OpenUCT :: Browsing by Subject "Exercise"

Browsing by Subject "Exercise"

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Open Access
A model for presenting accelerometer paradata in large studies: ISCOLE
(2015-04-20) Tudor-Locke, Catrine; Mire, Emily F; Dentro, Kara N; Barreira, Tiago V; Schuna, John M; Zhao, Pei; Tremblay, Mark S; Standage, Martyn; Sarmiento, Olga L; Onywera, Vincent; Olds, Tim; Matsudo, Victor; Maia, José; Maher, Carol; Lambert, Estelle V; Kurpad, Anura; Kuriyan, Rebecca; Hu, Gang; Fogelholm, Mikael; Chaput, Jean-Philippe; Church, Timothy S; Katzmarzyk, Peter T
Abstract Background We present a model for reporting accelerometer paradata (process-related data produced from survey administration) collected in the International Study of Childhood Obesity Lifestyle and the Environment (ISCOLE), a multi-national investigation of >7000 children (averaging 10.5 years of age) sampled from 12 different developed and developing countries and five continents. Methods ISCOLE employed a 24-hr waist worn 7-day protocol using the ActiGraph GT3X+. Checklists, flow charts, and systematic data queries documented accelerometer paradata from enrollment to data collection and treatment. Paradata included counts of consented and eligible participants, accelerometers distributed for initial and additional monitoring (site specific decisions in the face of initial monitoring failure), inadequate data (e.g., lost/malfunction, insufficient wear time), and averages for waking wear time, valid days of data, participants with valid data (≥4 valid days of data, including 1 weekend day), and minutes with implausibly high values (≥20,000 activity counts/min). Results Of 7806 consented participants, 7372 were deemed eligible to participate, 7314 accelerometers were distributed for initial monitoring and another 106 for additional monitoring. 414 accelerometer data files were inadequate (primarily due to insufficient wear time). Only 29 accelerometers were lost during the implementation of ISCOLE worldwide. The final locked data file consisted of 6553 participant files (90.0% relative to number of participants who completed monitoring) with valid waking wear time, averaging 6.5 valid days and 888.4 minutes/day (14.8 hours). We documented 4762 minutes with implausibly high activity count values from 695 unique participants (9.4% of eligible participants and <0.01% of all minutes). Conclusions Detailed accelerometer paradata is useful for standardizing communication, facilitating study management, improving the representative qualities of surveys, tracking study endpoint attainment, comparing studies, and ultimately anticipating and controlling costs. Trial registration ClinicalTrials.gov: NCT01722500
Open Access
Are children really different from adults in critical care settings?
(2005) Coetzee, Minette
Four years ago a Nursing Standards Generating Body (SGB) was established to gather wide input and formulate national educational standards for nursing. Possibly for the first time in South Africa this process offered a platform to consider how paediatric critical care is different from adult critical care. During the course of the 3-year SGB process, the Critical Care Society of South Africa (CCSSA) coordinated an exceptional response after having garnered wide participation from South African critical care nurses, educators and clinicians. It was an excellent opportunity to contribute to the issues around the nature and length of education programmes as well as the outcomes. The recommendations were thoroughly debated and offered a unique opportunity to influence policy and standards of critical care nursing education. This debate could also challenge assumptions, and it was in this process that the often misunderstood question of the differences between adult and child critical care could be tackled.
