O Método Pilates propicia melhora da flexibilidade, coordenação motora e força muscular, podendo refletir em ajustes posturais. Contudo, ainda não existem evidências acerca dos resultados da prática em relação à postura corporal, principalmente, devido às divergências metodológicas das pesquisas. Assim, os objetivos do presente estudo foram: verificar o efeito de 30 sessões do Método Pilates em mulheres adultas saudáveis no alinhamento postural estático, hábitos posturais, equilíbrio dinâmico e esquema corporal; além de adaptar um instrumento de avaliação do esquema corporal e testar sua repetibilidade e reprodutibilidade. A fim de verificar o estado da arte do objetivo geral da presente dissertação, foi conduzida uma revisão sistemática, em que uma busca em bases de dados foi realizada e somente os estudos que atingissem todos os critérios de elegibilidade foram incluídos. Quatro ensaios clínicos que verificaram o efeito da prática do Pilates na postura corporal estática foram incluídos. Os resultados desta revisão sugerem que a partir de 24 sessões de Pilates, praticadas duas vezes por semana, ocorrem ajustes nos alinhamentos frontal dos ombros e sagital da pelve em adultas jovens. E, após 48 sessões, soma-se a melhora no alinhamento sagital da cabeça. Entretanto, mais pesquisas são necessárias para entender os efeitos em relação à postura corporal como um todo, além de, verificar a afirmação empírica de Joseph Pilates acerca da prática “[...] em 30 sessões, você terá um novo corpo”. Para sanar essa lacuna, foi realizado um estudo de tipo quase-experimental, em que 19 mulheres adultas sedentárias saudáveis foram submetidas a 30 sessões de Mat Pilates, duas vezes por semana. Sendo avaliadas na admissão, pré e pós intervenção, quanto ao equilíbrio dinâmico (SEBT), postura corporal estática (protocolo e software DIPA) e hábitos posturais (questionário BackPEI). Houve melhora, após a intervenção, no equilíbrio dinâmico (p < 0,001) e ajustes posturais no alinhamento da coluna e sua respectiva flecha no plano frontal (p = 0,006) e no equilíbrio postural do tronco no plano sagital (p = 0,011). Porém, a participação em 30 sessões de Pilates, duas vezes por semana, parece não surtir efeito nos hábitos posturais na posição sentada (p > 0,05), melhorando apenas o modo de pegar um objeto do chão (p < 0,025). Com o intuito de avaliar o esquema corporal, foi conduzido um estudo adaptando uma metodologia já existente, além de testar sua repetibilidade e reprodutibilidade, bem como a aplicabilidade. Foram avaliadas 65 mulheres adultas saudáveis, e os resultados indicaram excelente repetibilidade, já, em relação à reprodutibilidade, essa fica restrita a área do esquema corporal e a distância entre trocânteres. A participação em trinta sessões de Pilates, duas vezes por semana, melhorou o índice de percepção do quadril (p = 0,037) porém parece não ser capaz de modificar a percepção da área do esquema corporal. / The Pilates Method provides improvements in flexibility, coordination and muscular strength resulting in postural adjustments. However, there are no evidences of practice results related to corporal posture, mostly because of the discrepancy among the methodology applied to the researches. Therefore, the objectives of this paper were: verify the influence of 30 sessions of Pilates Method in static postural alignment, postural habits, dynamical balance and body schema of healthy adult women and adapt an instrument of body schema evaluation and test its repeatability and reproducibility. In order to verify the art state of the general objective of this study, a systematic review was conducted, in which, a search on databases was executed and only the studies that completely fulfilled the eligibility criteria were selected. Four clinical trials that verified the effect of Pilates Method on static corporal posture were included. The results of this review suggest that after 24 sessions of Pilates, practiced twice a week, adjustments in the frontal alignment of shoulders and sagittal pelvis of young adult women occur. After 48 sessions, the increase of sagittal head alignment can be noticed. However, more research is needed to comprehend Pilates’ effects on corporal posture as a whole, aside from verifying the empiric affirmation of Joseph Pilates “[…] in 30 sessions, you are going to have a new body”. To remove any doubts, a quasi-experimental study was conducted, in which 19 healthy but sedentary adult women were submitted to Mat Pilates, two times a week, totalizing 30 sessions. They were evaluated at the admission, pre and post intervention about the dynamic balance (SEBT), static corporal posture (DIPA software and protocol) and postural habits (BackPEI questionnaire). After the intervention, there was improvement on the dynamic balance (p < 0,001) and trunk postural balance on the sagittal plane (p = 0,011) and postural adjustments on the spine alignment and its arrow of the frontal plane (p = 0,006). Nevertheless, practicing 30 sessions of Pilates, twice a week, did not improve the postural habits while seating (p > 0,05), increasing just the way of grabbing an object on the ground (p < 0,025). To measure the body schema, a paper was conducted by modifying one methodology that already existed and test the repeatability and reproducibility, as well as its applicability. 65 healthy adult women were evaluated and the results showed excellent repeatability albeit the reproducibility remained tied to the area of body schema and the distance between the trochanters. 30 sessions of Pilates, twice a week, upgraded the hip perception index (p = 0,037) but seemed unable to change the body schema area perception.

