised control trial, was conducted to evaluate the effectiveness of three types of foot orthoses in the treatment of plantar fasciitis. The research concluded that provision of appropriate foot orthoses produces small short-term benefits in function for people with plantar fasciitis, but no effect is apparent at twelve months.
Doctor of Philosophy (PhD)

The morphology and function of the lumbar region is poorly understood. Better understanding of lumbar regional anatomy may enable improved understanding of lumbar stability and may also improve the clinical management of low back pain. Extensive researches have been carried out on the thoracolumbar anatomy and biomechanics. However, these studies lacked detailed anatomical knowledge about the morphology and function of the lumbar region. This study aims to provide a precise and detailed description of the anatomy of the lumbar spine and its supporting structures. A detailed and thorough literature review of background data was undertaken. Gross degenerative features in the lumbar vertebrae were documented. Three dimensional models of the superior and inferior lumbar articular facets were created by Microscribe. This allowed calculation of the facet orientation and surface area by Rhinoceros software. The surface area was increased towards the inferior vertebral levels, while the orientation became less sagittal inferiorly. The investigations suggest that the coronally oriented facet protects and supports the facet joint, while the sagittal orientation may predispose the facet joint to degenerative spondylisthesis. Gross observation of the thoracolumbar fascia documented the superficial myofascial thickenings, decussation and connections. The posterior and middle layers of the thoracolumbar fascia were identified. A three dimensional model enabled visualization of the bilaminar layers of the fascia which was reconstructed in a virtual space. The morphological measurements of the lumbar multifidus, longissimus and iliocostalis muscles were taken. The cross sectional area of the multifidus muscle was increased gradually towards the L5 level. The foot prints of the multifidus, longissimus, iliocostalis lumborum and inter-spinalis muscles enabled the measurement of the surface areas of the attachments of these muscles. The histological study revealed the fibrous enthesis of the iliocostalis muscle and its indirect attachment to the transverse process of the lumbar spine. The multifidus muscle is attached by a fibrocartilaginous enthesis to the articular process and the facet joint capsule. This study suggests that multifidus muscle supports and stabilizes the facet joints. The lumbar enthesis investigation should receive more attention in future studies. The clinical implications of different lumbar structures and functions may provide insight about the lumbar dysfunction. The ability to identify such differences in situ may facilitate varied clinical management of the various types of lumbar disorders.