Open Access
Association between breakfast frequency and physical activity and sedentary time: a cross-sectional study in children from 12 countries
(BioMed Central, 2019-02-21) Zakrzewski-Fruer, Julia K; Gillison, Fiona B; Katzmarzyk, Peter T; Mire, Emily F; Broyles, Stephanie T; Champagne, Catherine M; Chaput, Jean-Philippe; Denstel, Kara D; Fogelholm, Mikael; Hu, Gang; Lambert, Estelle V; Maher, Carol; Maia, José; Olds, Tim; Onywera, Vincent; Sarmiento, Olga L; Tremblay, Mark S; Tudor-Locke, Catrine; Standage, Martyn
Background Existing research has documented inconsistent findings for the associations among breakfast frequency, physical activity (PA), and sedentary time in children. The primary aim of this study was to examine the associations among breakfast frequency and objectively-measured PA and sedentary time in a sample of children from 12 countries representing a wide range of human development, economic development and inequality. The secondary aim was to examine interactions of these associations between study sites. Methods This multinational, cross-sectional study included 6228 children aged 9–11 years from the 12 International Study of Childhood Obesity, Lifestyle and the Environment sites. Multilevel statistical models were used to examine associations between self-reported habitual breakfast frequency defined using three categories (breakfast consumed 0 to 2 days/week [rare], 3 to 5 days/week [occasional] or 6 to 7 days/week [frequent]) or two categories (breakfast consumed less than daily or daily) and accelerometry-derived PA and sedentary time during the morning (wake time to 1200 h) and afternoon (1200 h to bed time) with study site included as an interaction term. Model covariates included age, sex, highest parental education, body mass index z-score, and accelerometer waking wear time. Results Participants averaged 60 (s.d. 25) min/day in moderate-to-vigorous PA (MVPA), 315 (s.d. 53) min/day in light PA and 513 (s.d. 69) min/day sedentary. Controlling for covariates, breakfast frequency was not significantly associated with total daily or afternoon PA and sedentary time. For the morning, frequent breakfast consumption was associated with a higher proportion of time in MVPA (0.3%), higher proportion of time in light PA (1.0%) and lower min/day and proportion of time sedentary (3.4 min/day and 1.3%) than rare breakfast consumption (all p ≤ 0.05). No significant associations were found when comparing occasional with rare or frequent breakfast consumption, or daily with less than daily breakfast consumption. Very few significant interactions with study site were found. Conclusions In this multinational sample of children, frequent breakfast consumption was associated with higher MVPA and light PA time and lower sedentary time in the morning when compared with rare breakfast consumption, although the small magnitude of the associations may lack clinical relevance. Trial registration The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) is registered at (Identifier NCT01722500 ).
Open Access
Association between perceived built environmental attributes and physical activity among adults in South Africa
(2017) Malambo, Pasmore; Pheiffer, Carmen; Lambert, Estelle V; De Villers, Anniza; Puoane, Thandi
Abstract Background To investigate the association between perceived environmental attributes and leisure-time and transport-related physical activity. Methods This was a cross-sectional survey involving 671 South Africans aged ≥35 years from urban and rural settings. International Physical Activity Questionnaire and Neighbourhood Walkability Scale were used to collect data. Multivariable logistic regressions were used to investigate the associations. Results Significant urban vs. rural differences were apparent in the distribution of most attributes of neighborhood environment. After adjusting for gender, age, setting and relevant interaction terms, proximity to local stores was significantly associated with leisure-time physical activity (OR: 4.26; 95% CI, 1.00–18.08); while proximity to transit stops (2.44; 1.48–4.02), pleasant scenery (1.93; 1.07–3.46), sidewalks (2.36; 1.25–4.44), shade from trees (2.14; 1.19–3.85), traffic (2.17; 91.21–3.91) and well-lit streets (2.01; 1.04–3.89) were significantly associated with walking for leisure. Four-way intersections (4.54; 1.54–13.43), pleasant scenery (3.84; 1.35–10.99), traffic (0.28; 0.09–0.89), sidewalks (3.75; 1.06-13.27) and crosswalks were associated with transport related physical activity. Proximity to transit stops (2.12; 1.17–3.84) and well maintained sidewalks (2.69; 2.20–10.02) were significantly associated with total physical activity. Significant interactions by setting were apparent in some of the associations. Conclusion Some, but not all attributes of a neighborhood environment were significantly associated in expected directions with the three physical activity domains in this mixed urban and rural population. This study highlights the need for policy strategies aimed at improving or maintaining these perceived environmental attributes to promote physical activity.
Open Access
Cardiovascular prevention: lifestyle and statins – competitors or companions?
(2014) Opie, Lionel Henry; Dalby, Anthony John
Favourable lifestyles promote cardiovascular protection. Exercise can induce beneficial changes in the genome that decrease low-density lipoprotein cholesterol (LDL-C) and increase anti-inflammatory markers. The Mediterranean dietary pattern, fortified by nuts, while not reducing weight, reduces mortality. Lifestyle changes combined with statin therapy provide potent protection against coronary heart disease, especially when used for secondary prevention after cardiovascular events. Decisions regarding the initiation of statin therapy for primary prevention are more difficult, requiring consideration of both the LDL-C level and the degree of cardiovascular risk for dyslipidaemic patients. Combining intensive exercise and statin therapy substantially reduces the mortality risk, and thus is potentially the ideal risk-reducing combination.
