Browsing by Author "Naidoo, Nirmala"

Now showing 1 - 8 of 8
  • Thumbnail Image
    Item
    Open Access
    Are parents and adolescents in agreement on reporting of recurrent non-specific low back pain in adolescents? A cross-sectional descriptive study
    (BioMed Central, 2015-12-08) Chiwaridzo, Matthew; Naidoo, Nirmala
    Background: Non-specific low back pain is a prevalent symptom in adolescents and is recurrent in some instances. Recent studies have highlighted the marked impact the condition has on daily life of adolescents. However, it is unclear if parents of adolescents reporting recurrent non-specific low back pain know about their child’s status. The purpose of the study was to determine the level of agreement between adolescents and their parents in reporting recurrent non-specific low back pain in Harare, Zimbabwe. Methods: This cross-sectional study formed part of a large study carried out to ascertain the prevalence of non-specific low back pain in Zimbabwean adolescents. Six hundred and twenty (n = 620) Medical Health Questionnaires were sent to parents. School-children with returned questionnaires and informed consents signed were subsequently eligible to participate. A reliable and validated low back pain study questionnaire was administered to 544 adolescents between the ages of 13 and 19 years randomly selected from government-administered schools. The questionnaire sought to determine adolescents with recurrent NSLBP. The Kappa statistic (k) was used to analyse agreement between adolescents and parental reports on recurrent NSLBP status. Results: Parental and school-children response rates were acceptable (90.3 and 97.8 %, respectively). The prevalence of recurrent NSLBP was 28.8 % [95 % Confidence Interval, CI = 26.0–31.6]. Both sexes were equally affected [χ 2 (1) =0.19, p = 0.67]. The prevalence increased with age in both sexes [χ 2trend =90.9, p < 0.001]. Parental reports agreed in 16.3 and 98.7 % for the adolescents with and without recurrent NSLBP respectively. The value of kappa (k) was 0.20 [SE = 0.04; 95 % CI, 0.13–0.27] with a prevalence index and bias index of −0.65 and 0.23, respectively. These results suggest poor strength of the agreement. Conclusions: Recurrent non-specific low back pain is relatively common among Zimbabwean adolescents. Most of the parents of school-children with recurrent non-specific low back pain are unaware of the low back pain status of their children. Although this does not dismiss the relevance of non-specific low back pain reported during adolescence, these findings create a need to involve parents in awareness or preventive initiatives against low back pain in schools.
  • Thumbnail Image
    Item
    Open Access
    Content validity and test-retest reliability of a low back pain questionnaire in Zimbabwean adolescents
    (BioMed Central, 2017-02-28) Chiwaridzo, Matthew; Chikasha, Tafadzwa Nicole; Naidoo, Nirmala; Dambi, Jermaine Matewu; Tadyanemhandu, Cathrine; Munambah, Nyaradzai; Chizanga, Precious Trish
    Background: In Zimbabwe, a recent increase in the volume of research on recurrent non-specific low back pain (NSLBP) has revealed that adolescents are commonly affected. This is alarming to health professionals and parents and calls for serious primary preventative strategies to be developed and implemented forthwith. Early identification initiatives should be prioritised in order to curtail the condition and its progression. In an attempt to be proactive in minimising the prevalence of recurrent NSLBP, this study was conducted to evaluate the content validity and test-retest reliability of a survey questionnaire with the aim of proffering a valid and reliable questionnaire which can be used in non-clinical settings to identify adolescents with recurrent NSLBP in Harare, Zimbabwe and determine the possible factors associated with the condition. Methods: The study was conducted in two parts. The first part assessed content validity of the questionnaire using four experts derived from academia and clinical practice. The second part evaluated the reliability of the questionnaire among 125 high school-children aged between 13 and 19 years in a test-retest study. Results: Twenty-six (26) out of thirty questions in the questionnaire had an Item Content Validity index of 1.00, demonstrating complete agreement among content experts. Overall, the Scale Content Validity Index for the questionnaire was 0.97. Item completion for the reliability study was satisfactory. The questionnaire items had kappa values ranging from 0.17 (slight agreement) to 1 (perfect agreement). High levels of reliability were found for the questions on school bag use (k=0.94), sports participation (k=0.97), and lifetime prevalence (k=0.89). Conclusion: Excellent content validity and slight to perfect test-retest reliability was found for the Low Back Pain (LBP) questionnaire. These results are comparable to findings of other studies evaluating the psychometric properties of LBP questionnaires. Cognisant of the limitations of the study, the results of this study suggest that the LBP questionnaire could be used in local studies investigating LBP among adolescents although questions enquiring on functional limitations and sciatica may need further consideration.