Made available in DSpace on 2015-04-17T15:03:05Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1297233 bytes, checksum: c36b17635b56b3051e7d14bcfe06626e (MD5) Previous issue date: 2010-03-05 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Osteoporosis is a serious public health problem, and increasingly is recognized as a disease limiting quality of life, especially for the elderly. The role of zinc in human nutrition has been extensively studied. Several hormones and zinc-dependent enzymes are involved in bone metabolism. Physical activity has been advocated as a means to increase and maintain bone mineral density (BMD). Thus, this study aims to determine the effects of zinc supplementation and/or physical training with limited impact on the aquatic environment in bone metabolism and bone mineral density (BMD) in ovariectomized rats. Sixty (60) Wistar female rats were divided into 5 groups: Sham (S), ovariectomized control (Cox), zinc (Z), physical training (PT) and zinc + physical training (ZTF). The groups Z and ZTF received daily zinc supplementation (25 mg/kg of body weight) in the form of ZnSO4.7H2O by gavage for 9 weeks. Groups TF and ZTF performed a progressive loading exercise program of jumps in water three times a week for 10 weeks. The parameters were analyzed using Student t test and one-way ANOVA with post hoc Newman-Keuls. When necessary, ANOVA one way was replaced by its equivalent non-parametric Kruskal-Walli. A significance level of 5% was adopted for all tests. Serum alkaline phosphatase was higher in Cox (p <0.01) when compared to the groups C (p <0.01) and ZTF (p <0.05). The BMD analysis showed that it was greater for TF (p <0.05) and ZTF (p <0.05) when compared to Cox and Z groups for the femoral head and femoral neck surgery. Therefore, zinc supplementation was not effective in increasing bone turnover and BMD, but the physical training protocol was able to enhance the osteogenic response in osteopenic rats in a region dependent way, and may constitute a more effective therapeutic modality for use in the treatment and prevention of bone loss. / A osteoporose é um sério problema de saúde pública, e cada vez mais, é reconhecida como enfermidade limitante da qualidade de vida, em especial para pessoas idosas. O papel do zinco na nutrição humana vem sendo bastante estudado. Vários hormônios e enzimas zinco-dependentes estão envolvidos no metabolismo ósseo. A atividade física tem sido defendida como um dos meios de promover aumento e manutenção da densidade mineral óssea (DMO). Sendo assim, esta pesquisa tem como objetivo determinar os efeitos da suplementação com zinco e/ou do treinamento físico com impacto limitado pelo meio aquático sobre o metabolismo e a densidade mineral óssea (DMO) de ratas ovariectomizadas. Desta forma, utilizou-se 60 ratas Wistar divididas em 5 grupos: Sham (S), controle ovariectomizado (Cox), zinco (Z), treinamento físico (TF) e zinco + treinamento físico (ZTF). Os grupos Z e ZTF receberam diariamente suplementação de zinco (25 mg/Kg de massa corporal) sob a forma de ZnSO4.7H2O via oral (gavagem) durante 9 semanas. Os grupos TF e ZTF realizaram um protocolo de saltos aquáticos com carga progressiva três vezes por semana durante 10 semanas. Os parâmetros foram analisados por meio do teste t student pareado e ANOVA one way com post hoc de Newman-Keuls. Quando necessário, o teste ANOVA foi substituído pelo seu equivalente não paramétrico Kruskal-Walli. Adotou-se um nível de significância de 5% para todos os testes. A concentração sérica de fosfatase alcalina foi maior no grupo Cox (p < 0,01) quando comparado aos grupos C (p < 0,01) e ZTF (p < 0,05). A análise da DMO mostrou que esta foi maior para os grupos TF (p < 0,05) e ZTF (p < 0,05) quando comparados aos grupos Cox e Z para as regiões da cabeça e colo cirúrgico femorais. Então, pode se observar que a suplementação de zinco não foi eficaz em promover aumento do metabolismo ósseo e da DMO, porém o protocolo de treinamento físico conseguiu intensificar a resposta osteogênica em ratas osteopênicas de maneira região dependente, podendo constituir uma modalidade terapêutica alternativa mais eficaz a ser utilizada no tratamento e na prevenção de perda óssea.