Open Access
Comparative effects of calcium channel antagonism and beta-1 selective blockade on exercise performance in physically active hypertensive patients
(1997) Selvey, Christine Enid; Derman, Wayne
The current recommendations by the American Heart Association for health promotion are that all persons should partake in regular physical activity in order to reduce the risk of cardiovascular disease. Regular physical exercise reduces blood pressure and is an important component of the management of hypertension. It is therefore important that patients with hypertension participate in habitual physical exercise. Many hypertensive patients who exercise will require anti-hypertensive medication. However, some antihypertensive agents cause fatigue during exercise. In order for patients to gain the full benefits of an active lifestyle, it is important that the prescribed antihypertensive agent does not prevent them performing and enjoying sustained exercise. It has been well documented that β-blockers cause premature fatigue during physical exercise. The effects on exercise performance of other first line antihypertensive medications, such as calcium channel antagonists have not been extensively investigated. In particular, the effects of these agents on prolonged submaximal exercise endurance have not been well studied. The object of this thesis was to compare the effects of isradipine, a dihydropyridine calcium channel antagonist, to those of atenolol, a β₁-selective antagonist, on maximal and submaximal exercise performance and on short duration high-intensity exercise in physically active hypertensive patients. The study design was a crossover trial where drug treatments were double blinded and randomised. Physically active volunteers with mild to moderate hypertension were recruited. 11 subjects performed i) progressive exercise to exhaustion for determination of maximal oxygen consumption (VO₂max), maximal work load and cardiorespiratory responses to maximal exercise, ii) prolonged submaximal exercise for determination of exercise endurance, cardiorespiratory responses and ratings of perceived exertion (APE), and iii) short duration, high intensity exercise consisting of a 30 second maximal exercise test (Wingate test) to determine skeletal muscle power output, following 4 weeks ingestion of isradipine (2.5mg bd), atenolol (50mg bd) or placebo. Diastolic blood pressure at rest was reduced by both atenolol and isradipine, but was lowered to a greater extent by atenolol (83.3 vs 89.0 vs 96.1 mmHg, atenolol vs isradipine vs placebo, p<.0005). Systolic blood pressure at rest tended to be similarly reduced by both agents, but was significantly reduced during maximal and submaximal exercise by atenolol only (p<.001, atenolol vs isradipine, placebo). Heart rate at rest and during maximal and submaximal exercise was decreased by atenolol only (p<.0005, atenolol vs isradipine, placebo). Maximal exercise performance was reduced after atenolol ingestion compared to placebo but not after isradipine ingestion. Peak workload achieved during the maximal exercise test was decreased after atenolol but unchanged after isradipine ingestion (214 vs 243 W, atenolol vs placebo, p<.01). Similarly, VO₂max was reduced after atenolol compared to placebo but was unchanged after isradipine ingestion (33.6 vs 36.4, 33.6 vs 36.1 mlO₂/kg/min, atenolol vs placebo, atenolol vs isradipine, p<.05). Both atenolol and isradipine ingestion reduced submaximal endurance time compared to placebo (27.8 vs 46.4, 34.4 vs 46.4 min, atenolol vs placebo, isradipine vs placebo, p<.005), and increased rating of perceived exertion (APE) after 30 min of submaximal exercise (p<.05). Submaximal oxygen consumption (VO₂), ventilation, respiratory exchange ratio (REA) and blood lactate, glucose and free fatty acid concentrations were not altered after the ingestion of either agent. Neither agent influenced peak skeletal muscle power, total work done, or rate of fatigue during the Wingate test compared to placebo. The results of these studies indicate that impaired performance and increased RPE during submaximal exercise after ingestion of either atenolol or isradipine is not due to alterations of ventilation, VO₂, RER, or blood lactate, glucose and free fatty acid concentrations during prolonged submaximal exercise. Similarly, reduced submaximal exercise performance after atenolol or isradipine ingestion is not due to factors which would also limit the ability of skeletal muscle to perform short duration, high intensity exercise before a bout of prolonged exercise. This study demonstrates that prolonged submaximal exercise testing can reveal an impairment in exercise performance after ingestion of antihypertensive medication which is not evident during maximal exercise testing. This finding is important as prolonged submaximal exercise is the form of exercise which most hypertensive patients actually perform. Further research is required on the effects of anti-hypertensive medications on submaximal exercise performance before firm recommendations can be made regarding medications most suitable for the physically active hypertensive patient. The results of these and other studies indicate that it is not yet possible to make claims that the calcium channel antagonist agents are without effect on physical exercise performance in physically active hypertensive patients.
Open Access
Conference on "Multidisciplinary approaches to nutritional problems". Symposium on "Diabetes and health". Nutrition interventions for the prevention of type 2 diabetes.