  • Thumbnail Image
    Item
    Open Access
    Differences in personal and lifestyle characteristics among Zimbabwean high school adolescents with and without recurrent non-specific low back pain: a two part cross-sectional study
    (2015-12-01) Chiwaridzo, Matthew; Naidoo, Nirmala
    Background: Recurrent non-specific low back pain (NSLBP) is increasingly becoming common among adolescents worldwide. A recent study in Zimbabwe showed a relatively high prevalence (28.8 %) among high school students. Influential associated factors, however, remain unclear. This is a significant shortcoming. The aim was to determine personal or lifestyle-related factors associated with recurrent NSLBP among high school adolescents in Harare, Zimbabwe. Methods: This study was part of a large epidemiological study conducted in two continuous parts. Part one sought to determine self-reported associated factors among 532 participants (mean age =16 ± 1.72 years) drawn randomly from selected government schools using a reliable and content-validated questionnaire (Kappa coefficient, k = 0.32–1). Part two purposively identified adolescents (N = 64, median age =17 years, interquartile range, IQR = 15–18 years) with a history of ‘severe’ recurrent NSLBP from part one based on a specific eligibility criteria and compared body mass index, relative school bag weight and hamstring flexibility with matched adolescents without NSLBP. Data was analysed using Statistica version 11. Independent t-tests or χ 2 tests of association were used for continuous and categorical data, respectively. The statistical significance was set at p < .05. Results: Recurrent NSLBP was associated with self-reported factors such as perceptions of a heavy school bag [χ 2 (1) = 85.9, p < 0.001]. A significant proportion of adolescents with recurrent NSLBP spent over 30 min carrying the school bag to and from school [χ 2 (1) =32.2, p < 0.001]. It was also associated with prolonged sitting (p < 0.001), not playing sports [χ 2 (1) =5.85, p = 0.02] and tight hamstrings [χ 2 (1) =7.6, p = 0.006]. Conclusions: Although conclusions from this study are hesitant because of the cross-sectional nature of the study and the relatively small sample size in follow-up study, recurrent NSLBP is associated with perceptions of a heavy school bag, duration of school bag carriage, no sports participation, prolonged sitting on entertainment activities, and tight hamstrings. These findings add to the importance of promoting physical activity at school or home especially aimed at improving muscle flexibility.