O Método Pilates propicia melhora da flexibilidade, coordenação motora e força muscular, podendo refletir em ajustes posturais. Contudo, ainda não existem evidências acerca dos resultados da prática em relação à postura corporal, principalmente, devido às divergências metodológicas das pesquisas. Assim, os objetivos do presente estudo foram: verificar o efeito de 30 sessões do Método Pilates em mulheres adultas saudáveis no alinhamento postural estático, hábitos posturais, equilíbrio dinâmico e esquema corporal; além de adaptar um instrumento de avaliação do esquema corporal e testar sua repetibilidade e reprodutibilidade. A fim de verificar o estado da arte do objetivo geral da presente dissertação, foi conduzida uma revisão sistemática, em que uma busca em bases de dados foi realizada e somente os estudos que atingissem todos os critérios de elegibilidade foram incluídos. Quatro ensaios clínicos que verificaram o efeito da prática do Pilates na postura corporal estática foram incluídos. Os resultados desta revisão sugerem que a partir de 24 sessões de Pilates, praticadas duas vezes por semana, ocorrem ajustes nos alinhamentos frontal dos ombros e sagital da pelve em adultas jovens. E, após 48 sessões, soma-se a melhora no alinhamento sagital da cabeça. Entretanto, mais pesquisas são necessárias para entender os efeitos em relação à postura corporal como um todo, além de, verificar a afirmação empírica de Joseph Pilates acerca da prática “[...] em 30 sessões, você terá um novo corpo”. Para sanar essa lacuna, foi realizado um estudo de tipo quase-experimental, em que 19 mulheres adultas sedentárias saudáveis foram submetidas a 30 sessões de Mat Pilates, duas vezes por semana. Sendo avaliadas na admissão, pré e pós intervenção, quanto ao equilíbrio dinâmico (SEBT), postura corporal estática (protocolo e software DIPA) e hábitos posturais (questionário BackPEI). Houve melhora, após a intervenção, no equilíbrio dinâmico (p < 0,001) e ajustes posturais no alinhamento da coluna e sua respectiva flecha no plano frontal (p = 0,006) e no equilíbrio postural do tronco no plano sagital (p = 0,011). Porém, a participação em 30 sessões de Pilates, duas vezes por semana, parece não surtir efeito nos hábitos posturais na posição sentada (p > 0,05), melhorando apenas o modo de pegar um objeto do chão (p < 0,025). Com o intuito de avaliar o esquema corporal, foi conduzido um estudo adaptando uma metodologia já existente, além de testar sua repetibilidade e reprodutibilidade, bem como a aplicabilidade. Foram avaliadas 65 mulheres adultas saudáveis, e os resultados indicaram excelente repetibilidade, já, em relação à reprodutibilidade, essa fica restrita a área do esquema corporal e a distância entre trocânteres. A participação em trinta sessões de Pilates, duas vezes por semana, melhorou o índice de percepção do quadril (p = 0,037) porém parece não ser capaz de modificar a percepção da área do esquema corporal. / The Pilates Method provides improvements in flexibility, coordination and muscular strength resulting in postural adjustments. However, there are no evidences of practice results related to corporal posture, mostly because of the discrepancy among the methodology applied to the researches. Therefore, the objectives of this paper were: verify the influence of 30 sessions of Pilates Method in static postural alignment, postural habits, dynamical balance and body schema of healthy adult women and adapt an instrument of body schema evaluation and test its repeatability and reproducibility. In order to verify the art state of the general objective of this study, a systematic review was conducted, in which, a search on databases was executed and only the studies that completely fulfilled the eligibility criteria were selected. Four clinical trials that verified the effect of Pilates Method on static corporal posture were included. The results of this review suggest that after 24 sessions of Pilates, practiced twice a week, adjustments in the frontal alignment of shoulders and sagittal pelvis of young adult women occur. After 48 sessions, the increase of sagittal head alignment can be noticed. However, more research is needed to comprehend Pilates’ effects on corporal posture as a whole, aside from verifying the empiric affirmation of Joseph Pilates “[…] in 30 sessions, you are going to have a new body”. To remove any doubts, a quasi-experimental study was conducted, in which 19 healthy but sedentary adult women were submitted to Mat Pilates, two times a week, totalizing 30 sessions. They were evaluated at the admission, pre and post intervention about the dynamic balance (SEBT), static corporal posture (DIPA software and protocol) and postural habits (BackPEI questionnaire). After the intervention, there was improvement on the dynamic balance (p < 0,001) and trunk postural balance on the sagittal plane (p = 0,011) and postural adjustments on the spine alignment and its arrow of the frontal plane (p = 0,006). Nevertheless, practicing 30 sessions of Pilates, twice a week, did not improve the postural habits while seating (p > 0,05), increasing just the way of grabbing an object on the ground (p < 0,025). To measure the body schema, a paper was conducted by modifying one methodology that already existed and test the repeatability and reproducibility, as well as its applicability. 65 healthy adult women were evaluated and the results showed excellent repeatability albeit the reproducibility remained tied to the area of body schema and the distance between the trochanters. 30 sessions of Pilates, twice a week, upgraded the hip perception index (p = 0,037) but seemed unable to change the body schema area perception.