(2009) Steyn, Nelia P; Lambert, Estelle V; Tabana, Hanani
Diabetes mellitus is escalating globally and it is predicted that 200 million individuals worldwide will have diabetes by 2010 and 300 million by 2025. However, there is compelling evidence from many studies that for subjects with impaired fasting glucose or impaired glucose tolerance the presentation of type 2 diabetes can be delayed by lifestyle modification. The aim of the present review is to present a summary of lifestyle modification interventions that have included a dietary component in their overall diabetes prevention programme. Medline, allied health literature and diabetes journals were searched for peer-reviewed literature using the terms 'diet*' and 'diabetes' and 'intervention'. Inclusion criteria were: peer-reviewed studies from 1975 to 2008; a sample of at least fifty subjects; a healthy eating and/or physical activity component; prevention of diabetes as a primary goal. Generally, the participants were in a high-risk category for the development of diabetes. Outcomes were evaluated at two points in time (pre- and post-intervention) in terms of knowledge, behaviour change and clinical improvement, which included weight, blood pressure, BMI, body fat, waist circumference, waist:hip ratio and physiological and/or biochemical measures. Findings indicate that the most successful interventions combine individual dietary counselling with an activity component. Further factors predicting success are weight loss achieved, duration and intensity of the intervention and dietary compliance.
Open Access
Contemporary perspectives of core stability training for dynamic athletic performance: a survey of athletes, coaches, sports science and sports medicine practitioners
(Springer International Publishing, 2018-07-16) Clark, David R; Lambert, Michael I; Hunter, Angus M
Background Core stability training has grown in popularity over 25 years, initially for back pain prevention or therapy. Subsequently, it developed as a mode of exercise training for health, fitness and sport. The scientific basis for traditional core stability exercise has recently been questioned and challenged, especially in relation to dynamic athletic performance. Reviews have called for clarity on what constitutes anatomy and function of the core, especially in healthy and uninjured people. Clinical research suggests that traditional core stability training is inappropriate for development of fitness for heath and sports performance. However, commonly used methods of measuring core stability in research do not reflect functional nature of core stability in uninjured, healthy and athletic populations. Recent reviews have proposed a more dynamic, whole body approach to training core stabilization, and research has begun to measure and report efficacy of these modes training. The purpose of this study was to assess extent to which these developments have informed people currently working and participating in sport. Methods An online survey questionnaire was developed around common themes on core stability training as defined in the current scientific literature and circulated to a sample population of people working and participating in sport. Survey results were assessed against key elements of the current scientific debate. Results Perceptions on anatomy and function of the core were gathered from a representative cohort of athletes, coaches, sports science and sports medicine practitioners (n = 241), along with their views on effectiveness of various current and traditional exercise training modes. Most popular method of testing and measuring core function was subjective assessment through observation (43%), while a quarter (22%) believed there was no effective method of measurement. Perceptions of people in sport reflect the scientific debate, and practitioners have adopted a more functional approach to core stability training. There was strong support for loaded, compound exercises performed upright, compared to moderate support for traditional core stability exercises. Half of the participants (50%) in the survey, however, still support a traditional isolation core stability training. Conclusion Perceptions in applied practice on core stability training for dynamic athletic performance are aligned to a large extent to the scientific literature.
Open Access
The Effect of Sodium Alginate and Pectin Added to a Carbohydrate Beverage on Endurance Performance, Substrate Oxidation and Blood Glucose Concentration: A Systematic Review and Meta-analysis
(2022-06-21) Sutehall, Shaun; Muniz-Pardos, Borja; Bosch, Andrew; Pitsiladis, Yannis
Introduction Scientific and public interest in the potential ergogenic effects of sodium alginate added to a carbohydrate (CHO) beverage has increased in the last ~ 5 years. Despite an extensive use of this technology by elite athletes and recent research into the potential effects, there has been no meta-analysis to objectively elucidate the effects of adding sodium alginate to a CHO beverage on parameters relevant to exercise performance and to highlight gaps in the literature. Methods Three literature databases were systematically searched for studies investigating the effects of sodium alginate added to CHO beverage during prolonged, endurance exercise in healthy athletes. For the systematic review, the PROSPERO guidelines were followed, and risk assessment was made using the Cochrane collaboration’s tool for assessing the risk of bias. Additionally, a random-effects meta-analysis model was used to determine the standardised mean difference between a CHO beverage containing sodium alginate and an isocaloric control for performance, whole-body CHO oxidation and blood glucose concentration. Results Ten studies were reviewed systematically, of which seven were included within the meta-analysis. For each variable, there was homogeneity between studies for performance (n = 5 studies; I2 = 0%), CHO oxidation (n = 7 studies; I2 = 0%) and blood glucose concentration (n = 7 studies; I2 = 0%). When compared with an isocaloric control, the meta-analysis demonstrated that there is no difference in performance (Z = 0.54, p = 0.59), CHO oxidation (Z = 0.34, p = 0.71) and blood glucose concentration (Z = 0.44, p = 0.66) when ingesting a CHO beverage containing sodium alginate. The systematic review revealed that several of the included studies did not use sufficient exercise intensity to elicit significant gastrointestinal disturbances or demonstrate any ergogenic benefit of CHO ingestion. Risk of bias was generally low across the included studies. Conclusions This systematic review and meta-analysis demonstrate that the current literature indicates no benefit of adding sodium alginate to a CHO beverage during exercise. Further research is required, however, before firm conclusions are drawn considering the range of exercise intensities, feeding rates and the apparent lack of benefit of CHO reported in the current literature investigating sodium alginate.
