OpenUCT :: Browsing by Subject "Biokinetics"

Browsing by Subject "Biokinetics"

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Open Access
The assessment of the efficacy of the mobile training system after implementation in South African rugby playing schools
(2014) Van Aarde, Roedolf Frederik; Lambert, Michael I
Introduction: Rugby Union is a sport where physical size matters and the bigger, stronger and better conditioned players have an advantage over smaller and less powerful opponents. Research of adolescent rugby players in South Africa showed that Coloured and Black players weighed 8 kg less than their White counterparts. A possible explanation for the difference in size was the lack of weight training facilities in the disadvantaged areas. Therefore to address the potential handicap for these players having to compete against bigger players, the South African Rugby Union and the High Performance Centre at the Sport Science Institute of South Africa developed a mobile schools training system (MSTS). These are fully equipped units with sufficient weight training equipment for an entire team. The aim of this study was to determine whether the fitness characteristics associated with rugby, changed in players after the MSTS was given to a school for several months. Training of players was not controlled or supervised by any personal outside the infrastructure of the school. A secondary aim was to interview the staff member at each school responsible for the MSTS to enquire about their perceptions of the MSTS and whether there were any barriers to the uptake by the schools and players. Methods: Schools with a “rugby ethos” and from a previously disadvantaged background were selected by SARU for the MSTS Programme. Players (U16 and U18 age groups) at these schools participated in the study. A total of 382 players were tested both before they had exposure to the MSTS and approximately 16 weeks later. They were divided into two age groups; U18 (n = 224 forwards and backs) and U16 (n = 158 forwards and backs). The following characteristics were measured; stature, body mass, body % body fat, muscular strength (bilateral grip strength and bench press), muscular endurance (1min push-ups), sprint times (10 m and 40 m) and aerobic capacity (multi-stage shuttle run test). All Tests were conducted during February and October of 2013. A rating of the extent to the players used the MSTS was also calculated and this was used to categorise schools. Data are represented as means ± standard deviation. A repeated measures of analysis of variance (repeated measures of ANOVA) was used to determine whether there were significant differences between the ‘pre and post’ round of testing using either ‘age’, ‘provinces’ and whether the ‘gym was used or not’ as main effects. The interaction between ‘age x time’ and ‘province x time’ and ‘gym usage x time’ was calculated. If any interactions were significant, a Tukey post hoc test was used to identify specific differences. Statistical significance was accepted when p < 0.05. Coaches at the schools participated interviews to determine the barriers to implementation of the programme, and which areas need to be improved. Results: Changes over time was only shown for body mass (p < 0.037) and bench press (p < 0.001) in schools where the gym was used compared to schools who did not use the gym. When comparing U16 vs. U18 age groups, the U18 players were significantly taller, and heavier, had less % body fat, and a better performance for grip strength, bench press, push-ups, 10 m and 40 m sprint time and Multi-stage shuttle test (MSST) compared to the U16 players (p < 0.04 ). There was also a significant interaction (age x time) for stature (p < 0.002), body mass (p < 0.011), % body fat (p < 0.002). When comparing the 5 provinces of the U16 age group, pre-post differences where noted for stature, body mass bench press and the multi stage shuttle test (MSST) between provinces p < 0.00 01. Interactions (province x time) for changes over time between the 5 provinces was shown for stature, body mass, % body fat, bench press, push-up’s, 10 m sprint time and MSST. There were significant pre-post differences between provinces (U18) for stature, body mass, skinfolds, % body fat, bench press and the multi stage shuttle test (MSST) for all p < 0.0001 except skinfolds showed p < 0.041. Interactions (province x time) change over time between the 5 provinces was shown for stature, body mass, % body fat, bench press and push-up’s. An interaction for the age groups was determined for a variable if a level of significance was p < 0.05. The interviews with the coaches raised various issues which comprised the usage of the MSST with the most important being lack of resources at the school , inadequate knowledge of strength and conditioning training, lack of facilities to store the mobile gym and poor nutrition of the players. Conclusion: There is overwhelming evidence in the literature about the benefits of resistance training for youth, from the perspective of improving performance to reducing the risk of injury. The results from the MSTS programme were not as overwhelming as one would believe from the literature. This can be attributed to various reasons; inadequate facilities to house the MSTS, inadequate coaches ’ knowledge and experience in strength and conditioning, and poor nutrition. With increased provision of equipment at schools without adequate support of trained strength and conditioning specialists at each school the programme will be ineffective. To ensure future success of the programme it is recommended that; (i) a needs analysis is done at each school to determine which school has the correct facilities to house the mobile gym so that regular training sessions can take place, (ii) SARU employs qualified trainers at the schools involved in the MSTS programme to supervise all strength and conditioning sessions, (iii) there are regular follow up visits at schools to check on compliance, (iv) objective and subjective assessments are conducted at regular intervals to determine if there are improvements in the targeted variable.
