Previous studies of the effect of exercise therapy on scoliosis have demonstrated progression of spinal curves despite vigorous exercise regimens. This study presents evidence to the contrary. Ten children with functional scoliosis and attendant upper thoracic asymmetries were analyzed both before and after a specific exercise therapy programme, in order to determine the effect of the therapy on spinal functionality and the scoliotic curve. The effect of this intensive treatment, in which the subjects underwent a five-month exercise training programme with a total of 60 one-hour sessions, was investigated in a controlled clinical trial. A subjective and objective appraisal of posterior trunk asymmetry in schoolchildren aged 7-18 is reported. Selected functional and anthropometric measurements were made before and after the treatment, and antero-posterior x-rays were used to indicate changes in the scoliotic curve. New methods are described for quantifying the scoliotic curves in each child. Post-treatment tests showed a significant (p<0.05) decrease in Cobb's angles as well as a significant reduction in all the spinal and thoracic functional asymmetries observed in the study. The findings suggest that selective exercise programmes can contribute to improvement in cases of functional scoliosis. The study sheds new light on problems related to scoliosis and the benefits of exercise rehabilitation. Data on the incidence of scoliosis amongst 1052 black children are also presented and discussed.

The specialist responsible for providing prescribed exercise as a form of medicine to the South African population is the biokineticist. Biokinetics is a relatively new profession developed in response to empirical research supporting exercise as medicine. Although the role of the biokineticist is clearly defined by the Health Professions Council of South Africa (HPCSA), there is still confusion concerning this profession and its services. At present, the dominant medicalscientific and capitalist-economic discourses offer a narrowly mechanistic and instrumental understanding of the human body and its treatment, which contributes to this confusion. This dissertation proposes a new point of departure, enriched by historical and philosophical understandings of the human body, from which the biokineticist can begin to redefine him/herself. The study aims to shift biokinetics as a practice away from the reductionist and dehumanising influences of instrumentalist, scientific and neoliberal capitalist-economic discourses, and to restore to biokineticists, and their clients, the ability they need to interact as relatively autonomous individuals. The study draws on the ideas of Michel Foucault, specifically on his notions for ‘discipline’, ‘docility’, and ‘the care of the self’ (1991; 2005), as well as Gilles Deleuze and Felix Guattari and their ideas of ‘becoming’ and ‘rhizomatic thinking’ (1983; 1987); ultimately presenting a philosophically enriched, holistic representation of the human body. From here recommendations for best practice in contemporary biokinetics are suggested that encourage interactions and connections between the professional and his/her patients, which move beyond the mere physiological interpretations currently dominating health discourse.

A lack of fundamental movement skill (FMS) proficiency in children can contribute to decreased physical activity (PA) levels, increased adiposity and poor acquisition of specialised sport specific movement skills. To prevent the latter, the identification of FMS status in early and middle childhood years is needed for targeted and specific interventions. Against the backdrop of physical education being omitted from the South African school curriculum, the presence of a patriarchal society, gender sporting stereotyping, high levels of unemployment and low education levels; the assessment of FMS status is particularly warranted. Aim of Study: The primary aim of this study was to assess the FMS proficiency of girls aged 9-to-12 years from previously disadvantaged communities within Nelson Mandela Bay. Methodology:A descriptive-exploratory-contextual study design, employing quantitative assessment techniques, was utilized. The sample comprised of 227 girls. Convenience sampling was employed. Testing consisted of FMS proficiency tests in the 20m and 40m sprint, standing long jump, throwing for distance, catching, static balance and throwing for accuracy. FMS process scores were assessed with the body component (BC) and Test of Gross Motor Development II (TGMD II) approaches. Anthropometric measurements of the standing and seated height, mass, arm span and leg length were additionally measured. Microsoft Excel® and Statistica® were used for descriptive and inferential statistical analysis. In the case of significant ANOVA results, the Scheffe post hoc test was used for pairwise comparisons. Statistical significance was set at p<.05 and practical significance (Cohen’s d) was set at d>.2. Pearson Correlation Coefficient identified statistical and practical correlations between two variables and chi square was applied to indicate differences in frequency distribution tables. Cramer’s V values were applied to determine practical significance in the case where statistical significant differences were identified between sets of frequency distributions.