Open Access
Exercise and bone mass in mature premenopausal women
(1996) Micklesfield, Lisa Kim; Myburgh, Kathryn Helen
Open Access
Factors affecting energy expenditure and the efficiency of fuel utilization : feeding and exercise models
(1993) Lambert, Estelle Victoria; Koeslag, Johan; Noakes, Timothy D
The first aim of this dissertation was to monitor both rat and human responses to short-term perturbations in energy balance brought about through food energy restriction and refeeding, exercise training and the cessation of exercise training or surgical lipectomy. The second aim of this dissertation was to identify factors which might explain differences in food energy intake in weight-matched, weight-stable "large and small eaters". The final aim of this dissertation was to identify factors which might explain differences in resting energy expenditure in a large sample of weight-stable men and women, including exercising and non-exercising persons, and including persons who may be regarded as "restrained eaters".
Open Access
Fuel kinetics during intense running and cycling when fed carbohydrate
(1996) Derman, Kevin Dale; Hawley, John
On two occasions six competitive, male triathletes performed in random order, two experimental trials consisting of either a timed ride to exhaustion on a cycle-ergometer or a run to exhaustion on a motor-driven treadmill at 80% of their respective peak cycling and peak running oxygen uptakes (VO₂peak)- At the start of exercise, subjects drank 250 ml of a 15 g.100 ml⁻¹ w.v⁻¹ glucose solution with U-¹⁴C glucose added as tracer and, thereafter, 150 ml of the same solution every 15 min. Despite identical metabolic rates (VO₂ 3.51 ±0.06 vs. 3.51 ±0.10 l.min⁻¹; values are mean± SEM for the cycling and running trials, respectively), exercise times to exhaustion were significantly longer during cycling than running (96 ±14 vs. 63 ±11 min; P<0.05). The superior cycling than running endurance was not associated with any differences in either the rate of blood glucose oxidation (3.8 ±0.1 vs. 3.9 ±0.4 mmol.min⁻¹ ), nor the rate of ingested glucose oxidation (2.0 ± 0.1 vs. 1.7 ±0.2 mmol.min⁻¹) at the last common time point (40 min) before exhaustion, despite higher blood glucose concentrations at exhaustion during running than cycling (7.0 ±0.9 vs. 5.8 ±0.5 mmol.l⁻¹; P<0.05). However, the final rate of total CHO oxidation was significantly greater during cycling than running (24.0 ±0.8 vs. 21.7 ±1.4 mmol C6 .min⁻¹;P<0.01). At exhaustion, the estimated contribution to energy production from muscle glycogen had declined to similar extents in both cycling and running (68 ±3 vs. 65 ± 5%). These differences between the rates of total CHO oxidation and blood glucose oxidation suggested that the direct and/or indirect (via lactate) oxidation of muscle glycogen was greater in cycling than running.