Cette thèse s’est d’abord voulue pratique. La chirurgie de l’épaule est en pleine expansion avec le vieillissement croissant de la population et la pratique de plus en plus généralisée du sport. L’épaule est une articulation complexe. Paradoxalement les progrès techniques en chirurgie sont sans cesse grandissants et renouvelés tandis que l’on tientpour acquis des données anatomiques démontrées il y a longtemps et rapportées jusqu’à nos jours. Nous avons voulu confronter l’anatomie avec les techniques diagnostiques actuelles et voir si cela pouvait avoir un impact sur les pratiques chirurgicales. Nous avons également voulu voir si certaines complications chirurgicales pouvaient s’expliquer par des données anatomiques. Ce qui a orienté nos recherches sont les principaux problèmes actuels en pathologie de l’épaule c’est-à-dire la coiffe des rotateurs et le syndrome sous-acromial. Les observations lors des nombreuses dissections de l’épaule nous ont conduit à ces réflexions : comment la glène est-elle vascularisée?, pourquoi est-elle si fragile?, que se passe-t- il dans l’espace sous acromial?, quelle est l’utilité du ligament coraco-acromial?, quels sont ses rapports avec lesuprapinatus?, pourquoi l’insertion du supraspinatus est-elle fragile et difficile à reconstituer ?, la qualité osseuse de la tête humérale a-t-elle un impact sur la géographie des fractures, les échecs des ostéosynthèses, les descellements prothétiques?, qu’est ce que la chape delto-trapézoidienne? Autant de questions que nous nous sommes posées endisséquant cette articulation très complexe qui est l’épaule. Par ailleurs, l’anatomie classique peut maintenant secompléter non seulement de l’histologie, mais aussi de techniques radiologiques modernes comme l’IRM l, le microCT, le synchrotron, la reconstruction 3D, la modélisation en éléments finis
I would like to make a practical thesis. Shoulder surgery is growing and growing as the population is ageing and people is doing more and more sports activities. A lot of technical progress were done but there are still a lot of surgical complications. On the other way some very old anatomical ideas are still alive. I want to see with the actual knowledge, if some surgical complications could be explained by anatomy. Subacromial pathology and bone quality remain the two mainproblems of shoulder surgery and pathology. That’s what had suggested to me this study about the shoulder. I was supposed to analyze glenoid bone first .The aim was to know more about arterial supply of glenoid. That was my firststudy (article 1). Then, I was interested in glenoid bone quality. And the second study had appeared. (article 2). During the shoulder dissection, I was looking for the fascia delto-trapezoidal which I didn’t found as described in books. It was my third study. (article 3). Going on I found the coraco-acromial ligament and I was surprised to see the constant portion under the acromial process. And that gave me the idea for the fourth study. (article 4).As I had discovered the very interesting technique of micro-Ct densitometry, I would like to apply it to the humeral head bone. There was the fifth study. (article 5)But, I want to know more and more about bone quality and I went on with the greater tuberosity and especially the area ofsupraspinatus insertion. The insertion and the sub-chondral bone were analyzed. There’s the last but not least study!(article 6). I was really interested in supraspinatus muscle and tendon and I want to follow the course of the muscle as the zone of conflict. I was the subject of study in life as I went through RMI . The muscle was reconstructed as finite element. Then it was possible to describe the zone of conflict with the supraspinatus. Here’s the seventh article. (article 7)

Le fascia est un tissu conjonctif mou présent à plusieurs endroits dans le corps. Selon la littérature, le fascia pourrait jouer un rôle biomécanique au sein du système musculo-squelettique. On croit donc que la dégradation ou des lésions des fascias pourraient être la cause de certains troubles musculo-squelettiques. Il importe donc d'étudier la mécanobiologie de ce tissu in vivo, c'est-à-dire son évolution dans le temps en réponse aux stimuli mécaniques auxquels il est soumis. Pour ce faire, il est nécessaire de trouver un modèle biologique compatible à notre étude. Par le présent projet, on désire procéder à l'examen de la queue de rat comme modèle expérimental pour l'étude mécanobiologique du fascia in vivo. La queue de rat sera considérée comme un modèle expérimental valide si : (1) on démontre théoriquement et/ou expérimentalement qu'il contribue à la biomécanique de la queue; (2) il est possible d'influencer son évolution temporelle par l'application de chargements spécifiques; et (3) on peut identifier ou développer une technique d'analyse permettant d'évaluer cette évolution. L'investigation des deux premiers points a nécessité la modélisation mécanique de la queue de rat à l'aide du logiciel Adams/View. Afin de modéliser et paramétrer judicieusement les composantes de la queue de rat, on a donc : étudié exhaustivement l'anatomie de la queue de rat par la revue littéraire, la dissection et différentes techniques d'imagerie; effectué une revue littéraire sur les dernières avancées scientifiques sur le fascia de même que sur les propriétés mécaniques des différentes structures anatomiques (tissus) de la queue; programmé un traitement d'images pour évaluer l'aire transversale et le bras de levier des structures complexes; développé une méthodologie de tests pour la caractérisation des propriétés mécaniques de la peau et du fascia de la queue de rat. Deux points sur trois ont été validés au cours de ce projet. Le modèle de queue de rat a permis de valider qu'il serait possible de modifier les stimuli mécaniques auxquels le fascia est soumis par blocage et/ou déformation d'une articulation par un appareillage de type Ilizarov. De plus, l'élaboration des tests de traction sur le fascia a permis de confirmer la possibilité d'évaluer l'évolution du fascia en fonction des stimuli mécaniques auxquels il est imposé. En conclusion, le modèle ne démontre pas la contribution du fascia à la biomécanique de la queue puisqu'il ne modélisait que son apport en rigidité longitudinale. Par contre, la modélisation a apporté d'autres hypothèses à propos du rôle joué par le fascia. Un nouveau modèle testant son rôle en cisaillement et en rigidité radiale devra être créé. On conserve donc l'hypothèse que la queue de rat constitue un bon modèle pour l'étude mécanobiologique du fascia in vivo.