O Método Pilates propicia melhora da flexibilidade, coordenação motora e força muscular, podendo refletir em ajustes posturais. Contudo, ainda não existem evidências acerca dos resultados da prática em relação à postura corporal, principalmente, devido às divergências metodológicas das pesquisas. Assim, os objetivos do presente estudo foram: verificar o efeito de 30 sessões do Método Pilates em mulheres adultas saudáveis no alinhamento postural estático, hábitos posturais, equilíbrio dinâmico e esquema corporal; além de adaptar um instrumento de avaliação do esquema corporal e testar sua repetibilidade e reprodutibilidade. A fim de verificar o estado da arte do objetivo geral da presente dissertação, foi conduzida uma revisão sistemática, em que uma busca em bases de dados foi realizada e somente os estudos que atingissem todos os critérios de elegibilidade foram incluídos. Quatro ensaios clínicos que verificaram o efeito da prática do Pilates na postura corporal estática foram incluídos. Os resultados desta revisão sugerem que a partir de 24 sessões de Pilates, praticadas duas vezes por semana, ocorrem ajustes nos alinhamentos frontal dos ombros e sagital da pelve em adultas jovens. E, após 48 sessões, soma-se a melhora no alinhamento sagital da cabeça. Entretanto, mais pesquisas são necessárias para entender os efeitos em relação à postura corporal como um todo, além de, verificar a afirmação empírica de Joseph Pilates acerca da prática “[...] em 30 sessões, você terá um novo corpo”. Para sanar essa lacuna, foi realizado um estudo de tipo quase-experimental, em que 19 mulheres adultas sedentárias saudáveis foram submetidas a 30 sessões de Mat Pilates, duas vezes por semana. Sendo avaliadas na admissão, pré e pós intervenção, quanto ao equilíbrio dinâmico (SEBT), postura corporal estática (protocolo e software DIPA) e hábitos posturais (questionário BackPEI). Houve melhora, após a intervenção, no equilíbrio dinâmico (p < 0,001) e ajustes posturais no alinhamento da coluna e sua respectiva flecha no plano frontal (p = 0,006) e no equilíbrio postural do tronco no plano sagital (p = 0,011). Porém, a participação em 30 sessões de Pilates, duas vezes por semana, parece não surtir efeito nos hábitos posturais na posição sentada (p > 0,05), melhorando apenas o modo de pegar um objeto do chão (p < 0,025). Com o intuito de avaliar o esquema corporal, foi conduzido um estudo adaptando uma metodologia já existente, além de testar sua repetibilidade e reprodutibilidade, bem como a aplicabilidade. Foram avaliadas 65 mulheres adultas saudáveis, e os resultados indicaram excelente repetibilidade, já, em relação à reprodutibilidade, essa fica restrita a área do esquema corporal e a distância entre trocânteres. A participação em trinta sessões de Pilates, duas vezes por semana, melhorou o índice de percepção do quadril (p = 0,037) porém parece não ser capaz de modificar a percepção da área do esquema corporal. / The Pilates Method provides improvements in flexibility, coordination and muscular strength resulting in postural adjustments. However, there are no evidences of practice results related to corporal posture, mostly because of the discrepancy among the methodology applied to the researches. Therefore, the objectives of this paper were: verify the influence of 30 sessions of Pilates Method in static postural alignment, postural habits, dynamical balance and body schema of healthy adult women and adapt an instrument of body schema evaluation and test its repeatability and reproducibility. In order to verify the art state of the general objective of this study, a systematic review was conducted, in which, a search on databases was executed and only the studies that completely fulfilled the eligibility criteria were selected. Four clinical trials that verified the effect of Pilates Method on static corporal posture were included. The results of this review suggest that after 24 sessions of Pilates, practiced twice a week, adjustments in the frontal alignment of shoulders and sagittal pelvis of young adult women occur. After 48 sessions, the increase of sagittal head alignment can be noticed. However, more research is needed to comprehend Pilates’ effects on corporal posture as a whole, aside from verifying the empiric affirmation of Joseph Pilates “[…] in 30 sessions, you are going to have a new body”. To remove any doubts, a quasi-experimental study was conducted, in which 19 healthy but sedentary adult women were submitted to Mat Pilates, two times a week, totalizing 30 sessions. They were evaluated at the admission, pre and post intervention about the dynamic balance (SEBT), static corporal posture (DIPA software and protocol) and postural habits (BackPEI questionnaire). After the intervention, there was improvement on the dynamic balance (p < 0,001) and trunk postural balance on the sagittal plane (p = 0,011) and postural adjustments on the spine alignment and its arrow of the frontal plane (p = 0,006). Nevertheless, practicing 30 sessions of Pilates, twice a week, did not improve the postural habits while seating (p > 0,05), increasing just the way of grabbing an object on the ground (p < 0,025). To measure the body schema, a paper was conducted by modifying one methodology that already existed and test the repeatability and reproducibility, as well as its applicability. 