Open Access
Body size, socioeconomic status and training background of a select group of U16 South African rugby union players (2010-2013): The impact on national selection
(2016) Arkell, Robin; Lambert, Michael I
Background: Rugby Union is an international sport characterized by bouts of short duration, high intensity exercise in which players frequently collide into one another while running at high speeds. Players are commonly required to engage in phases of play involving contact such as tackling, rucking, mauling and scrumming. These phases of play require certain physical qualities, including strength, aerobic power, speed and explosive power. Perhaps, the growth and professionalization of the game has resulted in more emphasis being placed on the physical preparation of the players. Physical preparation of players not only happens at elite senior levels, but has also filtered down into the junior ranks, where it is common for school teams to be trained by professional strength and conditioning coaches. The rules of the game have changed, which have influenced the physical demands. For example, ball-in-play time has increased, players are covering more distance per game, making more tackles and engaging in more scrums. It is therefore important to identify the various physical characteristics that are required to be successful at a particular level of rugby union. The socioeconomic status and ethnicity of the player in association with the physical characteristics can determine the success of an adolescent rugby player. Objective: To determine the association between body mass and stature (referred to as physical characteristics for this study), race, socioeconomic status, and weight training (referred to as non-physical characteristics for this study) on the chances of success among U16 provincial rugby union players. In particular, size, socioeconomic status and ethnicity of players in the U16 national training squad were compared to players who represented their provinces but did not get selected for the national squad. Methods: Data were collected for each player who attended the Coca Cola National Grant Khomo week from 2010 to 2013. Players participating in this tournament had already undergone a process of selection trials to be selected to represent their province at U16 level. The national squad players were chosen based on performances at the Coca Cola National Grant Khomo week. The characteristics of the players selected for the national squad vs. players who did not get selected for the squad from 2010 to 2013 were compared using an ANOVA and the magnitude of the differences were quantified using effects sizes. Results: White players are heavier (ES = 0.59) and taller (ES = 0.8 2) than black players as well as heavier (ES = 0.8 7) and taller (ES = 0.8 2) than coloured players over the four-year period from 2010 to 2013. Players selected into the National squad were on average heavier (ES = 0.5 0) and taller (ES = 0.4 0) than those players not selected into the National squad. White players were the heaviest and tallest of the race groups selected into the National squad (p < 0.0000 2). Players with a high socioeconomic status were heavier (ES = 0.3 0), taller (ES = 0.4 0), and had more playing experience (ES = 0.3 0), than players from a low socioeconomic status background. Grouping according to socioeconomic status did not differentiate between race groups and selection for the national squad. Conclusion: This study showed that the taller and heavier players were more likely to get selected for the national U 16 squad. Since size was also associated with socioeconomic status, the players with a high socioeconomic status had an advantage over players with a low socioeconomic status. These findings have implications for transforming the game to ensure that the representative teams reflect the composition of the South African population.
Open Access
Coaches' perception of catastrophic injuries risks in South African Rugby Union : A qualitative exploration through a socio-ecological lens
(2017) Joshua, Jonathan; Draper, Catherine E; Brown, James Craig
Introduction: The annual rate of rugby-related catastrophic injuries (CIs) in South Africa has been classified as "acceptable". However, of all injuries, CIs are the most traumatic for all involved. Therefore, the BokSmart programme was introduced in South Africa to reduce CIs by training all coaches in safe coaching principles. South Africa presents a particularly difficult implementation context for injury prevention interventions due to large variations in socio-economic statuses (SES) of sport participants. In addition, individuals are known to accept perceived levels of risks and ignore the actual levels of risks. Thus, rugby policy makers, experts, coaches and players may have conflicting views regarding CIs risks associated with the sport. In rugby, objective measures of risks such as risk probability are well defined however; little is known about how rugby coaches perceive the risks of CIs in rugby. This is a concern for rugby governing bodies such as SARU because coaches' perceptions of CIs risks could play a role in their adoption of BokSmart coaching principles. Additionally, risk perceptions of South African rugby coaches may vary by SES. Socio-Ecological Models (SEM) give attention to the intrapersonal, interpersonal and societal influences that affect the perceptions of coaches from various SES settings. Using qualitative methods, the aim of this research was to explore South African rugby coaches' perceptions of CIs, through the lens of a SEM. Methods: Six semi-structured focus groups were conducted with junior and senior coaches from three tiers of SES settings: low, middle and high. An additional focus group was conducted with rugby referees' to corroborate evidence from the coaches' focus groups. For analysis, a thematic framework was developed based on factors that were found to influence risk perceptions from catastrophic event studies. Themes were: 1) SES, 2) Knowledge of rugby and CIs, 3) CIs experience, 4) Cognitive biases, 5) Attitudes and intentions, 6) Coach pressure, and 7) Mass media. Results and Discussion: This study's findings suggest that coaches' perceptions of CI risks vary according to SES. Low SES coaches predominantly implied that lack of adequate rugby infrastructure influenced beliefs that their players are at risks of CIs. For Middle SES coaches, lack of knowledge about CIs prevention influenced perceptions about their players' risks of CIs. Lastly, high SES coaches' were mainly influenced by cognitive biases, perceiving their players to be less vulnerable to CIs than players in lower SES settings. All coaches were influenced by 1) a lack of CIs experience that prompted perceptions of invulnerability to CIs, 2) 'win at all costs' attitudes and intentions, and 3) coaches' pressure, both of which lowered concerns for CIs risks and resulted in players 'playing on' despite injuries. In addition, the SEM provided the overall perspective of the ecological factors that influenced coaches' perceptions of CIs. Conclusion: Perceptions of CIs risk differ among coaches from various SES settings. Therefore interventions such as the BokSmart programme should be tailored towards targeting various SES groups.