The iliotibial band (ITB) is a complex structure that is unique to humans among apes and is derived from the fascia lata (FL) of the thigh. Although the ITB evolved in the hominin lineage, it is unclear whether it evolved to improve locomotor economy, increase stability, or serve a different function. This dissertation tests the hypothesis that the ITB stores and recovers elastic energy during walking and running.
Human Evolutionary Biology

IntroductionL’anatomie nerveuse pelvienne est imprécise dans la littérature. ObjectifsReprésenter en 3D l’innervation autonome du pelvis. Démontrer la capacité de l’IRM voir cette innervation.Matériels et méthodesDes coupes ont été faites sur le bassin de fœtus et d’adultes, puis traitées par des colorations et immunomarquages. Les lames ont été numérisées et reconstruites en 3D.Nous avons effectué une confrontation anatomo-radiologique entre des images d’IRM et de dissection.RésultatsNous avons pu décrire l’innervation autonome du pelvis et faire une cartographie des neuromédiateurs. Nous avons également pu suggérer des plans d’épargne nerveuse lors de la chirurgie. Les acquisitions IRM ont permis une visualisation de l’innervation de façon précise avec une bonne concordance.ConclusionCe travail permet une meilleure description de l’innervation pelvienne et des plans chirurgicaux à emprunter en chirurgie pelvienne. L’IRM permet bien de visualiser l’innervation pelvienne
Introduction :Pelvis nervous anatomy is imprecise in literature. Objectives:1-To describe and represent in 3D pelvic autonomic innervation. 2-To demonstrate the capacity of MRI to visualize pelvic autonomous innervation.Materiel/patients and methods:Serial histological sections were made from foetuses and adults. Sections were treated with conventional and immunostainings. Sections were digitalized and reconstructed in 3D. An anatomo-radiological comparison was made between MRI images and dissection. Results:Our study enabled to localize the pelvic autonomous innervation and to realize a complete neuro-mediators cartography.MRI acquisition allowed an good visualization of the autonomous innervation, with a good correlation with dissection.Conclusion and perspectives:This study enabled a better understanding of pelvic nervous anatomy and physiology. It also demonstrated that this anatomy is visible on MRI

Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 12, xiii, 84 leaves
Plantar Fasciitis (PF) or “painful heel syndrome” is an inflammation of the plantar fascia at its insertion on the medial calcaneal tubercle. Accounting for 7-9% of total sports injuries, this condition is predominantly due to overuse and is notoriously difficult to treat. Traditionally treatment focused on the resolution of the inflammation with the application of such modalities cross frictions / transverse frictions being the modality of choice. With such modalities there are however limitations which include the detection of the appropriate areas in which treatment should be given as well as the treatment depth achieved. The GISTM, however is an advanced form of soft tissue mobilisation that employs the use of specifically designed stainless steel instruments that, when manually brushed over the skin of the affected area, are thought to detect and release scar tissue, adhesions and fascial restrictions. This complementary technique is hypothesized to work in the same manner as cross friction massage, and is thought to achieve quicker and improved outcomes by its detection of the treatment area(s) as well as improving the depth of treatment application. This assertion was however untested. Therefore the purpose of this study was to determine the efficacy of the Graston Technique Instrument-assisted Soft Tissue Mobilisation (GISTM) in the treatment of Plantar Fasciitis in runners.

