Thesis (M.S.)--Purdue University, 2005. / Includes bibliographical references (leaves 52-58).

Thesis (M.S.)--West Virginia University, 2007. / Title from document title page. Document formatted into pages; contains x, 185 p. : col. ill. Includes abstract. Includes bibliographical references.

Thesis (M.S.)--West Virginia University, 2007. / Title from document title page. Document formatted into pages; contains vi, 98 p. : ill. (some col.). Includes abstract. Includes bibliographical references.

Thesis (M.A.)--Western Kentucky University, 2008. / Includes bibliographical references (leaves 45-50).

The overarching aim of this thesis was to examine factors that affect post-exercise glycaemia and contribute to minimising the risk of hypoglycaemia after exercise. An inability to regulate circulating insulin concentrations is considered the primary gluco-regulatory defect within T1DM. Therefore, the aim of chapter 3 was to examine the effects of pre-exercise rapid-acting insulin reductions on blood glucose responses before and after running in T1DM individuals, to test the hypothesis that reducing pre-exercise insulin dose may help preserve post-exercise glycaemia. The results demonstrate that a 75% reduction to pre-exercise rapidacing insulin dose best preserved blood glucose before and after exercise, without increasing the risk of ketoacidosis, and reduced the risk of hypoglycaemia in free living conditions for 24 hours following running. An important factor determining blood glucose concentrations and subsequent patterns of fuel oxidation is the rate of appearance of carbohydrate into the circulation. Potentially, low GI carbohydrates may raise blood glucose less and increase the percentage contribution of lipids as a fuel because of a slower digestion. Therefore, the aim of chapter 4 was to examine the metabolic and blood glucose responses to ingestion of a high or low GI carbohydrate, combined with a 75% reduced insulin dose, before, during and for 24 hours after running. The results demonstrate that compared to a high GI carbohydrate, the low GI carbohydrate increased blood glucose concentrations less before exercise and maintained blood glucose better for 24 hours after running, via lower carbohydrate and higher lipid oxidation rates during the latter stages of running. After manipulating both the insulin dose and the pre-exercise carbohydrate GI, to improve post-exercise blood glucose concentrations, the timing of the ingestion of carbohydrate (alongside a reduced insulin dose) before exercise is an important factor which may further refine these strategies. Therefore, chapter 5 examined the metabolic and blood glucose responses to alterations in the timing of carbohydrate feeding and insulin administration prior to running. Our results demonstrated that administration of both a reduced rapid-acting insulin dose and low GI carbohydrate 30 minutes before exercise improved glycaemia for 24 hours after running, by reductions in carbohydrate oxidation, leading to increased carbohydrate availability post-exercise.

The impact of acute resistance exercise (RE) on glycaemia in type 1 diabetes (T1DM) individuals is poorly understood. Yet, such knowledge would have great use in improving our understanding of blood glucose control during and after the performance of RE. Increasing research in this area might help minimise complications associated with blood glucose vulnerability and potentially maximise health benefits related to RE which are known to be obtained by people without diabetes. The overarching aim of this thesis was to examine the impact of acute RE on glycaemia in T1DM individuals, and promote confidence in people with T1DM to partake in this form of exercise and lead a more physically active lifestyle. Exercise volume, or the total weight lifted during a RE session, is a primary component in the design of a RE session. Therefore, Chapter 3 examined the acute impact of manipulating RE session volume in T1DM individuals. The results demonstrate that exercise volume is an important factor in determining the blood glucose responses to RE; specifically, blood glucose concentrations rose above rest for one hour after one and two sets of similar intensity RE, but this exercise-induced hyperglycaemia was attenuated by increasing the volume of exercise by addition of a similar intensity third set of RE. Additionally, performing morning RE after an overnight fast and in the absence of rapid-acting insulin, did not induce acute hypoglycaemia, ketoacidosis or raise a marker of muscle damage, but caused metabolic acidosis in a dose-dependent fashion. Exercise intensity is a characteristic that is integral to the design of a RE session, and this characteristic might play a role in explaining the exercise-induced hyperglycaemia caused by the thirty minute (two-set) RE sessions in Chapter 3. The aim of Chapter 4 was to examine the impact of manipulating exercise intensity in T1DM individuals. The findings from this study demonstrate that performing a low intensity RE session evoked a similar magnitude of post-exercise hyperglycaemia and metabolic acidosis than a higher intensity RE session, when sessions were matched for total weight lifted. In an attempt to alleviate the consistent exercise-induced hyperglycaemia presented by the two-set RE session, the aim of Chapter 5 was to implement a modified algorithm that delivers an individualized dose of rapid-acting insulin after morning RE, to counter acute post-exercise hyperglycaemia in T1DM individuals. The results demonstrate that post-exercise rapid-acting insulin injection delivered by means of an algorithm resulted in reductions to post-RE hyperglycaemia without the occurrence of hypoglycaemia during two hours after exercise. However, during the subsequent twenty hours of freely living conditions, T1DM individuals remained unprotected from post-exercise hypoglycaemia as per a control condition. Overall, the findings of this thesis underpin some important factors that determine the glycaemic and metabolic responses to acute performance of RE, which may facilitate the better management of blood glucose around this form of exercise, in T1DM individuals.