Open Access
Factors assciated with success in South African Rugby Union
(2013) Parker, Ziyaad-Ahmad; Lambert, Mike
Rugby Union is a popular sporting code in South Africa and the national team (Springboks) has won two World Cups (1995 and 2007). As the pool of players to select the Springboks from has diminished in recent times, it is important for the South African Rugby Union (SARU) to identify and develop young, talented individuals to strengthen the pool of available players. Several talent identification and development programmes have been implemented by SARU with limited success and many of them are not offered anymore.
Open Access
Factors associated with participation in a phase three cardiac rehabilitation programme
(2013) Noorbhai, Mohammed Habib; Kolbe-Alexander, Tracy; Draper, Catherine E
Background Patients with cardiovascular diseases (CVDs) and non-communicable diseases (NCDs) benefit from participating in cardiac rehabilitation programmes (CRPs). The aim of this research project was to evaluate the factors associated with participation in a phase three CRP, the Prime Time programme (PTP). A secondary aim was to compare attendance and baseline measures between Prime Time (PT) and non-Prime Time (NPT) members at a commercial gym. Methodology The first chapter comprised of focus group discussions (n = 3) and key-informant interviews (n = 5 current members and n = 5 ex-members). Staff participants (n = 9) included the Biokineticists, programme managers and sales consultants who participated in key-informant interviews and provided their perceptions and experiences while working on the programme. Atlas.ti was used for the data analysis and a thematic coding framework was used to analyse the focus groups and interviews. The second chapter, which was a pilot study, employed a case-control research design to compare attendance and baseline data between PT (n = 11) and NPT (n = 40) members at a commercial gym. Three age-matched controls for every case were included in this pilot study. Descriptive statistics (means and standard deviations), one-way analysis of variance (used to determine if there were any significant differences between groups at baseline for continuous variables) and Chi-square analysis (used to determine if there were any significant differences between groups at baseline for categorical variables) were performed. The level of significance was set at p<0.05.
Open Access
A formative assessment of nurses' lifestyle behaviours and health status
(2015) Phiri, Lindokuhle P; Kolbe-Alexander, Tracy; Lambert, Estelle V
Background: Previous research has identified health care workers (HCWs) and shift workers as having an increased risk for non-communicable diseases (NCDs). Nurses in particular have a high prevalence of obesity, poor eating habits and insufficient physical activity and are at an increased risk for NCDs. Nurses are required to work non-traditional hours, outside the parameters of traditional day shift. Furthermore, shift work is associated with obesity and lower levels of physical activity. Even though nurses' occupations require them to be active in doing ward rounds and other duties, it is possible for these professionals to be physically active, yet highly sedentary. Sedentary behaviours such as occupational sitting, leisure-time sitting and television (TV) viewing may be associated with overweight and obesity independent of physical activity. Aim: The primary aim of this mini-dissertation was to determine the health concerns, health priorities and barriers to living a healthy lifestyle among nurses and hospital management staff from public hospitals in the Western Cape Metropole, South Africa. The mini-dissertation included two different research methods. Study 1: The main purpose of this qualitative descriptive study was to describe health concerns, health priorities and determinants of healthy lifestyle behaviours among nurses. The objectively measured and self-reported physical activity and sedentary behaviour in day and night shift nurses were compared in Study 2. Combined, the results of these studies may be used to inform the development of worksite-related interventions for South African nurses. Methods: Participants for the first study were purposively sampled from public hospitals based in Cape Town, South Africa. The participants included 103 nurses, of whom 57 worked night shift and 36 worked day-shift. Twelve focus group discussion (FGD's) were conducted with nursing staff to obtain insight into their health concerns, lifestyle behaviours and the nature of and access to worksite health promotion programmes (Whip's). Nine hospital management personnel participated in key informant interviews (KII) to gain their perspective on health promotion in the worksite. The FGDs and interviews were conducted by a trained facilitator using guided questions. These included questions such as: 'What are your main personal health concerns?' and 'How does your work affect your lifestyle behaviours and health?' Thematic analysis was used 12 to analyse the qualitative data with the assistance of (Atlas.ti Qualitative Data Analysis Software (Scientific Software Development GmbH, Berlin, Germany). In a sub-study, 64 nurses (day shift n=30 and night shift n=34) working at two of the five public hospitals volunteered to complete a socio-demographic questionnaire and wear the ActiGraph GT3x accelerometer for 7 consecutive days to measure physical activity levels. Valid data was defined as ≥ 600 minutes wear time per day, minimum of 4 days (2 shift days and 2 non-shift days). In addition, self-reported physical activity was assessed using the Global Physical Activity Questionnaire (GPAQ). Statistical analyses included a T-test to determine differences in PA and SB between day and night shift nurses. If data were normally distributed, ANOVA (analyses of variance) was performed to determine the significant differences in continuous outcome variables between day and night shift nurses. If data were not normally distributed, such as the GPAQ data, a non-parametric comparison Mann Whitney U test was applied. Results: Study 1: Night shift nurses frequently