Thesis (PhD)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Research objective To test a novel concept that exposing patients with fibromyalgia syndrome (FMS) to visuals of exercise activities elicits neurophysiological changes in functional brain areas associated with pain catastrophization; thereby providing preliminary support for the further development/testing of a virtual reality exposure therapy (VRET) exercise program aimed at reducing pain catastrophization toward exercise therapy in patients with FMS. Methods The main study of this research consisted of a three-phase exploratory fMRI study. Phase 1 involved the development/validation of the fMRI visual task. Phase 2 involved the exploration of the differences in neural correlates associated with pain catastrophizing between participants with FMS and healthy controls when exposed to various visuals of exercise and passive/relaxing activities. Phase 3 involved the testing of the preliminary efficacy of a novel VRET exercise program on pain catastrophization in participants with FMS. The fMRI task consisted of two stimuli: active (exercise activity visuals)/passive (relaxing activity visuals). Structural images as well as blood-oxygenation-level-dependent (BOLD) contrasts were acquired for the conditions and compared within-subjects/groups and between-groups. The condition of interest was the active>passive condition (where brain activations for the passive condition were subtracted from the active condition). The brain volumes collected during ‗on‘ conditions were compared with the brain volumes collected during ‗off‘ conditions using Students‘ t test. Statistic images were thresholded using clusters determined by Z>2.3 and a (corrected) cluster significance threshold of p=0.05. Results The right (R) middle and inferior frontal gyrus and R posterior cerebellum were significantly activated for the participants with FMS, and not the healthy control group, during the active>passive condition (phase 2). At baseline, during the active>passive condition (phase 3), the intervention/VRET group showed significant activation (p<0.05) in the R insular cortex, R anterior and posterior cerebellum, R parahippocampal gyrus, R middle frontal gyrus, R corpus callosum, R thalamus, R supramarginal gyrus and R middle and superior temporal gyrus; the control group showed significant activation in the R anterior and posterior cerebellum, R middle and superior temporal gyrus, R middle frontal gyrus, R insular cortex, R supramarginal gyrus and R precentral gyrus. Post-intervention, during the active>passive condition, R posterior cerebellum activation was still significant (p<0.05) for the intervention group; R anterior cerebellum, left (L) middle and inferior frontal gyrus, and R superior parietal lobe activation was found to be significant (p<0.000) for the control group, although these areas were not found to be significantly activated at baseline for the control group. Conclusion We could not provide confirmatory evidence for the efficacy of a novel VRET program for pain catastrophization in patients with FMS. However, the findings of this study does suggest that pain catastrophization in patients with FMS could be confirmed with fMRI. Research is therefore warranted to further develop a proper VRET exercise program and to test the effect of this program on pain catastrophization in patients with FMS. / AFRIKAANSE OPSOMMING: Navorsing doelstelling Om 'n nuwe konsep dat die blootstelling van pasiënte met fibromialgie sindroom (FMS) aan beeldmateriaal van oefening, ontlok neurofisiologiese veranderinge in funksionele brein-areas wat verband hou met pyn katastrofering te toets; sodoende voorlopige steun vir die verdere ontwikkeling/toetsing van 'n virtuele realiteit blootstelling terapie (VRET) oefenprogram wat gemik is op die vermindering van pyn katastrofering na oefenterapie in pasiënte met die FMS te bied. Metodes Die hoofstudie van hierdie navorsing bestaan uit 'n drie-fase verkennende fMRI studie. Fase 1 het die ontwikkeling/validering van die fMRI visuele taak behels. Fase 2 het die ondersoek van die verskille in die neurale korrelate geassosieer met pyn katastrofering tussen deelnemers met FMS en gesonde kontroles wanneer hulle blootgestel word aan verskeie beeldmateriaal van oefening en passiewe/ontspannende aktiwiteite behels. Fase 3 het die toets van die voorlopige effektiwiteit van 'n nuwe VRET oefenprogram op pyn katastrofering in deelnemers met FMS behels. Die fMRI taak het bestaan uit twee stimuli: aktiewe (oefening aktiwiteit beeldmateriaal)/passiewe (ontspannende aktiwiteit beeldmateriaal). Strukturele beelde sowel as bloed-suurstof-vlak-afhanklike (BSVA) kontraste is vir die toestande verkry en vergelyk binne-deelnemers/groepe en tussen-groepe. Die toestand van belang was die aktiewe>passiewe toestand (waar brein aktivering vir die passiewe toestand afgetrek is van die aktiewe toestand). Die