M.Tech. (Chiropractic) / Aim: The aim of this study was to determine the effectiveness of chiropractic spinal manipulative therapy to the thoracic spine or stretch and strengthening exercises (stretching the pectoralis major muscle and strengthening the rhomboid, middle and inferior trapezius muscles), versus the combined treatment of chiropractic spinal manipulative therapy to the thoracic spine in conjunction with the stretch and strengthening exercises. This would then establish which treatment approach was the most effective in improving postural kyphosis with regards to a change in thoracic curvature over time. Method: A total of thirty female participants volunteered to take part in this study. All the participants were between the ages of twenty and thirty nine. The participants were randomly placed into one of three groups, each group consisted of ten participants. Group 1 received chiropractic spinal manipulative therapy to the thoracic spine. Group 2 received chiropractic spinal manipulative therapy to the thoracic spine as well as stretch and strengthening exercises i.e. stretching the pectoralis major muscles and strengthening the rhomboid, middle and inferior trapezius muscles. Group 3 received stretch and strengthening exercises. The stretch and strengthening exercises were performed in the consultation rooms to ensure that the participants were complying with the treatment and doing the exercises properly. Procedure: In this study group 1 participants received treatment once a week for 6 weeks. Groups 2 and 3 participants received 3 treatments a week for 6 weeks. Postural advice was given to all 3 groups. One final follow-up visit was done in the 7th week where no treatment was administered but only data collection was done. Objective data was recorded at the beginning of the first, fourth and seventh consultations for Group 1 and the first, tenth and nineteenth consultations for groups 2 and 3. Objective data included the Flexicurve® Ruler measurements for the angle of kyphosis. Visual analysis was done by taking lateral (sagittal) view photographs at the beginning of the initial and final consultations. Results: Statistical analysis performed included the non-parametric tests to determine if significant results were found over time. The Friedman and Wilcoxon Signed Rank tests were performed for the intragroup analysis and the Kruskall-Wallis test for the intergroup analysis. Statistical analysis revealed significant statistical changes for the intragroup results for all 3 groups. No significant statistical difference was found between the groups for the intergroup analysis. Conclusion: The study showed that all three treatment protocols for groups 1, 2, and 3 were effective. However, group 1 had not shown a great improvement in their postural kyphosis. Group 3 had shown a VII relatively good improvement in their posture. Group 2 had shown the best results with regards to improvement of the participants’ posture. Therefore in conclusion group 2 and 3 treatment protocols can be used effectively to treat postural kyphosis but group 2’s treatment protocol consisting of chiropractic spinal manipulative therapy to the thoracic spine in combination with stretch and strengthening exercises will yield the best results.

M.Tech. / This study compared the effectiveness of two different Chiropractic treatment protocols in the treatment of patellofemoral pain syndrome. This was done in order to establish whether or not core stabilisation exercises play a role in the treatment of patellofemoral pain syndrome. Thirty participants were used for this study. They were randomly placed into two groups namely; group 1 and group 2. Group 1 received strengthening exercises of the quadriceps muscle group and stretching exercises of the hamstring muscles. Group 2 received strengthening of the quadriceps muscle group, stretching of the hamstring muscles and core stabilisation exercises. Six treatments were administered over a period of three weeks with each participant receiving two treatments per week. Prior to the commencement of treatments one, three and six; each participant was objectively measured for quadriceps strength using the isometric dynamometer. The subjective measurements used in this study were the Numerical Pain Rating Scale and the Patellofemoral Joint Evaluation Scale, these were also completed prior to the first, third and sixth treatments. All the collected data was statistically analysed using the one-way Anova test, the Independent-t test and the Paired-t test. The statistical analysis revealed statistical differences on intra-group analysis for both groups involved especially between treatment 3 and treatment 6 for both the objective and subjective measurements. On Inter-group analysis group 2’s subjective and objective measurements improved by a larger amount than group 1’s. It was thus concluded that a combined treatment of quadriceps strengthening, hamstring stretching and core stabilisation exercises was the most effective treatment protocol in individuals suffering from patellofemoral pain syndrome.