identified weight gain and living with NCDs such as hypertension as their main health concerns. The hospital environment was perceived to have a negative influence on the nurses' lifestyle behaviours, including food service that offered predominantly unhealthy foods. The most commonly delivered WHPPs included independent counselling and advisory services, an online employee wellness programme. The Western Cape Department of Health also offered wellness days in which clinical outcomes, such as blood glucose were measured. Most nurses identified a preference for WHPPs that provided access to fitness facilities or support groups. Both nurses and management personnel frequently mentioned lack of time to prepare healthy meals and/or participate in physical activity due to being overtired from the long working hours. Furthermore, both management and nurses reported a stressful working environment. The fact that the nurses were most concerned with the problems of overweight, obesity and living with NCDs such as diabetes and hypertension indicate that there is a need and desire for WHPP's aimed at addressing these concerns. Study 2: Based on the objectively-measured results from accelerometry, all the nurses in the sub-study met the physical activity recommendations of 150 minutes or more of moderate to vigorous intensity physical activity per w eek. The day shift nurses reported more leisure-time moderate and vigorous intensity physical activity than the night shift nurses (p=0.028). Objectively-measured physical activity also showed that night shift nurses accumulated significantly more moderate intensity physical activity than the day shift nurses ( 16.6 ± 5.6 hrs/week versus 12.1 ± 13 4.5 hrs/week, respectively, p=0.001). In addition, night shift nurses accumulated more steps per day than day shift nurses (10324 ± 3414 versus 8022 ± 3245, p=0.013). Self-reported sedentary behaviour was similar for the two shifts, 3.0 ± 1.8 hours versus 4.0 ± 2.6 hours a day, for day and night shift, respectively. Objectively-measured sedentary behaviour (SB) was significantly lower (as a % of wake time) in night shift compared to day shift workers, 66% and 69%, respectively, p= 0.047. These differences between groups remained significant, even after adjusting for differences in body size and age. Furthermore, results from the Bland – Altman plots indicate that the nurses significantly underreported their sedentary time. Summary: The nurses in this study were concerned about NCDs and being overweight. They expressed an interest and willingness to participate in future hospital-based intervention programmes. The most frequently identified preference for WHPPs was access to fitness facilities or support groups. Despite the fact that all the nurses met the current public health recommendations for physical activity, objectively-measured SB was substantial, with both day and night shift nurses spending an average of 13 hours a day in SB. Findings from this study highlight the need for WHPPs that minimize sedentary behaviour and create a more supportive environment for physical activity.
Open Access
Injury risk assessment and the incidence of musculo-skeletal injuries in recreational long-distance runners over a 3-month training period
(2017) Smith, Tanya; Kroff, Jacolene; Lambert, Estelle V
Background: Long distance road running is continually growing as competitive and recreational sport, globally. Despite its popularity, a high burden of incidence of injury exists among runners. Previous research has focussed on specific injuries, whereas others have investigated isolated risk factors that may contribute to running related injuries. The purpose of the study is to determine possible internal and external screening variables that may predict the incidence of running-related injuries in general. Methods: Forty one recreational runners participated in an observational study over the course of 12 weeks. Screening assessments consisted of injury history, training history, and anthropometric measurements. Functional and performance assessments included the Foot Posture Index (FPI), the Functional Movement Screen (FMS), vertical jump, single leg hop and sit-and-reach tests. Participants were monitored over a period of 12 weeks by completing a weekly online logbook regarding their training and possible incidence of injury. Monitoring was terminated after 12 weeks of observation. Differences between injured and non-injured runners were determined using Independent -T-tests for mean differences, or Mann-Whitney U Test for distributional differences (non-parametric data). Binomial Logistic regression models were used to determine the influence of internal, external functional and external behavioural factors on the risk for running injury, respectively. Results: The total group revealed a cumulative incidence of injury of 63% over the 12 weeks of observation. There was no gender difference between incidences of injuries over the 12 week observation training period (OTP). Injured runners achieved a higher total FMS score (median = 16, Interquartile Range = 3) compared to uninjured runners (median = 15, Interquartile range = 3; p = 0.006). Binomial logistic regression models of external functional (FMS, Vertical Jump, Sit-and-Reach scores) factors [X² (3) = 9.764, p = 0.021] were statistically significant. Only the FMS score contributed significantly to the incidence of injury (p = 0.013) of the three external functional factors in the Regression Model. Discussion and Conclusion: The study adds to current evidence that the assessment of the Functional Movement Screen is important in predicting injury, however, the present study shows that a higher score obtained during the FMS increase your odds to sustain an injury. The study is in contrast with the body of evidence that the incidence of previous injury is the strongest predictor of the incidence of a current injury. The study concluded that the Functional Movement Screen is a useful screening tool to determine a long distance runner's risk for running-related injuries and should be included in health-injury risk assessments of recreational runners.
