This thesis investigated the effect of high intensity, intermittent exercise (HIIE) on fat loss in young, sedentary women. It attempted also to identify possible mechanisms underpinning exercise-induced changes in adiposity. Study 1 investigated some of the metabolic and hormonal responses to two variations of HIIE. Sixteen female subjects were tested. The first session involved a cycle ergometer VO2peak test. The next two sessions were completed in random order. After baseline measures the women did 20 min of HIIE. There was a short bout exercise of 8 s work, followed by 12 s relative rest and a long bout exercise of 24 s work followed by 36 s relative rest. Seven subjects had excess postexercise oxygen consumption (EPOC) and resting metabolic rate determined. Both exercise modalities made significant demands on the participants??? oxygen delivery systems. RER diminished over the 20 min of exercise and plasma glycerol concentrations increased. Lactate concentrations rose. Catecholamine concentrations were elevated postexercise. There was an elevated EPOC associated with above baseline fat utilisation. Study 2, a 15-week training study, was a randomised controlled trial comparing the effects of short bout HIIE and steady state (SS) exercise on fat loss. Forty-five women were randomly assigned to one of three groups: HIIE, SS, or control. Preliminary and posttraining testing included a DEXA scan and a VO2peak test including blood collection. All participants completed 3-d diet diaries and maintained their current diet for the course of the study. Participants exercised three times a week for the next 15 weeks under supervision. The HIIE group did 20 min of HIIE (8 s work:12 s rest) at a workload determined from the VO2peak test. The SS group cycled at 60%VO2peak , building to a maximum of 40 min exercise. Both exercise groups increased VO2peak . The HIIE group had a significant loss of total body mass (TBM) and fat mass (FM) when compared to the other groups. There was no change in dietary intake. There have been a number of studies examining the acute effects of HIIE but, to our knowledge, this is the first study examining the chronic effects of this particular exercise protocol.

Osteoporosis is characterized by low bone mineral density (BMD), bone fragility, and an increased risk of osteoporotic fracture. The disease is systemic in nature but potential solutions include exercises prescriptions that target the clinically relevant sites of osteoporosis (hip and spine) to improve bone mass. The aim of this dissertation was to determine if atypical loading and load magnitude increased bone mass at the hip and spine, respectively, in young athletic women. The first study sought to determine if six months of uncustomary loading in the form of a "hip drop", increased BMD at the hip in young women (n=39, aged 20.2 �� 1.3 years). The hip drop applied a direct side impact to the right greater trochanter, the left hip was the control. The second study compared the spine BMD response after six months of rowing training in experienced (n=16, aged 21.2 �� 1.2 years) and novice rowers (n=19, aged 19.5 �� 0.8 years) with a control group (n=14, aged 19.2 �� 1.6 years). Bone mineral density at the hip and spine were measured in the first and second studies, respectively. Results from the first study showed a significant difference in BMD between hips at the femoral neck but there were no side-to-side differences at the greater trochanter or the total hip. The second study revealed that six months of rowing training increased spine BMD in the experienced rowers (2.1%) but not in the novices (-0.05%). / Graduation date: 2002

Background: Little is known about the impact cardiac rehabilitation (CR) exercise programs have on daily functional abilities. The purpose of this study was to determine the impact of CR on elderly patients ability to perform common household tasks. Methodology: Twenty-two post myocardial infarction patients (10 female, 12 male; age 75 6.3 years) were studied. Patients were tested prior to entering and again after completion of a CR program (20 combined aerobic + strength training sessions over 8 to 10 weeks; 45 min/day). Physical function was assessed using the Continuous Scale Physical Function Performance 10 test battery (PFP-10). Results: Post-CR the global PFP-10 score increased significantly (59 + 14 vs. 52 17; p = 0.003). Prior to CR 7 patients scored above the threshold for independent living, as defined by a global score 57 units. Post-CR, 12 patients scored above the threshold. Conclusions: A 20 session exercise-based CR program significantly enhanced the physical function of elderly patients. More importantly, 55% of patients scored above the threshold for independence post-CR, suggesting that CR may enhance elderly patients ability to live independently. / Rehabilitation Science

<p>The aim of the current study was to determine the relationship between low back pain and physical activity levels among nurses in Kanombe Military Hospital (KMH), as well as other confounding factors leading to low back pain. A quantitative, cross-sectional and descriptive design was used to conduct the study. The study population and sample included all clinical nurses in all the departments/wards at KMH (excluding three nurses doing administrative work only and the four who participated in the pilot study). A total of 133 nurses participated in the study and data was collected using three self administered questionnaires. The first one requested socio-demographic data, followed by the International Physical Activity Questionnaire (IPAQ) which examined the physical activity levels of nurses, and lastly the Nordic Musculoskeletal Disorder Questionnaire which examined low back pain prevalence. A response rate of 122 (92%) was obtained.</p>

Thesis (Ph. D.)--Lehigh University, 2003. / Includes vita. Includes bibliographical references (leaves 51-56).

Thesis (M.S.) -- University of Texas at Arlington, 2008.