  • Thumbnail Image
    Item
    Open Access
    The effect of a teacher-based intervention programme for primary schools on learner's health-related quality of life, body mass index and physical fitness: a randomised control trial
    (2017) Bowers, Jodie; Naidoo, Nirmala
    Background: Childhood obesity, a rising problem world-wide and within South Africa, has been negatively linked with both physical fitness (PF) and health-related quality of life (HRQoL). The school environment is the ideal setting for children to obtain the skills and knowledge to increase physical activity (PA) levels and healthy diets. PA and school-based nutrition intervention programmes have been shown to have positive effects on diet and PA behaviours in children. However, there is minimal literature reporting on the effectiveness of school-based interventions in a South African setting. Aim: The primary aim of the first phase of the study was to provide a contextual background regarding the provision of PA in school-based PE programmes within a small sample of schools from which the learners in the intervention study were drawn. The primary aim of the second phase of the study was to determine the effect of a teacher-based intervention programme after six weeks for primary schools with less than the mandated amount or no specific amount of PE on learner's HRQoL, Body Mass Index (BMI) and PF. Methodology: Ten schools were randomly selected from the circuit lists within the Port Elizabeth Education District. Ten staff members from the selected schools completed the School Environment Questionnaire in order to provide a situational analysis regarding the provision of PA in school-based PE programmes. A sample of 300 learners (aged nine to eleven) from four randomly selected schools participated in the pre-testing measures in order to establish the weight status (using BMI and waist circumference (WC)), HRQoL (using the EQ-5D-Y), and PF (using the Eurofit test battery). Class teachers, from schools with less than the mandated amount of PE or no specific amount of PE, who were part of the experimental group, implemented the intervention. In order to implement the intervention, they received training and were given a PE programme booklet. The PE intervention programme was in line with the Curriculum and Assessment Policy Statement teaching plan for life skills, and was based on targeting the deficiencies found in the pre-testing fitness measurements. Post-testing measures, using the same learners, were conducted six weeks later. The obtained results were analysed using STATISTICA version 12. Results: Phase one of the study revealed that PE was provided at all schools. The curriculum was followed by 90% of schools, but only 30% had teachers with PE qualifications. PE policies and practices were being developed and/or implemented in 70% of schools, and 50% had no specific amount of time mandated to PE, or less than the mandated amount. Soccer was offered at all schools, and 80% of schools had access to an outdoor sports field and an outdoor paved area. Phase two of the study found that the control and experimental groups were not equivalent at baseline with regard to gender distribution, BMI Z-scores and interpretations, the EQ-5D-Y "looking after myself" variable, and the sit-up test. No positive significant differences were noted in BMI Z-scores, WC, HRQoL, or PF components in the experimental group after the six-week intervention. Discussion: The average duration of PE at 70% of the participating schools was longer than the national average, despite half of the schools not implementing the mandated amount of PE. Gaps in the curriculum content and unqualified PE teachers may have prevented learners from developing the necessary skills associated with PE, including the various components of PF. The six-week teacher-based intervention was found to be ineffective. Similar results were seen in other South African studies. Insignificant intervention findings may be the result of poor intervention implementation or compliance, time constraints experienced by participating teachers, and the short six-week duration of the intervention. Teachers mainly commented on the enjoyment of the intervention programme by the learners. Conclusion: This study concludes that the effects of the six week teacher-based intervention, on primary school learners' HRQoL, BMI, and PF, was insignificant. Nevertheless, all schools provided PE, despite half of the schools not implementing the amount mandated. This study provides a platform for future studies in the attempt to reduce the occurrence of obesity in school children; thereby reducing its increasing national burden on health and the economy.
  • Thumbnail Image
    Item
    Open Access
    Perceived and objective neighborhood support for outside of school physical activity in South African children
    (BioMed Central, 2016-06-01) Uys, Monika; Broyles, Stephanie T; Draper, Catherine E; Hendricks, Sharief; Rae, Dale; Naidoo, Nirmala; Katzmarzyk, Peter T; Lambert, Estelle V
    Background: The neighborhood environment has the potential to influence children’s participation in physical activity. However, children’s outdoor play is controlled by parents to a great extent. This study aimed to investigate whether parents' perceptions of the neighborhood environment and the objectively measured neighborhood environment were associated with children's moderate-to-vigorous intensity physical activity (MVPA) outside of school hours; and to determine if these perceptions and objective measures of the neighborhood environment differ between high and low socio-economic status (SES) groups. Methods: In total, 258 parents of 9–11 year-old children, recruited from the South African sample of the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE), completed a questionnaire concerning the family and neighborhood environment. Objective measures of the environment were also obtained using Geographic Information Systems (GIS). Children wore an Actigraph (GT3X+) accelerometer for 7 days to measure levels of MVPA. Multilevel regression models were used to determine the association between the neighborhood environment and MVPA out of school hours. Results: Parents’ perceptions of the neighborhood physical activity facilities were positively associated with children’s MVPA before school (β = 1.50 ± 0.51, p = 0.003). Objective measures of neighborhood safety and traffic risk were associated with children’s after-school MVPA (β = −2.72 ± 1.35, p = 0.044 and β = −2.63 ± 1.26, p = 0.038, respectively). These associations were significant in the low SES group (β = −3.38 ± 1.65, p = 0.040 and β = −3.76 ± 1.61, p = 0.020, respectively), but unrelated to MVPA in the high SES group. Conclusions: This study found that several of the objective measures of the neighborhood environment were significantly associated with children’s outside-of-school MVPA, while most of the parents’ perceptions of the neighborhood environment were unrelated.