Open Access
Physiological evaluation of sleep surfaces in healthy volunteers and patients with acute-upon-chronic lower back pain
(1998) Hulse, Bronwyn Leigh; Derman, Wayne
Studies have documented that the use of a lumbar support while in the sitting position results in reduced back and leg pain, centralisation of pain and reduced erector spinae muscle activity in patients with lower back pain (LBP). While the positive effects of a lumbar support in sitting have been studied, few researchers have attempted to document the value of such a support in the supine position. Since many patients with LBP suffer from insomnia and nocturnal discomfort, it may be possible that the use of a foam surface overlay could positively influence their symptoms. Several foam surface overlays are currently used as a popular form of management for patients presenting with LBP. These include the convoluted foam surface ("egg box'' shape), which to my knowledge has not been scientifically studied and the lumbar body support, the value of which has only recently been reported. That study found that patients with chronic LBP have decreased electromyographic (EMG) activity of the erector spinae muscles, lower heart rates (HR) and decreased perception of discomfort (ROD) when lying on this locally designed, triple density, contoured, lumbar body support system (LBS) compared with a conventional flat innerspring mattress (CM). Accordingly the aim of this thesis was to measure the EMG activity, heart rate response, perception of comfort and pattern of pressure distribution after lying on a variety of different surfaces, thus endeavouring to determine a mechanism of action of the LBS. In the first study of this thesis, ten patients with LBP were exposed to a random order, 30 minute period on three sleep surfaces: Lumbar body support on top of a conventional mattress (LBS+ CM), 60 mm convoluted foam surface on top of a conventional mattress (CFS + CM), and a conventional mattress (CM) alone. Each patient acted as his/her own control. Recordings of EMG activity, HR and ROD were measured for each patient. Average HR over the 30 minute period was lower after acute exposure to the LBS+ CM (60 ± 11 b/min) compared to the CM (66 ± 10 b/min, p < 0.05; LBS+ CM vs. CM). Although average HR response to the LBS+ CM was lower compared to CFS + CM (64 ± 9 b/min), this difference was not significant. ROD reported after acute exposure to the LBS+ CM was improved (1.9 ± 0.7 units), compared to the CFS+ CM (3.9 ± 1.0 units) and CM (4.7 ± 2.2 units; p < 0.05). Average EMG activity was lower after 30 minutes on the LBS + CM (2.68 ± 1.1 mv) compared to the CFS+ CM (4.46 ± 2.7 mv) and CM (4.19 ± 2.4 mv; p < 0.05). These results suggest that patients with LBP have reduced EMG activity and HR measurements with lower ROD when lying on a LBS + CM compared with a CM and CFS + CM. The second series of experiments involved a further ten patients with lower back pain, who were required to lie supine in random order on the LBS + CM, on a polystyrene mould (PM) (identical to the shape of the LBS) and on a CM. Recordings of EMG activity, HR and ROD were measured for each patient. Average HR over the 30 minute period was lower on the LBS + CM (60 ± 7 b/min) vs. PM + CM (66 ± 10 b/min) and CM (68 ± 9 b/min; p < 0.01 ). Average ROD was improved when patients lay on the LBS+ CM (1.8 ± 0.6 units) vs. PM + CM (5. 7 ± 2.5 units) and CM (4.1 ± 1.8 units; p < 0.05). Furthermore, average EMG activity was significantly reduced after lying on the LBS + CM (2.5 ± 1.0 mv) vs. PM + CM (4.3 ± 1.9 mv) and CM (4.6 ± 1.8 mv; p < 0.01 ). The findings of this study mirror our initial findings. The elevated EMG activity, heart rate and perception of discomfort after lying on a PM suggests that it could be a combination of both the correct density and the correct contour features that is important in reducing muscle spasm in patients with acute-upon-chronic lower back pain. Average HR over the 30 minute period was lower after acute exposure to the LBS+ CM (60 ± 11 b/min) compared to the CM (66 ± 10 b/min, p < 0.05; LBS+ CM vs. CM). Although average HR response to the LBS+ CM was lower compared to CFS + CM (64 ± 9 b/min), this difference was not significant. ROD reported after acute exposure to the LBS+ CM was improved (1.9 ± 0.7 units), compared to the CFS+ CM (3.9 ± 1.0 units) and CM (4.7 ± 2.2 units; p < 0.05). Average EMG activity was lower after 30 minutes on the LBS + CM (2.68 ± 1.1 mv) compared to the CFS+ CM (4.46 ± 2.7 mv) and CM (4.19 ± 2.4 mv; p < 0.05). These results suggest that patients with LBP have reduced EMG activity and HR measurements with lower ROD when lying on a LBS + CM compared with a CM and CFS + CM. The second series of experiments involved a further ten patients with lower back pain, who were required to lie supine in random order on the LBS + CM, on a polystyrene mould (PM) (identical to the shape of the LBS) and on a CM. Recordings of EMG activity, HR and ROD were measured for each patient. Average HR over the 30 minute period was lower on the LBS + CM (60 ± 7 b/min) vs. PM + CM (66 ± 10 b/min) and CM (68 ± 9 b/min; p < 0.01 ). Average ROD was improved when patients lay on the LBS+ CM (1.8 ± 0.6 units) vs. PM + CM (5. 