Biomedical subjects
J W Fisk
Publications and source records attributed to J W Fisk.
Scheuermann's disease. Clinical and radiological survey of 17 and 18 year olds.
This is a study of the incidence and possible predisposing stress factors of Scheuermann's disease (S.D.). 500, 17 and 18 year old, students from the local larger schools, from one country town school and from the local Teachers' Training College, took part. Each student filled in a questionnaire, underwent a simple spinal examination including a clinical assessment of the available passive hamstring stretch, and had a lateral X-ray of the dorsal and upper lumbar spine. 56.3% of the males and 30.3% of the females had X-ray evidence of previous S.D., in varying degrees of severity. Dynamic stress, such as playing sports involving a lot of potential compression stress, weight lifting, and heavy lifting work in spare time and holidays, seem to play little if any part in the pathogenesis of S.D. Tall males and males who had spent more than 2 weeks in bed, due to sickness or injury, were more prone to S.D. Hamstring tightness showed a significant relationship to X-ray evidence for males. In the absence of possible dynamic stress factors it is suggested that prolonged sitting may be an important factor in the pathogenesis of end plate breakdown and thus S.D.
Incidence of Scheuermann's disease. Preliminary report.
This is a report on a study of 96 students aged 17 and 18 at two of our local schools. Each student completed a questionnaire, underwent a simple examination of the spine and a measurement of the passive stretch in the hamstring muscles, and had a lateral X-ray of the dorsal and upper lumbar spine. An overall X-ray evidence of Scheuermann's Disease was detected in 60% of males and 23% of females. The possible significance of these results is discussed.
Hamstring tightness and Scheuermann's disease a pilot study.
The lateral radiographs of the dorsal spines of 20 patients presenting with mainly low back pain are studied. These patients had clinically evident loss of flexion in the low dorsal spine and very tight hamstring muscles. 85% of them showed definite evidence of previous Scheuermann's Disease. The possibility that tight hamstrings may be an important factor in the aetiology of this disease is discussed, and a further large scale study is proposed.
A controlled trial of manipulation in a selected group of patients with low back pain favouring one side.
Ten patients with low back pain favouring mainly one side are treated by manipulation, using a specified technique. Tension measurements in both legs are taken at five degree increments as the legs are passively raised, with the knees extended, both before and after manipulation. The resultant tension gradients are compared with a control group of subjects with no back pain who are also manipulated. There is a statistically significant alteration in the tension measurements after manipulation of the painful side as compared with the change after manipulation of the controls.
The passive hamstring stretch test: a comparison of clinical estimates with tension gauge measurements.
A comparison of the clinical estimate of the available passive stretch in the hamstring muscles is made against the changing tension in a spring gauge, as the leg is raised. It was found that the angle at which rotation was palpable in the contralateral anterior superior spine occurred after there was a sharp rise in the tension measurements. The spring gauge was incorporated in a pulley system which allowed the leg to be pulled up and the tension readings were taken at 5 degrees increments of raise. Comparison of the clinical estimates with the tension gauge measurements show the latter to be a more reliable and objective research tool.
The passive hamstring stretch test: clinical evaluation.
The passive hamstring stretch test is described. Using a modified goniometer it is shown that independent measurements taken by trained examiners approximate very closely to each other. This establishes the test as a valid objective measurement. The possible value of this test as a research tool in low back pain problems is discussed.
The straight leg raising test: its relevance to possible disc pathology.
The records of 40 patients who had suffered from low back pain, and who had a marked restriction of straight leg raising (SLR) have been studied. Thirty-four of these cases had referred pain down the lower limb. They were all treated, at least in the first place, by manipulation. The response to manipulation demonstrates that, in the absence of evidence of interference with nerve root conduction, limitation of SLR is an unreliable sign of possible disc pathology. Furthermore, the immediate response to manipulation, particularly in the known disc protrusions, strongly suggests that muscle spasm plays a major role in limiting SLR. These points are discussed.
Clinical and radiological assessment of leg length.
This paper compares a clinical and a radiological method of measuring leg-length discrepancy in 107 adults, showing that clinical estimation is unreliable and suggesting that moderate degrees of leg-length difference play little, if any, part in the aetiology of backache.
Manipulation in general practice.
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