Open Access
Improving wear time compliance with a 24-hour waist-worn accelerometer protocol in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE)
(2015-02-11) Tudor-Locke, Catrine; Barreira, Tiago V; Schuna, John M; Mire, Emily F; Chaput, Jean-Philippe; Fogelholm, Mikael; Hu, Gang; Kuriyan, Rebecca; Kurpad, Anura; Lambert, Estelle V; Maher, Carol; Maia, José; Matsudo, Victor; Olds, Tim; Onywera, Vincent; Sarmiento, Olga L; Standage, Martyn; Tremblay, Mark S; Zhao, Pei; Church, Timothy S; Katzmarzyk, Peter T
Abstract Background We compared 24-hour waist-worn accelerometer wear time characteristics of 9–11 year old children in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) to similarly aged U.S. children providing waking-hours waist-worn accelerometer data in the 2003–2006 National Health and Nutrition Examination Survey (NHANES). Methods Valid cases were defined as having ≥4 days with ≥10 hours of waking wear time in a 24-hour period, including one weekend day. Previously published algorithms for extracting total sleep episode time from 24-hour accelerometer data and for identifying wear time (in both the 24-hour and waking-hours protocols) were applied. The number of valid days obtained and a ratio (percent) of valid cases to the number of participants originally wearing an accelerometer were computed for both ISCOLE and NHANES. Given the two surveys’ discrepant sampling designs, wear time (minutes/day, hours/day) from U.S. ISCOLE was compared to NHANES using a meta-analytic approach. Wear time for the 11 additional countries participating in ISCOLE were graphically compared with NHANES. Results 491 U.S. ISCOLE children (9.92±0.03 years of age [M±SE]) and 586 NHANES children (10.43 ± 0.04 years of age) were deemed valid cases. The ratio of valid cases to the number of participants originally wearing an accelerometer was 76.7% in U.S. ISCOLE and 62.6% in NHANES. Wear time averaged 1357.0 ± 4.2 minutes per 24-hour day in ISCOLE. Waking wear time was 884.4 ± 2.2 minutes/day for U.S. ISCOLE children and 822.6 ± 4.3 minutes/day in NHANES children (difference = 61.8 minutes/day, p < 0.001). Wear time characteristics were consistently higher in all ISCOLE study sites compared to the NHANES protocol. Conclusions A 24-hour waist-worn accelerometry protocol implemented in U.S. children produced 22.6 out of 24 hours of possible wear time, and 61.8 more minutes/day of waking wear time than a similarly implemented and processed waking wear time waist-worn accelerometry protocol. Consistent results were obtained internationally. The 24-hour protocol may produce an important increase in wear time compliance that also provides an opportunity to study the total sleep episode time separate and distinct from physical activity and sedentary time detected during waking-hours. Trial registration ClinicalTrials.gov NCT01722500 .
Open Access
Levels of physical activity in people living with chronic pain: Do they change after participating in a Chronic Pain Management Program?
(2019) Swartz, Damian; Parker, Romy
Purpose: The purpose of this study was to determine whether levels of physical activity in people with chronic pain change after participating in a Chronic Pain Management Program (CPMP) at Groote Schuur Hospital (GSH). Methods: A pre-experimental pre-test, post-test study was conducted, consisting of 14 men and women suffering from chronic pain who were referred to a Chronic Pain Management Program (CPMP) from the Chronic Pain Management Clinic at GSH in Cape Town, South Africa. Subjective and objective measuring tools, including pedometry, were used to collect data and non-parametric analysis was conducted to analyse data. Results: 14 participants met the Inclusion criteria. Levels of physical activity changed markedly, but not significantly. Objectively-tested and self-reported physical activity levels changed significantly among participants who took part in a CPMP. Significant improvements in Pain Severity Scores and Pain Interference Scores occurred after the CPMP and there was convergent validity between self-reported and objectively-tested levels of physical activity in those suffering from chronic pain after the CPMP. Conclusion: The Chronic Pain Management Program at Groote Schuur Hospital in Cape Town has shown to improve function and physical activity of those patients living with chronic pain who take part in the CPMP, with function improving significantly, and physical activity nearly doubling in the group being tested who took part in the 5-week long program. The CPMP at GSH should be seen as the beginning of a greater movement towards increasing physical activity in the chronic pain sphere. Research in more public healthcare facilities is needed to increase knowledge around education, pacing and implementation strategies across South Africa.
Open Access
Managing pain in HIV/AIDS: a therapeutic relationship is as effective as an exercise and education intervention for rural amaXhosa women in South Africa
(2021-02-05) Jackson, Kirsty; Wadley, Antonia L; Parker, Romy
Background Pain is one of the most prevalent symptoms in people living with HIV/AIDS and is largely undermanaged. Both a peer-led exercise and education Positive Living programme (PL programme) and the PL programme workbook alone were previously found to be effective in reducing pain in urban amaXhosa Women Living With HIV/AIDS (WLWHA). A therapeutic relationship was hypothesised to have contributed to the efficacy of both interventions. The aim of the study was to determine the effectiveness of the PL programme and a therapeutic relationship, compared to a therapeutic relationship alone in managing pain amongst rural amaXhosa WLWHA on pain severity and pain interference, and secondary outcomes, symptoms of depression, health-related quality of life (HRQoL) and self-efficacy. Methods In this two-group, single-blind, pragmatic clinical trial with stratified convenience sampling, the PL programme and therapeutic relationship, was compared to a therapeutic relationship alone in rural amaXhosa WLWHA. The PL programme was a 6-week, peer-led intervention comprising education on living well with HIV, exercise and goal setting. The therapeutic relationship comprised follow-up appointments with a caring research assistant. Outcome measures included pain severity and interference (Brief Pain Inventory), depressive symptoms (Beck Depression Inventory), HRQoL (EuroQol 5-Dimensional outcome questionnaire) and self-efficacy (Self-efficacy for Managing Chronic Disease 6-Item Scale). Follow-up was conducted at 4, 8, 12, 24, and 48 weeks. Mixed model regression was used to test the effects of group, time, and group and time interactions of the interventions on outcome measures. Results Forty-nine rural amaXhosa WLWHA participated in the study: PL group n = 26; TR group n = 23. Both intervention groups were similarly effective in significantly reducing pain severity and interference and depressive symptoms, and increasing self-efficacy and HRQoL over the 48 weeks. A clinically important reduction in pain severity of 3.31 points occurred for the sample over the 48 weeks of the study. All of these clinical improvements were obtained despite low and suboptimal attendance for both interventions. Conclusions Providing a therapeutic relationship alone is sufficient for effective pain management amongst rural amaXhosa WLWHA. These findings support greater emphasis on demonstrating care and developing skills to enhance the therapeutic relationship in healthcare professionals working with rural amaXhosa WLWHA. Trial registration PACTR; PACTR201410000902600, 30th October 2014; https://pactr.samrc.ac.za .
