Thesis (M.S.)--University of British Columbia, 2004. / Includes bibliographical references (leaves 52-57). Also available online (PDF file) by a subscription to the set or by purchasing the individual file.

Thesis (M.S.)--University of British Columbia, 2004. / Includes bibliographical references (leaves 52-57).

Thesis (M.S.)--University of Florida, 2004. / Typescript. Title from title page of source document. Document formatted into pages; contains 41 pages. Includes Vita. Includes bibliographical references.

Insulin resistance is a precursor to type II diabetes mellitus and in conjunction with dyslipidaemia, hypertension, and obesity, these abnormalities constitute the metabolic syndrome. Insulin resistance usually develops before these other diseases and therefore identifying and successfully treating insulin resistant patients may have potentially great preventive value. Insulin resistance, obesity, and subsequently type II diabetes mellitus have increased dramatically and have reached epidemic proportions. The incidence of diabetes, and in particular type II diabetes mellitus, is increasing in developing countries and throughout the world and this is mainly as a result of increasingly sedentary lifestyle and obesity in an aging population. The specific aim of this study was to explore and describe the effect of a 14-week strength-based resistance training programme on insulin resistance amongst individuals aged 25 to 68 years, who are pre-diabetic, have T2DM, and/or are overweight. The research approach used in this investigation was explorative, experimental, and quantitative in nature. The quasi-experimental design consisted of a pre-test and post-test for an experimental and comparison group who were chosen through convenience and snowball sampling. A total of 30 participants were involved in this study, 15 participants in each group. The following dependent variables were selected, namely: body weight; BMI; body composition; waist-to-hip ratio; total cholesterol levels; triglyceride levels; HOMA-IR; and muscle strength for upper and lower body. Pre-and post-test analysis was performed at the Biokinetics and Sport Science Unit, located at the Nelson Mandela Metropolitan University (NMMU). Blood samples of the participants were drawn by nurses at the Health Clinic at the Nelson Mandela Metropolitan University and these blood plasma samples were stored at the Department of Microbiology and Biochemistry at NMMU for later analysis of glucose and insulin. The experimental group trained three times per week for a period of fourteen weeks, performing strength training exercises with progressive increments in the intensity of the exercise. The control group remained sedentary throughout the intervention period. Analysis of the data was conducted utilizing descriptive and inferential statistics. Analysis of variance (ANOVA) was used as a hypothesis-testing procedure to evaluate the mean differences. The following dependent variables showed a decrease in mean values: body weight, body mass index, body fat percentage, waist minimum, cholesterol and insulin. However these differences in results were not practically and statistically significant. The following dependent variables showed an increase in mean values: hip maximum, arm relaxed, arm flexed, thigh circumference, glucose and HOMA-IR. However these results were not practically and statistically significant. The mean differences in the plasma insulin level, pre- to post-test, between both groups indicated that a significant difference (t = -1.77, p = 0.044) existed between them. Cohen‟s d revealed a value of 0.64, which indicates moderate practical significance. The only dependent variable which showed both statistical and practical significance was sum of skinfolds. The findings for sum of skinfolds revealed that the mean differences, from pre- to post-test, between both groups indicated that a significant difference (t = -2.30, p = 0.015) existed between them. Cohen‟s d revealed a value of 0.84, which indicated a large practical significance. Although the sample size was too small to indicate generalisations to the diabetic population as a whole, strength training should be furthermore explored as an alternative and successful modality in the existing range of options available to the health and exercise professional to address the needs of the person with T2DM. The researcher proposed that a bigger sample size be used for the experimental and control group, the intervention period increased as well as various differences related to frequency, intensity and duration of strength training could possibly result in significant changes.

The purpose of this study was to evaluate the changes in work capacity, personality and body fat in obese women undergoing training. Twenty-six subjects from the Vancouver Y.W.C.A. "180-Plus Club" voluntarily participated in the study. The subjects were tested before and after a nine month program. The pretraining and posttraining test environments and test procedures were standardized for all subjects. The experimental group met once per week, until halfway through the program, and then met twice a week. The program consisted of a gymnasium and pool exercise session. A control group of eleven subjects was used to help establish the reliability of the Astrand test of physical work capacity. The following variables were measured as follows: (a) physical work capacity -- Astrand submaximal test, (b) personality -- Cattell's Sixteen Personality Factor Questionnaire, Forms A and B, and (c) body fat -- determination of body density by underwater weighing and the use of Brozek and Keys formula, as well as subcutaneous fat measurements taken at six sites. Three groups were formed on the basis of attendance. The results of the study show that there was a slight improvement associated with a higher frequency of attendance, however, even the group with the highest frequency of attendance failed to show any physiologically important change in work capacity or 'percent body fat’. The combined group results showed a departure from the general female adult population for intelligence, which was higher than the population mean, and for ego strength, which was lower at pretest. The poorest attenders, Group I, showed evidence of departures from the population in factors which described them as being happy-go-lucky, absent-minded, casual and undependable. It is, therefore, not unexpected that persons with these characteristics would drop out of the program. Groups II and III, with respective higher frequencies of attendance, showed significant changes from pretest to posttest in factors which indicated that they became more emotionally mature (Group II) and more sensitive and composed (Group III). These would appear to be desirable changes in view of the Y.W.C.A.'s objectives for psychological as well as physical changes. On the basis of the findings of this study, it does not appear that the time, money and effort required to run the "180-Plus Club" program can be justified. / Education, Faculty of / Curriculum and Pedagogy (EDCP), Department of / Graduate