  • Thumbnail Image
    Item
    Open Access
    Prevalence and individual risk factors associated with non-specific low back pain among secondary school adolescents in Harare, Zimbabwe
    (2013) Chiwaridzo, Matthew; Naidoo, Nirmala
    Traditionally, non-specific low back pain (NSLBP) has been described as an important public health issue among adults but a rare phenomenon in the young. However, recent epidemiological studies have provided evidence that NSLBP affects all age groups. In adolescents, the literature has shown that the prevalence has increased tremendously during the past two decades. The reasons for this remain unclear. In addition, there is substantial evidence to suggest some adolescents will experience severe episodes of recurrent NSLBP associated with adverse consequences such as long-term chronicity into adulthood, reduced health-related quality of life, and school absenteeism. In-spite of such evidence, no studies have been conducted in Zimbabwe to investigate the subjective presence of NSLBP symptoms among school-aged adolescents and to screen adolescents in schools affected by the condition in an attempt to identify the associated risk factors. The aim of the study was to estimate the prevalence (lifetime and point) and the one-year prevalence of recurrent NSLBP. In addition, the study aimed at identifying the individual risk factors associated with the report of recurrent NSLBP. A further aim was to compare the health-related quality of life between adolescents with recurrent NSLBP and those without.
  • Thumbnail Image
    Item
    Open Access
    Sports physiotherapists' knowledge, attitudes and beliefs of pain a cross-sectional correlational study
    (2012) Clenzos, N; Parker, Romy; Naidoo, Nirmala
    Includes abstract. Includes bibliographical references.
  • Thumbnail Image
    Item
    Open Access
    The design of an intervention programme to address the prevalence of obesity and physical fitness of adolescents attending high school
    (2021) Naidoo, Shane; Naidoo, Nirmala
    Background: South Africa has the highest prevalence rate (8.3%) of childhood obesity in sub-Saharan Africa. Obesity is a complex condition to control as it has environmental, as well as genetic factors that influence its prevalence. Childhood obesity, a rising problem worldwide and within South Africa, has been negatively linked with both physical fitness and physical activity. PA and school-based nutrition intervention programmes have been shown to have positive effects on diet and PA behaviours in children. However, there is minimal literature reporting on the effectiveness of school-based interventions in a South African setting. The aim of this study was to determine the prevalence of obesity, levels of physical fitness and physical activity in adolescents attending school in an urban setting. Together with the literature, an intervention programme was designed addressing key outcome measures identified from the sample. Methodology: The study was conducted in two phases. Ten schools were randomly selected from the school education district in KwaZulu-Natal Department of Education (KZNDoE) for phase one. A total of 400 eligible students were identified by the respective school teachers and parental consent was obtained, with assent obtained from the participants. A sample of 278 (girls n = 150, boys n = 128) participants with a mean age of 15yrs 1 month (CI 95% 12,1 – 17.1 and SD 1.14), was measured for height, weight, hip circumference, waist circumference and physical fitness (standing broad jump, sit-ups in 30s, hand grip strength, sit-and-reach and 20m shuttle run). BMI and WHR were calculated using anthropometric measurements. Physical activity (PA) was self-reported using the Physical Activity Questionnaire for Adolescents (PAQ-A) and the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) demographic form were completed by the participants' guardians/parents. Phase two involved the design of a PA intervention programme using evidence-based