Open Access
Perceptions of body size, obesity threat and the willingness to lose weight among black South African adults: a qualitative study
(2016) Okop, Kufre Joseph; Mukumbang, Ferdinand C; Mathole, Thubelihle; Levitt, Naomi; Puoane, Thandi
Abstract Background The obesity epidemic is associated with rising rates of cardiovascular disease (CVD) among adults, particularly in countries undergoing rapid urbanisation and nutrition transition. This study explored the perceptions of body size, obesity risk awareness, and the willingness to lose weight among adults in a resource-limited urban community to inform appropriate community-based interventions for the prevention of obesity. Method This is a descriptive qualitative study. Semi-structured focus group discussions were conducted with purposively selected black men and women aged 35–70 years living in an urban South African township. Weight and height measurements were taken, and the participants were classified into optimal weight, overweight and obese groups based on their body mass index (Kg/m 2 ). Participants were asked to discuss on perceived obesity threat and risk of cardiovascular disease. Information on body image perceptions and the willingness to lose excess body weight were also discussed. Discussions were conducted in the local language (isiXhosa), transcribed and translated into English. Data was analysed using the thematic analysis approach. Results Participants generally believed that obesity could lead to health conditions such as heart attack, stroke, diabetes, and hypertension. However, severity of obesity was perceived differently in the groups. Men in all groups and women in the obese and optimal weight groups perceived obesity to be a serious threat to their health, whereas the overweight women did not. Obese participants who had experienced chronic disease conditions indicated strong perceptions of risk of obesity and cardiovascular disease. Obese participants, particularly men, expressed willingness to lose weight, compared to the men and women who were overweight. The belief that overweight is ‘normal’ and not a disease, subjective norms, and inaccessibility to physical activity facilities, negatively influenced participants’ readiness to lose weight. Conclusion Low perception of threat of obesity to health particularly among overweight women in this community indicates a considerable challenge to obesity control. Community health education and promotion programmes that increase awareness about the risk associated with overweight, and improve the motivation for physical activity and maintenance of optimal body weight are needed.
Open Access
Perceptions relating to body size, weight loss and weight-loss interventions in black South African women: a qualitative study
(2016) Draper, Catherine E; Davidowitz, Kesiah J; Goedecke, Julia H
Abstract Objective A higher tolerance for a larger body size has been associated with obesity in black South African (SA) women. The aim of the present study was to explore perceptions regarding body size and weight loss in a sample of black women from a low-income community in Cape Town, SA. Design Qualitative pilot study including five focus groups. Data were analysed using thematic analysis. Setting Khayelitsha, Cape Town, SA. Subjects Twenty-one black SA women. Results The majority of participants had positive perceptions of overweight/obesity, which were influenced by community and cultural perceptions, but some inconsistencies were observed as overweight/obesity was also associated with ill health. Participants identified many benefits to weight loss, but due to the association with sickness, they were concerned about being stigmatised in their community. Although participants had knowledge about healthy eating, the main barrier to eating healthily included the perceived higher cost of healthier food and food insecurity. All participants saw exercise as a strategy to lose weight and improve health, and were interested in participating in a community-based exercise intervention, but negative community perceptions and conflicting views regarding who should lead the intervention were identified as barriers. Conclusions These findings highlight the complexities surrounding participants’ perceptions regarding body size, weight loss and weight-loss interventions, and emphasise low socio-economic status as a barrier to change. The study also highlights the strong influence of cultural ideals and community perceptions on personal perceptions. These findings underscore the necessity for culturally appropriate weight-loss interventions in low-income, transitioning communities.