7 ± 2.5 units) and CM (4.1 ± 1.8 units; p < 0.05). Furthermore, average EMG activity was significantly reduced after lying on the LBS + CM (2.5 ± 1.0 mv) vs. PM + CM (4.3 ± 1.9 mv) and CM (4.6 ± 1.8 mv; p < 0.01 ). The findings of this study mirror our initial findings. The elevated EMG activity, heart rate and perception of discomfort after lying on a PM suggests that it could be a combination of both the correct density and the correct contour features that is important in reducing muscle spasm in patients with acute-upon-chronic lower back pain. body support is altered and pressures are more equally distributed when compared to the pressure distribution of the other surfaces measured, without increases in pressure at any point on the body. Similar average and peak pressure results were obtained for the 90 mm CFS + CM and LBS. Since these results were not mirrored by the 60 mm CFS, the thickness of a foam surface possibly plays a role in reducing pressure. The data of these three separate studies could have implications in the adjunctive treatment of i)low back pain and ii) pressure sores. Firstly, the results of this thesis suggest that the use of a 60 mm foam overlay may not be the optimum form of management for patients presenting with paraspinal muscular spasm. Further, it is postulated, that the density and contour features of the lumbar body support are likely to play a role in reducing EMG activity and heart rate, while improving perception of comfort compared to the flat surfaces (CM and 60 mm CFS), which offer little support to the lumbar region of these patients. X Secondly, either the LBS or 90 mm CFS are likely to reduce the incidence of pressure sores in patients required to lie supine for prolonged periods, due to the reduction in peak and average pressures. In view of the contoured surface, it is unlikely that pressure sores could develop in patients lying on the LBS. This hypothesis needs to be confirmed in longer term studies in patients who are severely debilitated or paraplegic, as they are often most at risk for the development of pressure sores.
Open Access
Rehabilitation outcomes of a lifestyle intervention program for chronic disease medical insurer referred and funded patients versus self-initiated and self-funded patients.
(2012) Hope, Fallon
Chronic diseases of lifestyle are typically diseases of long duration and slow progression and are the major cause of morbidity and mortality globally. In 2008, 57 million people died worldwide of which 33 million deaths were due to chronic diseases. The burden of chronic disease in low and middle income countries is increasing, yet the capacity for prevention and control thereof is inadequate. It has been suggested that more than 50 % of global deaths can be prevented by combining cost effective national and international efforts as well as individual action to target management of well established risk factors including increasing physical activity, improvement of nutrition, decrease tobacco and alcohol use and implementation of strategies to address adverse psychosocial stress. The main aims of this dissertation were 1) to review the existing literature focussing on the prevalence, associated risk factors, management and treatment interventions of chronic disease, and 2) to compare rehabilitation outcomes between a pilot group of patients referred and funded to the CDRRRP by their medical insurer, namely Fedhealth (FH) versus a self funded and referred group (SF) of patients with chronic disease, to determine if any differences exist in their outcomes achieved after completing the 12 week programme, and 3) to evaluate the effect of a chronic disease rehabilitation programme on outcomes after 12 weeks (36 sessions) for chronic disease patients.
Open Access
Secular changes in anthropometric and physical characteristics of South African National U/20 rugby union players (1998-2010).
(2012) Lombard, Wayne; Lambert, Michael I
The aim of this study was to compare changes in the physical and morphological characteristics of South Africa’s National U/20 rugby union players (Forwards and Backs) over a 12 year period from 1998 - 2010. This period spans an era starting just after the onset of professionalism of the game to the modern era where the influence of professionalism has filtered down to junior (U/20) levels. Any changes in morphology and physical ability of the players can be attributed to the changes in the demands of the game and reflect the characteristics that are required for a player to be successful at that level. Players who were U/20 at the time of representing the Junior South African National Team National over a period spanning from 1998 – 2010 were used for the study. A total of 453 players, split into two groups, Forwards (n = 256) and Backs (n = 197), underwent measurements of body mass, stature, body fat percentage, muscular endurance (pull ups), muscular strength (1RM bench press, sprint times (10m and 40m) and aerobic capacity (Multistage shuttle run test). All Tests were conducted once a year in either January or December of that year. Data are represented as means ± 95 % confidence intervals. A Levene’s test of homogeneity was used to determine whether the variance for each variable was equal. A two-way analysis of variance was used to determine whether there were significant differences for either main effect of ‘year’ or ‘position’ or for the interaction between ‘year x position’. If the main effect of ‘year’ or interaction (“year x position”) was significant, a Tukey post hoc test was used to identify specific differences. Statistical significance was accepted when p < 0.05.
Open Access
Self-reported measures versus objective measures of physical activity and sedentary behaviour : impacts of cardiovascular fitness and physical activity
(2014) Tomaz, Simone Annabella; Kolbe-Alexander, Tracy; Lambert, Vicki
Physical activity (PA) and sedentary behaviour (SB) can be quantified with both self-report and objective measures, using questionnaires and accelerometers, respectively. There is a paucity of research investigating the possible influence that cardiorespiratory fitness and PA might have on the accuracy of self-reported of PA and SB. This is especially important with the increasing evidence around the risks of SB, independent of PA. The aim of this research study is to describe the difference between self-reported measures of moderate PA, vigorous PA and SB against their objectively measured counterparts. The secondary aim is to identify factors influencing the error in self-report measures; including cardiorespiratory fitness and levels of PA.