Thesis (M.Tech.: Chiropractic)-Dept.of Chiropractic, Durban Institute of Technology, 2003 xv, 93 leaves
Plantar Fasciitis (PF) is a common injury, and one which is known to be stubborn to many forms of treatment. The purpose of this investigation was to determine the effectiveness of manipulation of the subtalar joint combined with static stretching of the Triceps Surae muscles compared to manipulation alone in the treatment of PF. Studies have shown chiropractic manipulation to be effective in treating this overuse injury, and gastro-soleus stretching is a treatment advocated by many authors, but which has not yet been investigated in combination with manipulation. This study consisted of 40 patients who were randomly divided into two equal groups. Group One received manipulation to restrictions in the subtalar joint, and Group Two received subtalar manipulation in addition to two static stretched of the gastro-soleus muscles.

M. Tech.
Plantar fasciitis is the most common cause of heel pain for which professional care is sought (Singh, 2008). Plantar fasciitis is a common injury, and one which is known to be stubborn to many forms of treatment. The aim of the study was to determine the most effective treatment for individuals suffering with plantar fasciitis comparing three protocols, i.e. mobilisation and manipulation of the foot and ankle with cross friction massage of the plantar fascia versus stretching of the gastroc-soleus complex with cross friction massage of the plantar fascia or a combination of the aforementioned treatments. Participants in the study were recruited from information pamphlets, the University of Johannesburg Chiropractic and Podiatry Day Clinics and running clubs. Only those participants that conformed to the selection criteria were allowed to participate in the study. A total of forty five participants were included. These participants were randomly placed into one of three groups of fifteen participants in each group. Group one received manipulation and mobilisation therapy to the foot and ankle with cross friction massage of the plantar fascia. Group two received cross friction massage of the plantar fascia and stretching of the gastroc-soleus muscle. Group three received a combination of the aforementioned therapies. Subjective data was collected using the Short Form McGill Pain Questionnaire (SF-MPQ) and the Foot Function Index (FFI). Objective data was collected using the algometer to test differences in pain at the plantar fascia as well as ankle range of motion in dorsiflexion and plantarflexion which was measured using a goniometer. The results of this study indicate that cross friction massage of the plantar fascia and stretching of the gastroc-soleus complex would appear to have shown the greatest overall improvement in terms of reducing the pain and disability and ankle dorsiflexion range of motion. Manipulation of the foot and ankle, cross friction massage of the plantar fascia and stretching of the gastroc-soleus complex proved to have shown the greatest overall improvement in plantarflexion only. Based on the results of the study, cross friction massage and gastroc-soleus stretching is the most effective treatment protocol for plantar fasciitis.

Thesis (M.Tech.: Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2005 xiv, 99 leaves
Plantar Fasciitis (PF), also called ‘the painful heel syndrome’, is a common cause of heel pain (Barrett and O’Malley, 1999:2200), accounting for between 7% and 10% of all running injuries (Batt and Tanji, 1995:77; Chandler and Kibler, 1993:345). Primarily an overuse injury, resulting from tensile overload, it involves inflammation and micro-tears of the plantar fascia at its insertion on the calcaneus (Lillegard and Rucker, 1993:168; Barrett and O’Malley, 1999:2200). The body’s attempt to heal these micro-tears leads to chronic inflammation and the formation of adhesions (Ambrosius and Kondracki, 1992:30). Transverse friction massage has been found to be beneficial in the treatment of PF (Hyde and Gengenbach, 1997:478,481; Hertling and Kessler, 1996:137). Cyriax (1984) and Prentice (1994) state the effect of frictions to include the breakdown of adhesions (scar tissue), as well as preventing the formation of further adhesions. Graston Technique Instrument-assisted Soft Tissue Mobilisation (GISTM), based on the principles of frictions, aims to break down adhesions, realign collagen fibres and aid in the completion of the inflammatory process (Carey-Loghmani, 2003:31, 51-62; Hammer, 2001). Enabling us to see changes on ultrasonography, which has been found to be an objective, non-invasive way of evaluating PF (Wall and Harkness, 1993:468; Tsai et al, 2000:259; Cardinal et al, 1996:258). These changes include decreased thickness of the fascia. The aim of the study was to see the effect of GISTM on PF in runners, in terms of ultrasonography, and identify any correlation between these findings and other objective and subjective findings.

Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Department of Chiropractic, Faculty of Health Sciences, Durban University of Technology, Durban, South Africa. 2015.
Background: Plantar fasciitis (PF) is inflammation of the plantar surface of the foot, usually at the calcaneal attachment and is most commonly due to overuse. It is the most common foot condition treated by healthcare providers. Conservative treatment using taping is one of the first lines of treatment for PF. Low-Dye taping and Kinesio taping are two types of taping techniques commonly used to treat PF. Low-Dye taping and Kinesio taping have different intrinsic tape properties as well as different mechanisms of action in the treatment of PF. Low-Dye taping involves the use of a non-stretch, rigid tape. Rigid tape is commonly used by therapists primarily for the mechanical properties the tape provides to support the injured structure as well as to protect against re-injury. Low-Dye taping shortens the distance between origin and insertion of the plantar musculature and fascia, decreasing stress and tensile forces along the plantar plate to protect the plantar fascia and allow healing to occur. Kinesio tape is an elastic tape that allows a one-way longitudinal stretch; it is applied in a specific manner to achieve its therapeutic effects and forms convolutions on the skin. The proposed mechanism of action of Kinesio tape involves improving circulation of blood and lymphatics to resolve oedema caused by the inflammatory component of PF; suppressing pain, and; relieving muscle tension to return fascia and muscle functioning to normal. Both forms of tape have shown effectiveness in the treatment of PF; however the effectiveness of one taping technique versus the other has not yet been explored. Objectives: The purpose of this study was to determine the effectiveness of Kinesio tape alone versus Low-Dye tape alone in the treatment of PF in terms of both objective and subjective measures. Methods: Thirty participants with a diagnosis of PF, between the ages of 20 and 45, were randomly allocated into two treatment groups. Both groups received treatment in the form of a taping technique, either Kinesio tape or Low-Dye tape. Assessments were made pre-treatment at each visit and at a follow up visit, with seven visits in total. Assessments included objective data measures (ultrasonography, algometer readings, weight-bearing ankle dorsiflexion measurements) and subjective measures (the visual analogue scale and the foot function index questionnaire). Data was recorded in a data collection sheet and Statistical Package for the Social Sciences version 21 was used to analyze the data with a p value of < 0.05 considered as being statistically significant. Results: Most outcomes showed a significant improvement over time regardless of which form of treatment they received. For the VAS and pain walking outside, in the disability section of the FFI, there was statistical evidence of the Kinesio tape group improving more than the Low-Dye tape group. For morning pain, in the pain section of the FFI, and pain climbing curbs, in the disability section of the FFI, there was statistical evidence of the Low-Dye tape group improving more than the Kinesio tape group. For all the other outcomes there was a non-significant trend towards the Low-Dye tape group showing a greater improvement than the Kinesio tape group. Conclusion: Kinesio taping and Low-Dye taping were both found to be effective in the treatment of PF with neither form of tape showing superiority to the other in the treatment of PF.

