Browsing by Author "Lamberts, Robert P"

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    Post-exercise oxygen consumption and heart rate recovery as possible measures of the homeostatic stress of an exercise bout Theresa Naomi Carol Mann.
    (2013) Mann, Theresa Naomin Carol; Lambert, Michael; Lamberts, Robert P
    Several methods have been used to quantify the internal training load of a bout of exercise. However, arecent novel approach to quantify the internal training load has been to investigate the dynamic returntowards resting homeostasis at the cessation of exercise. Objective and non-invasive methods ofmonitoring the return towards resting homeostasis include measures of heart rate recovery (HRR) andexcess post-exercise oxygen consumption (EPOC). However, the relative potential of autonomic- vs. metabolic-type recovery measurements to represent the internal training load or homeostatic stress of the preceding exercise bout has not been established. Therefore, the broad aim of this thesis was to investigate the magnitude of EPOC (EPOCMAG), the time constant of the EPOC recovery curve (EPOCτ),HRR within the first minute post-exercise (HRR60s) and the time constant of the HRR curve (HRRτ) as measures which might reflect the homeostatic stress of an exercise bout. It was hypothesized that a measure representing the homeostatic stress of an exercise bout could have the following possible applications; - to identify inter-individual variation in the homeostatic stress of a standardized exercise bout - to detect intra-individual variation in the homeostatic stress of different exercise bouts- to detect intra-individual variation in “readiness to train”, based on the response to a standardized exercise bout. Therefore, the investigations of this thesis aimed to assess the relative potential of EPOCMAG, EPOCτ,HRR60s and HRRτ in these different roles. The experimental work was divided into 4 studies.
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    A systematic review of the effects of single-event multilevel surgery on gait parameters in children with spastic cerebral palsy
    (Public Library of Science, 2016) Lamberts, Robert P; Burger, Marlette; Toit, Jacques du; Langerak, Nelleke G
    BACKGROUND: Three-dimensional gait analysis (3DGA) is commonly used to assess the effect of orthopedic single-event multilevel surgery (SEMLS) in children with spastic cerebral palsy (CP). Purpose The purpose of this systematic review is to provide an overview of different orthopedic SEMLS interventions and their effects on 3DGA parameters in children with spastic CP. METHODS: A comprehensive literature search within six databases revealed 648 records, from which 89 articles were selected for the full-text review and 24 articles (50 studies) included for systematic review. The Oxford Centre for Evidence-Based Medicine Scale and the Methodological Index for Non-Randomized Studies (MINORS) were used to appraise and determine the quality of the studies. RESULTS: Except for one level II study, all studies were graded as level III according to the Oxford Centre for Evidence-Based Medicine Scale. The MINORS score for comparative studies (n = 6) was on average 15.7/24, while non-comparative studies (n = 18) scored on average 9.8/16. Nineteen kinematic and temporal-distance gait parameters were selected, and a majority of studies reported improvements after SEMLS interventions. The largest improvements were seen in knee range of motion, knee flexion at initial contact and minimal knee flexion in stance phase, ankle dorsiflexion at initial contact, maximum dorsiflexion in stance and in swing phase, hip rotation and foot progression angles. However, changes in 3DGA parameters varied based on the focus of the SEMLS intervention. DISCUSSION: The current article provides a novel overview of a variety of SEMLS interventions within different SEMLS focus areas and the post-operative changes in 3DGA parameters. This overview will assist clinicians and researchers as a potential theoretical framework to further improve SEMLS techniques within different SEMLS focus groups. In addition, it can also be used as a tool to enhance communication with parents, although the results of the studies can't be generalised and a holistic approach is needed when considering SEMLS in a child with spastic CP.
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    The physical activity status and patterns in adults with Cerebral Palsy - an accelerometry study
    (2019) Behardien, Thulfieq; Lamberts, Robert P; Eken, M M; Langerak, Nelleke G
    One of the most common causes of physical disability acquired during childhood is cerebral palsy (CP). Due to improvements in medical care over the past decades, almost all children with CP survive into adulthood nowadays. In addition, based on a stable incidence rate and longevity of individuals with CP, currently most persons with CP are adults. Therefore, it is appropriate to draw awareness to focus on rehabilitation in adults with CP. Due to the nature of their physical disability, adults with CP are at risk to an inactive lifestyle, which can lead to increased health risks. Physical inactivity may be the predisposition to developing a cycle of deconditioning, in which reduced levels of PA (physical activity) may lead to lower levels of physical fitness. Lower levels of physical fitness cause individual’s with CP to expend more energy during daily activities such as walking. As a consequence, individuals with CP may experience earlier fatigue, pain or other factors that increase the impact of the disorder on daily functioning. It is therefore important to intervene in this vicious cycle of physical inactivity. This thesis provides an overview of the methods used to record PA and reports on PA levels in adults with CP. The literature review evidently showed that adults with CP were less physically active compared to TD (typically developed) peers and spent more time in sedentary behaviour compared to TD adults. Various methods have been shown to be available to assess levels of PA, such as questionnaires, pedometers, and more advanced accelerometers that allow for measuring acceleration in three directions (x-y-z axes). Previously, research studies’ most commonly used hip-worn devices among adults with CP to assess PA levels, such as the Actigraph that has been used and validated in various populations with and without disabilities. Unfortunately, the Actigraph is not water resistant, which does not allow individuals to continuously wear the device. Alternatively, wrist-worn devices can be used to assess PA levels, such as the Polar Loop 2, which is convenient to wear and water-resistant. However, no previous research has proven the validity of the Polar Loop 2 to assess PA levels in a cohort with CP. In addition, most studies focused on adults with CP in developed countries, while no studies have been conducted in developing countries. Therefore, the aim of the second study was to determine differences in PA between adults with CP and TD adults living in South Africa, assessed with the Actigraph and Polar Loop 2 accelerometers. In addition, we aimed to determine the validity of the Polar Loop 2 compared to the Actigraph for different levels of PA. This study showed that adults with CP were less physically active than TD adults, based on findings that the number of steps taken per day were substantially lower, they spent more time being sedentary and less time in low and moderate intensity PA. The Polar Loop 2 showed to be a valid measure for PA in adults with CP and TD adults. Since the Polar Loop 2 is water-resistant and convenient to wear it can be a useful tool to measure PA in clinical practice. The reduced levels of PA presented in this thesis highlight that adults with CP are at risk of reduced fitness levels and secondary complications during daily life activities. This cycle of deconditioning may progress during ageing in adults with CP. More PA and exercise, at the correct intensity and duration, can break the barrier of this vicious cycle. Regular exercise can have a variety of beneficial effects on the health of adults with CP. For example, it may reduce the incidence of obesity, improve muscle function and muscle strength. Furthermore, exercise can reduce the incidence of chronic health conditions like diabetes, cardiovascular diseases and osteoporosis. In order to avoid health issues at older ages and to prevent inactive lifestyles, it is important to encourage a healthy and active lifestyle during early adulthood to promote physically active when growing older. Regular exercise also positively influences the development of the musculoskeletal system, which may prevent the decline in mobility.