Open Access
Stress in the workplace the contrasting effects of 10 minutes of listening to Chopin vs. HRV biofeedback on autonomic reactivity and cognitive performance
(2012) Smit, Sita; Rauch, Laurie
Includes abstract. Includes bibliographical references.
Open Access
"Sweet Hearts": A biokinetics primary prevention programme in the South African public health sector: A qualitiative analysis
(2015) Evans, Robert William
This minor dissertation is comprised of 3 chapters. The first chapter is a meta-analysis that provides a quantitative summary of data from 10 community-based physical activity interventions across 5 countries. The analysis provides evidence for the efficacy of physical activity interventions (standardized mean difference (SMD) = 1.275; percentage increase in physical activity = 29.5%) in increasing levels of physical activity. These findings support the notion that multi-strategic community-wide interventions are able to reach a large proportion of the population regardless of social class and socioeconomic level. Broad-based instead of individual interventions are more cost-effective and help to spread knowledge about the importance of physical activity, stress reduction and nutrition, thereby improving health. The second chapter details the effect of a 3-month pilot Biokinetics primary prevention program ("Sweet Hearts") on health outcome measures. A total of twenty-seven exercise sessions, combined with nutritional advice and stress reduction techniques, were conducted. Despite a small sample size (n = 10), the intervention showed significant improvements in health outcome measures amongst participants (p ≤ 0.05). These improvements include: a decrease in waist circumference and resting respiratory rate, as well as an increase in 1-minute time perception, Global Physical Activity Questionnaire (GPAQ) score, 12-minute walk distance and sit-to-stand test repetitions. Improvements were also noted in cognitive restraint with regards to eating behaviour as well as heart rate variability (HRV), specifically in the low frequency spectrum. The combination of lowered resting breathing rates and improved HRV measures suggests that participant's autonomic nervous system (ANS) regulation improved during the course of the intervention. Correlational analysis revealed that higher income levels were associated with poorer HRV measures. The favourable results of the community intervention show promise for the future expansion of the program into the public health sector and provide proof of concept to dedicate resources to conduct more robust research within a community setting. The final chapter uses a mixed methods approach to explore factors promoting participation and predicting adherence to a community health intervention. The qualitative interviews conducted during this study offers rich and valuable information on how to improve the "Sweet Hearts" intervention. Five main themes were identified from the interviews conducted: 1) Enjoyment of the intervention 2) Benefits of the intervention 3) Obstacles affecting adherence 4) Future improvements to the intervention 5) State of non-communicable diseases in South Africa. Quantitative analysis showed that superior ANS regulation in participants at baseline was indicative of higher attendance rates. This improved regulation is evident through lowered systolic blood pressure and the ability to better regulate (attenuate an increase in) both breathing rate and HRV (low frequency power) from Rest to the Stroop Task s. The detail collected within this analysis will be incorporated into an updated conceptual model that will then form the basis of improving adherence and ensuring the intervention grows from strength to strength in coming years. South Africa is without a focused approach to reduce physical inactivity. The primary function of a Biokineticist is to improve physical functioning and health through exercise as a modality. An alarming number of non-communicable diseases (NCDs), such as cardiovascular disease and type-2 diabetes mellitus, were attributable to physical inactivity among South Africans based on the 1998 South African Demographic and Health survey data. The findings of this dissertation advocate for the support and funding of community-based physical activity interventions in combatting NCDs. The time has come for South African policy makers to act upon the Strategic Plan for Prevention and Control of NCDs (2013-2017). Such action should be A) the inclusion of Biokinetics into the public health sector and B) funding of multi-disciplinary community health programs supporting education, healthy eating and physical activity levels.