outcome measures from previous studies and problem areas identified in this study. Results: The mean BMI z-score was 0.30 (CI 95% 0.12 to 0.49) with boys displaying a mean of 0.19 (CI 95% -0.89 to 0.46) and girls 0.39 (CI 95% 0.15 to 0.65). There was a 16.2% prevalence of overweight (1 < BMI-z score ≤ 2), 13.3% prevalence of obesity (2 < BMI-z score ≤ 3) and 2.9% prevalence of morbid obesity (3 < BMI-z score ≤ 4). Mean WHR for the sample was 0.82 (CI 95% 0.81 – 0.83). Low levels of PA were reported by 45% (girls n = 83, boys n = 42) of the sample and 53.6% (girls n = 66, boys n = 83) reported moderate levels of PA. Girls in the sample had a higher mean sit-and-reach (t = 4.68, p < 0.05) and hand grip strength (t = 5.49, p < 0.05) than the normative values. Boys in the sample had higher mean (t = 13.2, p < 0.05) sit-and-reach than normative values. Multiple regression models were applied and BMI was found to be an inverse predictor for sit-ups ß = -0.07 (p < 0.05, CI 95% -1.0 to -0.03) and broad jump ß = -0.01 (p < 0.05, CI 95% -0.01 to -0.005). BMI was also a direct predictor for hand grip strength ß = -0.07 (p < 0.05, CI 95% 0.05 to 0.09). Discussion: The 16.2% prevalence of obesity was higher than the reported 8.5% in another South African study on adolescent scholars and the national reported level of 5.5%. The waist-hip ratio (WHR) was lower than the national reference level of 0.84 and higher compared to values obtained from adolescents in Europe (comparisons were made to age and gender specific normative values obtained in Europe, as there are no national reference physical fitness values for adolescents). Girls displayed lower values in three of the five physical tests (standing broad jump, sit-ups and 20m shuttle run), while boys displayed lower values for four (standing broad jump, hand grip strength, sit-ups and 20m shuttle run) of the five physical fitness tests. PA is indirectly correlated with BMI, and with BMI being a predictor for physical fitness, the promotion of PA amongst adolescents is imperative and urgent to curb the growing prevalence of obesity. Using evidence from previous research an intervention programme was designed to address the problems areas identified. These were high prevalence of obesity and overweight, low PA levels, poor cardiovascular function , low muscular power and poor muscular endurance across the sample. Boys also exhibited low levels of muscular strength than the normal population mean. PA programmes must be 60 minutes of duration implemented at least three times per week over 12 weeks minimum in order to have a reduction in BMI. Programmes should incorporate aerobic and anaerobic training as concurrent training has shown best results for decreasing BMI. The aerobic component of the programme must include a high intensity interval training (HIIT) as this has positive benefits on cardiovascular markers. The anaerobic component must include free weights as this showed better improvements than using resisted exercise devices in body composition, increases in upper and lower limb muscle strength in boys and improved lower limb muscle power especially in girls. Programmes should be implemented in schools with trained instructors and incorporate the family as a combination of these showed favourable compliance and overall better outcome measures. PA programmes that have a circuit formation and that incorporate a fun element has also shown to have better outcome measures and compliance. Conclusion: Physical activity levels are on the decline and obesity prevalence is on a rapid upward trajectory amongst South African adolescents. These trends could be ominous for the next workforce generation as these have been linked to numerous non-communicable diseases where the already constrained health system is placed under added pressure. PA programmes should be incorporated into schools' curricula as this may be a viable way to implement successful interventions to address obesity, physical fitness and physical activity.