Magister Scientiae (Physiotherapy) - MSc(Physio) / 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. / South Africa

Rheumatoid Arthritis (RA) is the most common type of chronic inflammatory arthritis (Thompson, 1998). When appropriately prescribed, therapeutic exercise is useful in the care of patients with RA (Semble et aI., 1990). A pre-test - post-test randomized groups design was adopted for the study to compare the effects of a land- and water-based exercise programme in RA patients. A total of ten subjects, diagnosed with RA functional class I or II according to Steinbrocker, were assigned to either a group performing water-based exercises (W, n=4), a group performing land-based exercises (L, n=4), or a control group, who were requested to continue with their present sedentary lifestyle (C, n=2). For inclusion in the study, subjects were required to be on stable medication. Categories of dependent variables measured, were disease activity, haematology, functional and psychological status as well as physical status. There was a reduction in total swollen and tender joint counts in both experimental groups, but not the control group. The reduction was greater in group W than group L. Total tender joint count (DC) decreased by 53% (p<0.1O) and the total swollen joint count (SJC) decreased by 31% (p>0.05) in group W. In group L, the total TIC decreased by 4,7% (p>0.05) and the total SIC decreased by 8,5% (p>0.05). The haematological values remained globally unchanged in all three groups concerning the hemolglobin (Hb) values. There were changes in the erythrocyte sedimentation rate (ESR) in the groups, however changes were not significant (p>0.05). The ESR decreased by 29% in group Wand by 33% in group C. There was a slight increase in group L's ESR (11,9%) but values remained within the normal range. There was an improvement in the patients self-assessed disability and psychological status in the experimental groups while there was a deterioration in the control group's. Health Assessment Questionnaire (HAQ) scores improved by 15% in group W (p>0.05), 18% in group L (p>0.05) and deteriorated by 13% in group C (p>0.05). There was no change in the total Profile of Mood States (POMS) score of the control group, however, significant (p<0.05) improvements were observed in the experimental groups. There was a 163% improvement in group L's and a 990/0 improvement in group W's affective states. As far as physical condition is concerned, in genera~ there was an improvement in group Wand group L's physical condition, while there was no improvements noted in group C. Group W showed the following changes in physical condition: Body mass decreased by 9,2% (p>0.05). Mean blood pressure values remained unchanged. 50-ft walk time improved by 18% (p<0.05). Right and left grip strength increased by 18% and 35% respectively, (p<0.05). Absolute VO2max increased by 28% and relative VO2max increased by 30% (p<0.05). Right knee flexor strength increased by 43% (p<0.05) and left knee flexor strength by 24% (p>0.05). Increases in right and left knee extensor strength were 32% (p>0.05) and 34% (p>0.05) respectively. Improvement in joint mobility was also noted. There was a significant (p<0.05) improvement in both right and left wrist extension range of motion(ROM). Right wrist extension ROM improved by 49% and left wrist extension ROM improved by 31%. Improvements were also noted in wrist flexion ROM however changes were not significant (p>0.05). There was an 12% and 19% increase in right and left wrist flexion ROM respectively. In addition, there was a 12% (p<0.05) increase in right knee flexion ROM and a 14% increase in left knee flexion ROM (p<0.05). Mean body mass and blood pressure remained unchanged. 50-ft walk test time improved by 15% (p<0.05). Right and left grip strength increased by 4,8% and 16.1% respectively (p>0.05). Relative VO2max increased by 16.6% and absolute VO2max by 31% (p<0.05). Right knee flexor strength increased by 22.1% and left knee flexor strength by 23.8% (p>O.05). Increase in right and left knee extensor strength was 9% and 2,4% respectively (p>O.05). Right wrist extension ROM increased by 20.7% and left wrist extension ROM increased by 15,7% (p>0.05). There was a significant (p<0.05) increase in left wrist flexion (7,6%), but right wrist flexion ROM decreased by 2.6% (p>0.05). Improvements in right and left knee flexion ROM were also significant (p<0.05), 9,2% and 7,4%, respectively. Group C showed the following changes in physical condition: Mean body mass increased by 2% (p>O.05), while blood pressure and 50-ft walk time remained globally unchanged. Left grip strength decreased by 16% (p>O.05) and right grip strength remained the same. Although not significant (p>O.05), there was a 11% decrease in relative VO2max and a 6,7% decrease in absolute VO2max. Muscle strength also showed deterioration in group C. Right and left knee flexor strength decreased by 1,8% and 12%, respectively (p>0.05). Left knee extensor strength remained unchanged while right knee extensor strength decreased by 9,7% (p>0.05). Right wrist extension ROM decreased by 4.7% and left wrist extension ROM increased by 6.7%, although the increase was not significant (p>O.05). While right wrist flexion ROM decreased by 1,3% and left wrist flexion ROM decreased by 21% (p>0.05). There were no significant (p>O.05) changes in group C's right and left knee flexion ROM. Right knee flexion ROM decreased by 1,2% and left knee flexion ROM increased by 1,2%. Based on the above results of the study, both exercise interventions are beneficial in the treatment of RA. Appropriate land-based exercises do not appear to enhance disease activity, however, the water-based exercise programme was superior in controlling the disease activity. Further research is required, using larger samples and evaluating the long-term effects of various exercise interventions. / Dissertation (MA (Human Movement Sciences))--University of Pretoria, 2006. / Biokinetics, Sport and Leisure Sciences / unrestricted