Open Access
The comparison between subjective and objective free-living physical activity in women with diverse weight loss histories
(2023) Burrows, Robyn Toni; Kroff, Jacolene
Introduction: Weight regain following weight loss is a universal concern for successful obesity management strategies. The tendency evident in reduced-weight women to overestimate physical activity may be one of the causes of unsuccessful weight loss maintenance in the long term. The current study aimed to 1) identify differences in objective (accelerometry) and self-reported (GPAQ) free-living physical activity in women who experienced weight loss, and 2) determine whether overor-underestimation of physical activity was related to time at goal weight. Methods: Reduced-obese women (n = 19) were recruited for this study. The reduced-obese condition consisted of women who had lost a minimum of 10% of their body weight 18-6 months before testing. Prior to visiting the laboratory, participants were telephonically questioned to determine their inclusion or exclusion status for the study. During the first visit, participants completed physical assessments (BMI, body fat percentage), the Global Physical Activity Questionnaire (GPAQ), and underwent the accelerometer fitting. The accelerometer was worn for a period of 7 days and was used to measure free-living daily activity. Means ± SD were used to analyse parametric data and medians and interquartile range were used to assess non-parametric data. Pearson correlations were used to measure the association between the two methods. Paired sample t-tests, Chi-square tests and Effect sizes using Cohen's d were run. Finally, we visually inspected and statistically tested the results using Bland-Altman plots and simple liner regressions. Results: On average, participants lost 23.3  9.1 percent of their weight over an average period of 7  2.8 months. Participants underestimated their sedentary time and time spent in moderate-intensity activity and overestimated their vigorous-intensity activity. Bland-Altman plots revealed a proportional bias for time spent per day in sedentary time, vigorous-intensity activity, and MVPA. MVPA showed a statistically significant positive correlation between the two measures, r = 0.72, p = 0.0006. Time spent in moderate activity showed the best agreement between the self-reported measure and accelerometry, revealing no proportional bias (mean SD bias of -61.8 38.2 min per day). Chi-squared results revealed that 11 participants (of which 9 were at their goal weight for 6 months and 2 were at their goal weight for longer than 6 months) underestimated their MVPA. Chisquared results also revealed that 7 participants (of which 6 were at their goal weight for 6 months and 1 was at their goal weight for longer than 6 months) overestimated their vigorous-intensity activity. Discussion and conclusion: Underestimation of sedentary time and overestimation of vigorous intensity exercise put the group of reduced-obese women at risk for weight regain in the long term. The moderate-intensity activity was largely underreported, which requires further investigation. It is imperative that research on reduced-weight women make use of objective measures for the measurement of free-living activity, for self-reported measures will lead to a misinterpretation of this specific population's physical activity status.
Open Access
The development of an exercise intervention framework as a modality of treatment for individuals with obstructive sleep apnea, in the South African public healthcare setting
(2023) Jaffer, Zakirah; Rae, Dale; D'alton Caroline
Introduction: Obstructive sleep apnoea (OSA) is described as a breathing-related sleep disorder wherein your ventilation is impaired during sleep, due to the narrowing and collapse of the upper airway. Untreated OSA has been shown to increase the number of severe cardiovascular and cerebrovascular events. Common treatment modalities for OSA, including surgical intervention and continuous positive airway pressure therapy are effective but remain extremely expensive. It is thus often inaccessible to those in a low-income, under-resourced setting, or those without access to healthcare, as is the case for the majority of South Africans. Since addressing weight loss is a key component of OSA treatment, exercise may provide the benefits of addressing both weight loss and inflammation in OSA patients, as well as lowering the risk of cardiovascular disease, depression, and comorbidities that arise from obesity. Aims: The aims of this study were to understand the nature of, and perception to, current physical activity (PA) habits as well as barriers to exercise, faced by individuals with obstructive sleep apnoea (OSA group) compared to a control group of individuals without OSA (CON group). This information was then used to design an exercise intervention framework for OSA patients which can be implemented in an under-resourced setting, such as in the public healthcare system in South Africa. Methods: This is a secondary analysis of data already collected as part of a larger study investigating “Physical activity and sedentary behavior among patients with obstructive sleep apnoea in South Africa” (HREC Ref: 142/2021). The parent observational study made use of custom and validated questionnaires answered by adults diagnosed with moderate to severe OSA and control participants with no OSA. Participants were asked to report on current and past exercise habits, perceptions, enablers, and barriers to PA, as well as preferred modes of exercise, which were further analyzed. Results: A total of thirty-seven adults were included in the current study; eighteen of whom had been diagnosed with OSA, matched with nineteen CON adults for age, BMI, neck circumference, waist circumference, and blood pressure (all p>0.050). Self-reported current participation in PA was lower in the OSA group (61%) compared to the CON group (74%), although not significantly different (p=0.410), with lower levels of PA between the two groups reported as being due to time constraints, dark/unsafe environment, laziness, covid restrictions, a lack of interest, motivation, and illness/injury/surgery within the OSA group specifically, There was a high presence of structural pain within the OSA group (83%) compared to the CON group (58%), although not significantly different (0.091), which was aggravated by PA (33% and 36% respectively). Frequency of PA was most commonly recorded as four to seven days per week by both the CON and OSA group (p=0.975, with a self-reported medium intensity ranging between 4-7 out of 10 (p=0.281) based on a subjectively designed 10-point scale (1: very low intensity, 10: very high intensity). Walking was the preferred form of PA within the OSA group (72%), as well as within the CON group (63%) (p=0.556), and both groups identified the ‘lack of motivation' as a barrier to participation in PA (p=1.000). Conclusion: Taking into account the observations 7 from evidence-based reviews in Chapter 1 and the results from Chapter 2, the proposed framework should include an exercise intervention that considers a moderate frequency of three to five times/week, a medium and building up to a higher intensity of 40-80% HRR, shorter sessions of 25-40 minutes per session but building up to 60 minutes where possible, and inclusion of aerobic and resistance exercises with a focus on walking as well as lower body activities. Group sessions should be considered to allow space for social interactions through physical activity which may help work around the barrier of motivation. Patient education on OSA and its consequences, the role of sleep, sleep hygiene, and disease management should also be included as part of the exercise intervention. Importantly, our results provide a basis for further development on this framework to establish an exercise Intervention as an adjunct therapy for OSA patients, specifically in lower income settings. Future studies can explore the efficacy of these exercise interventions in the management of OSA in adults from low income settings.
Open Access
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.

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