Low back pain (LBP) is a common complaint and health problem in Hong Kong, particularly among middle-aged individuals. LBP is the main cause of chronic disability which significantly affects the daily life activities of patients. Pain might result in repeated hospital admissions and subsequently increase the burden on health care providers in Hong Kong. LBP has an enormous effect on quality of life and therefore deserves research attention. Growing evidence shows that yoga may help reduce the level of chronic LBP in adult patients. However, no systematic review has been conducted to support the translation of this theory into practice. Therefore, this thesis aims to evaluate the current evidence on the efficacy of yoga in reducing chronic LBP among adult patients to achieve the following objectives: formulate an evidence-based protocol on yoga practice, assess the implementation potential of the formulated protocol, and develop implementation strategies and evaluation plan for the use of this protocol in a local public hospital in Hong Kong. Five databases were used for the systemic review of relevant studies. These databases were those of Cochrane Library, CINAHL Plus, PudMed, British Nursing Index and Medline (Ovid). A total of eight papers (randomized controlled trials) fulfilled the inclusion criteria of this study. The Scottish Intercollegiate Guidelines Network (SIGN) was used to extract the data and evaluate the paper quality. The findings of the selected papers indicated that yoga practice has a significant effect on reducing pain among adult patients with chronic LBP. The innovation is proposed to be conducted in an adult orthopedic and traumatoloy (O&T) ward. Evidence-based yoga guideline is developed to guide nurses in the effective implementation of the protocol. The SIGN grading system is chosen to grade the recommendations in the guideline. Adult patients with persistent LBP longer than three months are the target population. All study participants practice specific yoga postures under the supervision of yoga instructors and trained nurses in the outpatient clinic. These patients continue home practice for 30 minutes daily or at least twice a week. Based on the findings of the reviewed literatures and the adaptation of these findings into the proposed innovation, the feasibility of implementing evidence-based yoga guideline in the local clinical setting in Hong Kong is demonstrated. An effective communication plan is developed to gain support from stakeholders and efficiently implement the innovation. A two-month pilot study is designed to test the feasibility of the guideline. Pain level, which is the primary outcome of the study, is measured by using Pain Numerical Pain Scale (NRS). Evaluation will be completed after the pilot test and at the end of the whole programme and refinement of the protocol will be accomplished according if necessary. Protocol effectiveness will be determined by a decrease in back pain level after practicing yoga. Other outcomes include the knowledge and satisfactory level of the staff with regards to the protocol, as well as and the costs and benefits of program implementation. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Physical inactivity has been widely regarded as a leading cause of non-communicable chronic diseases such as type 2 diabetes mellitus (T2DM) and hypertension. Physical activity (PA) has been shown to be the most effective self-care behaviour in alleviating T2DM, an incurable chronic disease. Previous behavioural modification programs intended to encourage and maintain PA behaviour among middle-aged and older patients with T2DM have had inconsistent results. PA has remained as a recommended diabetes self-care behaviour with the lowest compliance rate in many regions of the world. This thesis proposes a program focusing on health literacy (HL) as a means to nurture T2DM patients’ ability to navigate, read, understand, process, comprehend and act on health information, and thereby modify PA behaviour. This approach is proposed for three reasons: (1) the flood of available health information of varying quality affects patients’ decision making with regard to self-care behaviour; (2) the high prevalence of low HL in the US, Europe, and Asia affects the comprehension of self-care behaviour programs; (3) because 50% of older T2DM patients are impaired cognitively due to the impact of aging and hence have difficulty in carrying out suitable self-care behaviour without proper guidance. All of these factors can influence the effectiveness of PA behavioural modification programs designed to help middle-aged and older T2DM patients make self-care decisions based on sound health information according to their level of HL. This thesis reviews existing HL-oriented programs and models and validates the instrument used to examine the effects of a culture-, language-, disease- and age-specific, theory-based, HL-oriented program on PA behaviour among middle-aged and older patients with T2DM. In the study, 324 middle-aged and older Chinese T2DM patients recruited from two hospital diabetes centres in Hong Kong were divided randomly into intervention and control groups. The intervention group participated in an HL-oriented program on PA behaviour. The program significantly improved the mean of PA behaviour of patients in the intervention group from a sedentary level (under 1,000 average Metabolic Equivalents/minutes/week; 4463 mean number of steps per week) to an internationally acceptable standard (over 2,000 average METs-minutes/week; 7459 mean number of steps per week), and this improvement was maintained at three- and six-month follow-ups. The PA behaviour of the control group actually subsided. This study showed that a program addressing and nurturing patients’ ability to explore, understand and manage health information on T2DM and PA was effective in improving the PA behaviour of middle-aged and older adults with T2DM. This thesis is the first study to use objective measurements to evaluate the effect of a culture-, language-, disease- and age-specific, theory-based, HL-oriented program on PA behaviour. It extends the generalizability of culture and language-sensitive HL oriented programming from the United States (where previous HL studies were conducted) to China. The study can serve as a model for future investigations of self-care behaviour among patients with different chronic illnesses in various regions of China. / published_or_final_version / Nursing Studies / Doctoral / Doctor of Philosophy

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