65 healthy adult women were evaluated and the results showed excellent repeatability albeit the reproducibility remained tied to the area of body schema and the distance between the trochanters. 30 sessions of Pilates, twice a week, upgraded the hip perception index (p = 0,037) but seemed unable to change the body schema area perception.

Orientador: Maria Jose D'Elboux / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Enfermagem / Made available in DSpace on 2018-08-25T01:39:10Z (GMT). No. of bitstreams: 1 Rampazo-Lacativa_MarianaKatia_D.pdf: 3832763 bytes, checksum: 74508e760d038080210f9abd42778325 (MD5) Previous issue date: 2014 / Resumo: Com a crescente população idosa, a artroplastia total de quadril (ATQ) é um tratamento cada vez mais comum para pacientes idosos com osteoartrite do quadril. Os efeitos de várias estratégias de reabilitação no pós-operatório desta cirurgia devem ser melhor compreendidos quando voltadas para pacientes idosos. O presente estudo teve como objetivo avaliar o efeito do exercício no cicloergômetro associado aos exercícios convencionais no desempenho funcional e na qualidade de vida relacionada à saúde de idosos submetidos à artroplastia total de quadril. Este estudo é classificado como um ensaio clínico aleatorizado, com grupos paralelos. Os pacientes com 60 anos ou mais submetidos à ATQ, primária e unilateral, devido à osteoartrite do quadril, foram consecutivamente, aleatorizados em dois grupos. O Grupo 1 (n = 8) realizou reabilitação por meio de exercício no cicloergômetro associado aos exercícios convencionais e o Grupo 2 (n = 7) realizou somente o programa de exercícios convencionais no pós-operatório. As sessões foram iniciadas após a segunda semana de pós-operatório, duas vezes por semana, durante 8 semanas. As medidas de desfecho primário incluiram a função do quadril avaliada pelo Harris Hip Score (HHS) e a avaliação do desempenho físico pelo Short Physical Performance Battery (SPPB), que engloba testes de equilíbrio, da velocidade da marcha e de força nos membros inferiores. A qualidade de vida relacionada à saúde foi considerada o desfecho secundário, sendo utilizado o questionário genérico: The Medical Outcomes Study 36 -Item Short-Form Health Survey (SF- 36) e o específico: Western Ontario e McMaster Universities Osteoartrite Index (WOMAC). As avaliações foram realizadas antes e após as intervenções, além do acompanhamento por seis meses após a cirurgia (24 semanas de pós-operatório). Os resultados são apresentados no formato de dois artigos. O Artigo 1 refere-se ao protocolo de estudo do ensaio aleatorizado e o Artigo 2 contempla a aplicação das intervenções propostas no protocolo. Nesse último, os resultados mostraram que os dois grupos melhoraram após as intervenções. No entanto, os idosos do Grupo 1, obtiveram significativamente melhores resultados comparados com seus pares do Grupo 2 para as medidas do HHS: função, escore total do SPPB, bem como, nos teste de equilíbrio, velocidade da marcha do mesmo, além da dimensão atividade física do WOMAC (P < 0,05). Não foram encontradas diferenças significativas entre os grupos no teste de força muscular dos membros inferiores do SPPB, nas dimensões dor e rigidez do WOMAC e nas dimensões do SF-36. Este estudo mostrou que a reabilitação por exercício no cicloergômetro associado aos exercícios convencionais pode ser uma estratégia mais eficaz para a recuperação do desempenho funcional e físico de idosos, após a artroplastia total de quadril. (Registro: NCT01622465) / Abstract: Following the growing of elderly population, the total hip arthroplasty is an increasingly common treatment for elderly patients with hip osteoarthritis. The effects of various rehabilitation strategies in the postoperative phase of this surgery should be better understood when targeting elderly patients. This study aimed to evaluating the effect of the exercise on cycle ergometer associated with conventional exercises on the functional performance and health-related quality of life in older people undergoing total hip arthroplasty. This study is classified as a randomized clinical trial with parallel groups. Patients aged 60 years or older undergoing primary unilateral THA, due to osteoarthritis of the hip, were consecutively assigned into two groups, randomically. The Group 1 (n = 8) performed exercise on cycle ergometer associated with conventional exercises and the group 2 (n = 7) performed the conventional exercises program, carried out