Submitted in fulfillment of Masters Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2016.
Background: Myofascial therapies are widely researched with regards to their effects on pain, disability and range of motion. The benefits of such therapies are attributed to the mechanical changes that myofascial therapies are proposed to have on the fascial and myofascial structures. Breakthrough imaging and laboratory techniques, have allowed the in vivo study of these structures, resulting in new hypotheses regarding the roles that connective tissues might play in proprioception. Objectives: The purpose of this investigation was to assess the effects of two myofascial therapies, in terms of immediate changes in navicular pronation, great toe extension measurements and balance tests, as indicated by the postural stability (eyes open and closed) and limits of stability tests. Pre-, post-intervention analysis was used to determine if there were significant changes between the groups. Aims: The myofascial interventions aimed to reduce myofascial restriction and adhesions, within the plantar and crural fasciae’s of individuals with bilateral pronation. Methods: The study recruited 45 subjects with bilateral pronation (2 or more degrees) and randomly allocated them into a placebo ultrasound, ischaemic compression or myofascial release group. Each subject underwent a case history, physical examination, foot, ankle and knee regional examinations, as well as screened for contraindications. A blinded assistant examiner helped measured and record the baseline measurements for navicular position and great toe extension, using a standard two arm goniometer. The researcher then tested participants for postural stability (eyes open, eyes closed) and limits of stability, on the Biosway Portable Balance System. Subjects were then examined and treated bilaterally, for myofascial restrictions in the foot, lower leg and ankle, related or unrelated to the pronation present. Pre- and post-intervention measurements were recorded within a 20 minute window immediately before and after the relevant intervention. Statistical Analysis: Repeated measures ANOVA testing was used to compare the rate of change (between pre- and post-intervention measurements) amongst the three groups, and a p-value <0.05 was considered statistically significant. Post hoc Bonferroni adjusted tests were done to compare all pair wise groups, as well as identify trends between groups. Results and Discussion: The data showed that both myofascial groups, significantly improved in postural stability (eyes closed) overall, post hoc testing showed the ischaemic compression group (p=0.004) and myofascial release group (p=0.031), compared to changes in the placebo ultrasound group.The overall changes were predominantly found in the anterior-posterior axes, with significant improvements in ischaemic compression (p=0.007) and myofascial release group (p=0.053) axes compared to placebo. For the other outcome variables, statistically significant treatment effects were not consistant bilaterally between the groups. Significant (p=0.051) time*group differences for changes in right navicular position. Post hoc testing revealed a borderline significant (p=0.056) improvement in pronation for the myofascial release group in comparison to the ischaemic compression group, which on average got worse. With regards to passive non-weight bearing great toe extension left, significant (p=0.067) improvements for the ischaemic compression group were shown compared to placebo, although this was not consistent for all the great toe extension tests. A borderline significant (p=0.059) time*group effect for postural stability (eyes open) medial-lateral test was obtained. Post hoc Bonferroni adjusted testing showed a non-significant (p=0.063) correlation between the myofascial release group and placebo ultrasound group. Conclusion: The results of this study, rejects the Null hypothesis for changes in balance measurements and suggests that both myofascial interventions had a significant positive outcome for postural stability, compared to placebo. The postural stability (eyes closed) test gave an indication of positive or negative changes in centre of pressure displacement, about the centre of gravity. It is noted that the sham ultrasound, used as a placebo intervention may have produced a treatment effect and is therefore not a reliable placebo measure for this type of investigation.
M

Thesis (M.Sc.), Faculty of Science, University of the Witwatersrand, 2011
General descriptions of the fascia lata as a structure could be found in all major anatomy textbooks. However, there is a paucity of information on the fascia lata and its surrounding structures in scientific literature. This study investigates how fascia and muscle relate in the extensor compartment of the thigh – i.e. as the muscle epimysium or as a separate fascial layer. Using detailed dissections of ten cadaver lower limbs and axial Magnetic Resonance Imaging and Ultrasonography in four volunteers, findings were compared to correlate all observed features. Results highlighted anatomical aspects and relationships not previously documented. The fascia lata demonstrated a single, epimysial relationship to the tensor fascia lata, upper sartorius and parts of the vastus medialis muscles, while forming a separate fascial layer over the lower sartorius, rectus femoris and vastus lateralis muscles. Findings suggest the fascia lata may function as more than containment of musculature and allude to functional implications for surgery and rehabilitation.