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Development of a management model for the treatment of asthmaShaw, Ina 19 April 2010 (has links)
D.Phil. / Asthma exemplifies a major medical concern and is a considerable cause of morbidity and mortality globally and in South Africa. Biokineticists have in the past primarily prescribed aerobic modes of exercise to asthmatics regardless of other modes of exercise that could be used in the management of asthma, each with their own unique benefits. The aim of this investigation was to develop a management model from a biokinetic perspective for the management of asthma in moderate, persistent asthmatics. The present study utilised a quantitative, comparative, research trial making use of a pre-test, eight-week intervention period and a post-test. Eighty-eight sedentary moderate, persistent asthmatics were matched by age and gender and randomly assigned to either a non-exercising control group (NE) (n = 22), an aerobic exercise group (AE) (n = 22), a diaphragmatic inspiratory resistive breathing group (DR) (n = 22) or an aerobic exercise combined with diaphragmatic resistive breathing group (CE) (n = 22). Dependent t-Tests and rank-ordered analyses revealed that five of the 13 pulmonary function parameters assessed were found to be significantly altered following the AE and CE training, with the CE training having a larger impact than AE training. The DR training resulted in improvements in four of the 13 pulmonary function parameters. The CE and AE training were also found to be equally effective at altering physical work capacity, while the DR training proved ineffective at altering physical work capacity. The CE training proved to be the most effective at improving the abdominal and chest wall excursion parameters. The DR training was found to be the least effective mode of exercise training to impact favourably on abdominal and chest wall excursion parameters. The DR and CE training had a similar significant and favourable change in respiratory muscle flexibility followed by the AE training only impacting on nine of the 11 respiratory muscle flexibility parameters. Regarding the respiratory muscle strength, despite AE and CE training altering 18 of the 20 parameters, CE training was found to be more effective. DR training only altered 16 of the 20 respiratory muscle strength parameters. The DR training was the only modality to alter a postural parameter, albeit unfavourably. Even though the DR and AE training significantly altered four of the six anthropometric parameters, the AE training proved to be superior, while CE training proved least effective as it altered v only three of the measured anthropometric parameters. The overall success of the CE training exemplified the fact that an optimal training regime for the management of asthma may require both an aerobic exercise and diaphragmatic inspiratory resistive breathing component. Exercise training, and specifically CE training is a cost-effective, home-based asthma management programme that may reduce the public health burden of this disease and provide the patient with alternative treatment options. CE training should form the cornerstone in the management of asthma to minimise and prevent asthma exacerbations and thus improve health-related quality of life and may even prove to be life-saving.
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Whole body vibration training effects on asthma specific pulmonary variablesMansell, Ingrid Joan January 2008 (has links)
The aim of the study was to determine and document evidence of the comparative effect of a 12- week whole body vibration training programme, exercise training programme and sedentary control group on the anthropometric profile, aerobic capacity, lung volumes and hence, the pulmonary capacity in people with asthma. The study used a descriptive, exploratory, quasi-experimental research approach employing randomised pairing to classify participants into either the whole body vibration therapy or exercise training group. Accidental and snowball sampling was used to identify and obtain a base of volunteers. A three-group pre-test/post-test design was employed to gain insight into statistical differences that might be apparent between the whole body vibration therapy group, the exercise group and the control group, and which could potentially be attributed to participation in the whole body vibration exercise programme. Randomised pairing for participant selection was selected because of the potential effects varying pulmonary variables might have had on the reliability of the study. A Physical Activity Selection Criteria Questionnaire was completed by participants to ascertain baseline physical activity readiness and as a means of determining selection criteria for their allocation to the whole body vibration training group, the experimental exercise group or the true control group. The pre-test/post-test assessment made use of a combination evaluation that incorporated an anthropometric profile assessment of height, weight, biceps, triceps, subscapular and suprailliac skinfolds, waist and hip circumference and posture, an aerobic capacity evaluation that incorporated aspects of both the YMCA and Astrand and Rhyming Physical Work Capacity (PWC) evaluation on a cycle ergometer and, lastly, a pulmonary variable assessment that made use of both the Datospir Peak-10 peak flow meter and the Spirovit SP-100AT spirometry unit integrated into the Cardiovit AT-6 model for all spirometry measurements. Participants were required to complete either the whole-body vibration or the exercise training programme a minimum of twice a week and a maximum of four times over the same period. The duration of the intervention programmes was approximately 30 minutes and consisted of three sections including a warm-up comprising flexibility exercises, whole body strength training exercises, and a cool-down which, in turn, consisted of massage exercises or replicated flexibility exercises. The main difference between the whole body vibration and exercise training group thus lay in the exclusion of the use of vibration for those participants assigned to the exercise training programme. Analysis of data was performed using descriptive and inferential statistics with the help of a qualified statistician. The identified variables were tested at a 95 percent level of probability (p<0.05) as recommended by Thomas and Nelson (1996:117). Descriptive data, in the form of a statistical mean, standard deviation, minimum, median and maximum values, obtained during this study were reported in the form of a t-score for selected anthropometric and pulmonary variables. The 12-week intervention programme, on analysis of the results, produced statistically insignificant improvements in the variables of anthropometric profile, aerobic capacity and lung volumes identified as determinants of, and factors influencing, the cardiorespiratory fitness level of participants with asthma and hence, the subsequent severity of this chronic condition. However, slight mean increases for the whole body vibration training group were evident for certain variables identified in this study. Based on the results, the inference could be made that whole body vibration therapy and exercise were both effective modes of training to improve the cardiorespiratory fitness level of people with asthma, but the results of the study did not show sufficient practical or statistical significance to verify the assumption that whole body vibration training was a method superior to conventional exercise training. Hence, the significance of whole body vibration training on the pulmonary variables of people with asthma could not be determined. The researcher recommends that future studies be undertaken to verify whether whole body vibration training incorporating larger participant groups could produce significant improvements in pulmonary variables in people with asthma.
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