during the postoperative phase. The reahabilitation sessions began after the second week of the postoperative phase and they were performed twice a week, for eight weeks. The primary outcome measures included hip function assessed by Harris Hip Score (HHS) and the evaluation of physical performance by the Short Physical Performance Battery (SPPB), which includes balance, gait speed and strength of the lower limbs tests. The health-related quality of life was considered a secondary outcome and it was assessed both by the generic questionnaire - Medical Outcomes Study 36 - Item Short - Form Health Survey (SF -36), and the specific one - Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). The evaluations were performed before and after rehabilitation interventions, in addition to six-month follow-up after surgery (24 weeks postoperative). The results are presented in format of two articles. Article 1 refers to the study protocol of the randomized trial, and Article 2 contemplates the implementation of the proposed interventions in the protocol. The results showed that after interventions both groups improved. However, the elderly in Group 1 presented significantly better results compared to their peers in Group 2 regarding the following variables: HHS function, total score of the SPPB and on tests of balance and speed gait, and on the WOMAC physical activity dimension (P < 0.05). No significant differences between groups were found in the lower limb muscle strength test of the SPPB, in the pain and stiffness dimensions of the WOMAC and in the SF-36. This study showed that the rehabilitation exercise on cycle ergometer associated with conventional exercises can be a more effective strategy for the recovery of functional and physical performance in elderly patients after total hip arthroplasty. (Registration: NCT01622465) / Doutorado / Enfermagem e Trabalho / Doutora em Ciências da Saúde

Ph.D. / The Acquired Immunodeficiency Syndrome (AIDS) has taken on pandemic proportions world wide, providing the health care system with the greatest challenge since its existence. At present, infection with the Human Immunodeficiency virus (HIV) is incurable, fatal and dangerously contagious influencing the health of the public as well as exerting profound effects on political, social and economic circumstances of the world. The challenge was and still is, to develop an effective treatment method for Human Immunodeficiency Virus (HIV) infection and /or Clinical AIDS. Up to the present time no effective treatment method has been found, as the retroviral agents typically only cause a temporary inhibition of the progression of the HIV and not a permanent cessation of the activity of the virus. In the absence of any pharmacological treatment, behavioral interventions and in particular biopsychosocial interventions utilizing cognitive-behavioral therapy and ergometric aerobic exercise take on particular importance as adjunctive treatment methods, especially during the asymptomatic and early symptomatic HIV, (CDC stages 2 and 3 and WR stages 2-4 A), but non-Clinical AIDS stages. Adding Electromyographic-feedback assisted relaxation training to the above therapeutic modalities increased the likelihood of addressing specific physiological variables associated with HIV-seropositivity, and served as a direct operant intervention in indirectly enhancing immune system functioning, through psychophysiological mechanisms or by means of the relaxation effect which it produces. In South-Africa the HIV\ AIDS situation is further compounded by a number of social and economic factors in a society expressing rapid political changes against a background of apartheid. Herein, issues of poverty, violence, proper medical care for HIV sufferers, especially in the rural areas where antiviral medications and other health services are not easily accessible, inadequate housing and unemployment place even greater burdens on the already under-served HIV sufferer. With the above aspects in mind and considering the seriousness of the AIDS pandemic in South-Africa as well as the absence of effective pharmacological agents in curing this disease, an 8-week combined biopsychosocial treatment intervention utilizing individualised cognitive-behavioral therapy, aerobic exercise and Electromyographic-feedback assisted relaxation training was developed. The objective of this research was to determine whether the combined biopsychosocial treatment intervention that had been developed would serve as a successful adjunctive treatment method to the present pharmacological treatments, especially during the asymptomatic and early symptomatic stages of HIV-infection where the apparent sluggishness of immunological functioning may be most amenable to interventions that enhance effector functions and communication between CD4 T-lymphocytes, CD8 T-lymphocytes, macrophages and B cells via increases