Open Access
Prevention of diseases after menopause
(2014) Lobo, R A; Davis, S R; de Villiers, T J; Gompel, A; Henderson, V W; Hodis, H N; Lumsden, M A; Mack, W J; Shapiro, S; Baber, R J
AbstractWomen may expect to spend more than a third of their lives after menopause. Beginning in the sixth decade, many chronic diseases will begin to emerge, which will affect both the quality and quantity of a woman's life. Thus, the onset of menopause heralds an opportunity for prevention strategies to improve the quality of life and enhance longevity. Obesity, metabolic syndrome and diabetes, cardiovascular disease, osteoporosis and osteoarthritis, cognitive decline, dementia and depression, and cancer are the major diseases of concern. Prevention strategies at menopause have to begin with screening and careful assessment for risk factors, which should also include molecular and genetic diagnostics, as these become available. Identification of certain risks will then allow directed therapy. Evidence-based prevention for the diseases noted above include lifestyle management, cessation of smoking, curtailing excessive alcohol consumption, a healthy diet and moderate exercise, as well as mentally stimula...
Open Access
Proportion of children meeting recommendations for 24-hour movement guidelines and associations with adiposity in a 12-country study
(2016) Roman-Viñas, Blanca; Chaput, Jean-Philippe; Katzmarzyk, Peter T; Fogelholm, Mikael; Lambert, Estelle V; Maher, Carol; Maia, José; Olds, Timothy; Onywera, Vincent; Sarmiento, Olga L; Standage, Martyn; Tudor-Locke, Catrine; Tremblay, Mark S
Abstract Background The Canadian 24-h movement guidelines were developed with the hope of improving health and future health outcomes in children and youth. The purpose of this study was to evaluate adherence to the 3 recommendations most strongly associated with health outcomes in new 24-h movement guidelines and their relationship with adiposity (obesity and body mass index z-score) across countries participating in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE). Methods Cross-sectional results were based on 6128 children aged 9–11 years from the 12 countries of ISCOLE. Sleep duration and moderate-to-vigorous physical activity (MVPA) were assessed using accelerometry. Screen time was measured through self-report. Body weight and height were measured. Body mass index (BMI, kg · m −2 ) was calculated, and BMI z-scores were computed using age- and sex-specific reference data from the World Health Organization. Obesity was defined as a BMI z-score > +2 SD. Meeting the overall 24-h movement guidelines was defined as: 9 to 11 h/night of sleep, ≤2 h/day of screen time, and at least 60 min/day of MVPA. Age, sex, highest parental education and unhealthy diet pattern score were included as covariates in statistical models. Associations between meeting vs. not meeting each single recommendation (and combinations) with obesity were assessed with odds ratios calculated using generalized linear mixed models. A linear mixed model was used to examine the differences in BMI z-scores between children meeting vs. not meeting the different combinations of recommendations. Results The global prevalence of children meeting the overall recommendations (all three behaviors) was 7%, with children from Australia and Canada showing the highest adherence (15%). Children meeting the three recommendations had lower odds ratios for obesity compared to those meeting none of the recommendations (OR = 0.28, 95% CI 0.18–0.45). Compared to not meeting the 24-h movement recommendations either independently or combined, meeting them was significantly associated with a lower BMI z-score. Whenever the MVPA recommendation was included in the analysis the odds ratios for obesity were lower. Conclusions For ISCOLE participants meeting these 3 healthy movement recommendations the odds ratios of being obese or having high BMI z-scores were lower. However, only a small percentage of children met all recommendations. Future efforts should aim to find promising ways to increase daily physical activity, reduce screen time, and ensure an adequate night’s sleep in children. Trial registration The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) was registered at ClinicalTrials.gov (Identifier NCT01722500) (October 29, 2012).
Open Access
Pulmonary function and acid-base balance high intensity constant-load exercise
(1993) Odendal, Elsabe; Noakes, Timothy D
The possibility that an inadequate response of the pulmonary system might limit high intensity exercise in man has received increasing attention over the past few years. However, very few scientific investigations have focused systematically on pulmonary function during high intensity constant-load exercise. Furthermore, many studies have examined only one part of the pulmonary system during exercise and some have not included blood gas measurements as a measure of the adequacy of pulmonary function. The studies reported in this thesis were designed to investigate the possible failure of the gas exchanging and pump functions of the pulmonary system during high intensity constant-load exercise. In particular, the aim was to determine the extent to which the pulmonary system might be a factor causing fatigue during this form of exercise.