Chronic nonadherence is the complete lack of adherence on the part of a patient to at least one aspect of their therapeutic regime for extended periods of time. Chronic nonadherence is similar to other forms of nonadherence in that it is a phenomena which is dangerous for patients, frustrating for practitioners, and costly to the health care system. However, unlike other forms of nonadherence, very little is known about this subject. In order to determine factors related to chronic nonadherence to a home exercise program, 15 male arthritis patients of varying ages underwent an in-depth structured interview. Eight of these patients were identified by the Arthritis Society as being chronic, treatment nonadherents. The other seven patients were randomly chosen from among the population of male arthritis patients in order to provide a comparison to the chronic nonadherent population. Ten variables were examined in this study in the hopes of determining factors related to chronic nonadherence. These variables were as follows: demographics, The Health Beliefs Model, patient's explanatory model, nature of the illness, satisfaction with practitioner attributes, shared responsibility, overall satisfaction, attitudes of significant others, use of unorthodox treatments, and problems with the home exercise program. Data analysis failed to produce any statistically significant findings, however the study did point to some interesting associations. One finding from this study is that nonadherence seems to be related to patient's Health Beliefs Models. Based on this finding the study then goes on to recommend an appropriate intervention which can be used by practitioners to enhance patient adherence. A second finding from this study is that a small number of the chronic nonadherent group were actually adherent to their home exercise programs. Several explanations have been provided as to how these patients might have been falsely labelled as chronic nonadherents. / Arts, Faculty of / Social Work, School of / Graduate

No description available.

No description available.

Submitted in partial fulfillment of the requirements for the degree of Masters in Technology: Clinical Technology, Durban University of Technology, 2009. / Exercise assessment, counseling and training are not widely offered to patients with chronic kidney disease. Haemodialysis patient’s participation in exercise and an adequate assessment of exercise effects on haemodialysis outcome are needed so that more interventions can be developed to improve the well being of those patients with chronic kidney disease. Exercise is not routinely advocated in patients with end-stage renal disease receiving maintenance haemodialysis. Lack of widespread awareness of exercise in haemodialysis literature may be contributing to these shortcomings in clinical practice. Purpose of the study This study was aimed to establish the effect of exercise during haemodialysis on pedal oedema and solute removal. This is the first time that such a study was undertaken in dialysis units in South Africa. Methodolgy In a quasi-experimental design, thirty-four end-stage renal failure patients on three times weekly haemodialysis program from Bloemfontein and Newcastle MediClinic Renal Units participation in the study. Ethical approval for the study was obtained from Durban University of Technology Ethics Committee. Seventeen patients were in the intervention group (aged between 25 and 60) and seventeen in the control group (aged between 18 and 60). The intervention group did not exercise for the first three months of the study in order to establish a baseline period. Thereafter, exercising took place from the fourth to the ninth month. Patients pedaled on an exercise cushion for fifteen minutes every hour to achieve a total of sixty minutes of exercise over a four-hour dialysis session. Patients in the control group did not pedal on the exercise cushion during the nine-month study period. Pre and post haemodialysis measurements of creatinine, urea and potassium using the Alkaline Picrate, Urease and Ion Selective Electrode methods respectively were done for each patient monthly over the nine month period. Oedema of the lower limb was evaluated by measuring the right and left ankle circumference, in centimeters before and after dialysis. Urea Kt/V was also measured before and after haemodialysis for each patient over the study period. Results Statistical analysis of results showed a significant 30% reduction in urea levels and a 46% reduction in creatinine levels in the intervention group at the end of the nine month period, a 12% reduction in the potassium levels in the intervention group which was 4% more than the control group. The urea Kt/V in the intervention group showed a 9% greater reduction than the control group. There was a significant improvement in oedema of 45% of the right ankle for the first three months of exercise and thereafter there was a an increase in ankle size in the last three months which was a 13% reduction in oedema compared to baseline. There was a significant improvement in oedema of 60% of the left ankle for the first five months of exercise and thereafter there was an increase in ankle size in the last month which showed a 25% reduction compared to baseline. The reason for the increase in ankle size in both ankles in the last three months in inconclusive and future investigation is recommended. Conclusion The results of this study demonstrated benefits of exercise during haemodialysis on solute removal and oedema perhaps due to the acute increases in blood flow and therefore increasing perfusion of skeletal muscles.

A dissertation presented in partial compliance with the requirements for the Master's Degree technology: Chiropractic, Durban Institute of Technology, 2002. / Low back pain is estimated to effect 60-90% of the world's population sometime during their lives while 20-30% of people suffer from low back pain at any given time (Cassidy and Burton, 1992:3). Locally, epidemiological studies into low back pain have revealed incidence rates of 57.6% amongst black South Africans (Van der Meulen, 1997) and between 70 and 80% amongst Indians and Coloureds (Docrat, 1999). The use of spinal manipulation with the emphasis on restoring joint mobility, has been proven to be one of the most effective and cost effective approaches in the management low back pain of a mechanical origin (Di Fabio, 1992). McMorland (2000), showed in a study of 199 patients, that spinal manipulation resulted in an average of 52.5% and 52.9% reduction in low back pain and disability respectively. Panjabi (1992:1) has postulated a theory of a 'neutral zone' around which the passive lumbar spine operates. He describes the neutral zone as a region of intervertebral motion around the neutral posture where little resistance is offered by the passive spinal column. It is, according to Panjabi (1992:1), possible for this neutral zone to increase with injury to the spinal column or with weakness of stabilising muscles, which could result in low back pain. The trunk muscles therefore have to be able to co-contract isometrically to control the neutral zone and protect the spinal tissue from excessive motion (Richardson et aI.1990). The transversus abdominis muscle and multifidus muscle have been identified as playing an important role in the complex synergistic interaction of the trunk (Norris, 1995). The above concept involving muscles attempting to maintain a neutral zone is commonly referred to as 'core stabilisation' (Norris, 1995). / M