in lymphokine production. The intervention further aimed to decrease depression, physiological tension and anxiety and fatigue levels, as well as increase vigor-activity levels important in the overall health status of HIV-seropositive patients. The intervention was implemented on a group of South- African asymptomatic and early symptomatic (CDC stages 2 and 3 and WR stages 2-4 A) HIV- seropositives. The results of the research revealed no statistically significant between-group differences in any of the cellular immune measurements. Clinically and statistically significant withingroup differences were however found in baseline to post-test measures of total lymphocyte counts in subjects of the experimental group. Statistically significant between-group differences were also found in the tension-anxiety, depression-dejection, fatigue-inertia and vigor-activity levels of experimental subjects as compared to control group subjects. The study further found that subjects who recorded lower depression and tension-anxiety levels at baseline and post-intervention phases had higher CD4 -T lymphocyte counts and therefore, increased resistance to HIV-related infections and diseases. The study also revealed significant within-group differences in terms of the baseline to post-test relaxation effect of the EMG-feedback assisted relaxation training, as well as clinically significant within-group increases in the CD4-T lymphocyte counts of experimental subjects who experienced this relaxation effect.

D.Litt. et Phil. / Hypertension amongst older adults is one of the highest indices of prevalence in the general population, both in the United States and in South Africa. Due to this high 'indices in South Africa, it has. a tendency to develop into malignant hypertension, resulting in high indices of morbidity and mortality. Seniors South Africans, mainly Black South Africans (more than elsewhere in the world), face severe indices of morbidity and mortality as a result of uncontrolled, untreated or poorly treated hypertension. For this reason, the HELPS Project (Hypertension, Exercise and Lifestyle Program for Seniors) at San Diego State University was replicated in the South African context to determine wbetherit would show similar differential effects. The initial findings of this study suggest that exercise and physical activity has a significant effect on blood pressure in elderly hypertensives. There was a lowering of blood pressure, as well as reduction in some of the antihypertensive medication. The results indicated that all forms of exercise tend to lower blood pressure in older hypertensives. Very little difference was noted between groups who did only stretching and calisthenics exercise, slow walking, or brisk aerobic walking. This was attributed to a so-called "threshold effect" by the projectleader Dr J. Martin. The results of this study was in keeping with the findings of the HELPS (San Diego) Project. The study proved that both aerobic and anaerobic exercise alike provide elderly people with benefits in both physiological and psychological aspects of functioning. More specifically, where drug therapy may cause health risks and negative side effects, exerciseoften leads to overall benefits and enhances quality of life in the elderly. The overall results of the study was generally upheld and in keeping with the proposed hypotheses

M.Tech. (Chiropractic) / Purpose: This study aims to determine the effect of Bruegger’s exercise on chronic low back pain in association with lower crossed syndrome and compare it to spinal manipulation alone or a combination of Bruegger’s exercise and spinal manipulation with regards to pain and disability, hip and lumbar range of motion as well as degree of lumbar lordosis. Method: Thirty participants who met the inclusion criteria were randomly allocated to one of three different groups of ten participants each. Group one was only instructed on how to perform Bruegger’s exercise. Group two only received a spinal manipulation/s over the restricted joint/s in the lumbar spine. Group three received a spinal manipulation/s over the restricted joint/s in the lumbar spine in conjunction to being instructed on how to perform Bruegger’s exercise. All participants were assessed over a four week period. All groups attended six treatment sessions over three weeks of which Bruegger’s exercise and/or spinal manipulation were performed. The participants who needed to perform Bruegger’s exercise were also advised to continue doing the exercise out of the treatment session where applicable. In the fourth week only measurements were taken and no treatment was administered. Procedure: Subjective data was collected at the first and fourth consultations prior to treatment, as well as on the seventh consultation by means of a Numerical Pain Rating Scale and Oswestry Low Back Pain Disability Questionnaire to assess pain and disability. Objective data was collected at the first and fourth consultations prior to treatment, as well as on the seventh consultation by means of a universal goniometer for assessing passive hip flexion and extension, a digital inclinometer for assessing active lumbar range of motion and a flexible ruler for measuring the degree of lumbar lordosis. Analysis of collected data was performed by a statician. Results: Clinically significant improvements in group 1, group 2 and group 3 were noted over the duration of the study with regards to pain, disability, hip and lumbar range of motion as well as degree of lumbar lordosis. Statistically significant changes were noted in group 1 and group 2 with regards to pain, disability, hip and lumbar range of motion as well as degree of lumbar lordosis, and in group 3 with regards to hip and lumbar range of motion as well as degree of lumbar lordosis. Conclusion: The results show that Bruegger’s exercise, spinal manipulation and the combination of Bruegger’s exercise and spinal manipulation are effective treatment protocols both clinically and significantly in decreasing pain and disability (not statistically for the combination of Bruegger’s exercise and spinal manipulation), increasing hip and lumbar range of motion as well as decreasing the degree of lumbar lordosis. However, there was no treatment protocol that proved to be preferential over the other. Because spinal manipulation alone showed the greatest overall clinical improvements, it may be suggested that spinal manipulation alone is the most effective in the treatment of chronic low back pain associated with lower crossed syndrome with regards to pain and disability, hip and lumbar range of motion as well as degree of lumbar lordosis. Also, the addition of Bruegger’s exercise may help in some instances to further assist in treatment once the full effects of the spinal manipulation has occurred and allowed for the muscles to be in their optimum state for exercise.

M.A. / Chronic degenerative disease is responsible for a high percentage of deaths in industrialised westernised communities. These findings are not surprising if viewed in the light that most people consider physical activity not to be a priority in their daily activities. During the last decade, it would seem that employers have realised that the health status of an employee can have a direct influence on productivity, efficiency and absenteeism in the working environment. In an attempt to lower health-related costs, reduce absenteeism and improve productivity, some employers have started implementing a variation of total wellbeing and workers’ support programmes as part of their employee assistance programmes. A pressing question is, however, how effective these wellness programmes are. In order to evaluate the effect of such a programme, the present study used a sample of 76 employees in middle- to top management at a big corporate company. During 2002, tests were performed on twelve CAD risk factors, after which an intervention programme was introduced. Twelve months later (2003), the first intermediate test was conducted, using the same protocol. The second intermediate test followed in 2004, duplicating the procedures. The post-test and data analysing were conducted four years after the first evaluations. Subjects were monitored for changes in: total cholesterol, HDL-cholesterol, LDLcholesterol, triglycerides, TC/HDL ratio, LDL/HDL ratio, fasting blood glucose, systolic blood pressure, diastolic blood pressure, body mass index, waist-to-hipratio and waist circumference. The Repeated Measures General Linear Model Test was used to determine significance (P ≤ 0.05) from pre- to post-test. A novel CAD risk score was also iv developed from peer-reviewed literature by considering each of the 12 CAD risk factors measured. The results demonstrated that the wellness programme decreased CAD risk by 26% amongst the 76 participants in this study. The TC, LDL-C, LDL/HDL-C ratio, TC/HDL-C ratio, fasting blood glucose, resting systolic blood pressure, resting diastolic blood pressure and waist-to-hip ratio improved significantly, while triglycerides showed a non-significant improvement. The three CAD risk factors that deteriorated significantly during the study period were high-density lipoprotein cholesterol, BMI and waist circumference. The major finding of this investigation thus suggests that a corporate wellness programme has long-term beneficial effects on CAD risk and that the reduction in CAD risk is mainly attributed to the beneficial effects of regular exercise.

Magister Scientiae (Physiotherapy) - MSc(Physio) / The aim of this study was to determine assessment and treatment choices of physiotherapists treating non-specific low back pain in Rwanda. The main objectives were to identify the common types of low back pain treated by physiotherapists, to determine the / South Africa