brein volumes wat ingesamel tydens die 'aan' toestande is vergelyk met die brein volumes wat ingesamel is gedurende die 'af' toestande met die gebruik van Studente se t-toets. Drempel statistiek beelde is gegroepeer deur Z> 2,3 en 'n (gekorrigeerde) groepeerde betekenisvolle drempel van p = 0.05. Resultate Die regter (R) middel- en inferior-frontale gyrus en R posterior serebellum is betekenisvol geaktiveer vir die deelnemers met FMS, maar nie vir die gesonde kontrole groep nie, gedurende die aktiewe>passiewe toestand (fase 2). By basislyn, tydens die aktiewe>passiewe toestand (fase 3), die intervensie / VRET groep het betekenisvolle aktivering (p <0.05) in die R insulaire korteks, R anterior en posterior serebellum, R para- hippokampus gyrus, R middel-frontale gyrus, R korpus kallosum, R talamus, R supramarginale gyrus en R middel- en superior-temporale gyrus; die kontrole groep het betekenisvolle aktivering in die R anterior en posterior serebellum, R middel- en superior-temporale gyrus, R middel-frontale gyrus, R insulaire korteks, R supramarginale gyrus en R presentrale gyrus. Post-intervensie, tydens die aktiewe>passiewe toestand, was R posterior serebellum aktivering betekenisvol (p <0.05) vir die intervensie groep; R anterior serebellum, links (L) middel- en inferior-frontale gyrus en R superior pariëtale lob aktivering was betekenisvol (p <0.000) vir die kontrole groep, alhoewel geen betekenisvolle basislyn aktivering in hierdie areas by die kontrole groep plaasgevind het nie. Gevolgtrekking Ons kan nie bewyse vir die effektiwiteit van 'n nuwe VRET program vir pyn katastrofering in pasiënte met FMS bevestig nie. Nietemin, dui die bevindinge van hierdie studie wel daarop dat pyn katastrofering in pasiënte met FMS bevestig kon word met fMRI. Verdere navorsing is dus geregverdig om 'n behoorlike VRET oefenprogram te ontwikkel en die uitwerking van hierdie program op pyn katastrofering in pasiënte met FMS te toets.

Problem Statement A lack of fundamental movement skill (FMS) proficiency in children can contribute to decreased physical activity (PA) levels, increased adiposity and poor acquisition of specialised sport specific movement skills. To prevent the latter, the identification of FMS status in early and middle childhood years is needed for targeted and specific interventions. Against the backdrop of physical education being omitted from the South African school curriculum, the presence of a patriarchal society, gender sporting stereotyping, high levels of unemployment and low education levels; the assessment of FMS status is particularly warranted. Aim of Study The primary aim of this study was to assess the FMS proficiency of girls aged 9-to-12 years from previously disadvantaged communities within Nelson Mandela Bay. Methodology A descriptive-exploratory-contextual study design, employing quantitative assessment techniques, was utilized. The sample comprised of 227 girls. Convenience sampling was employed. Testing consisted of FMS proficiency tests in the 20m and 40m sprint, standing long jump, throwing for distance, catching, static balance and throwing for accuracy. FMS process scores were assessed with the body component (BC) and Test of Gross Motor Development II (TGMD II) approaches. Anthropometric measurements of the standing and seated height, mass, arm span and leg length were additionally measured. Microsoft Excel® and Statistica® were used for descriptive and inferential statistical analysis. In the case of significant ANOVA results, the Scheffe post hoc test was used for pairwise comparisons. Statistical significance was set at p<.05 and practical significance (Cohen’s d) was set at d>.2. Pearson Correlation Coefficient identified statistical and practical correlations between two variables and chi square was applied to indicate differences in frequency distribution tables. Cramer’s V values were applied to determine practical significance in the case where statistical significant differences were identified between sets of frequency distributions The BC approach indicated that most participants could not proficiently perform the run for speed (94.71 percent), standing long jump (96.9 percent) or throw for distance (83.56 percent). Only the catch was performed proficiently (91.19 percent). TGMD II results for the present study indicated that participants’ run for speed (100 percent) and catch (96.92 percent) were performed proficiently and their standing long jump (93.78 percent) and throw for distance (83.56 percent) process scores were performed least proficiently. Only the catch composite BC scores had a statistically (df=1.31; f=3.24; p=.024) and practically significant (d=0.82) improvement in the BC scores between the age groups 9 and 12 years. Only the standing long jump, throw for distance and throw for accuracy product scores improved statically and practically significantly with aging (p<.05; d>.2). Hence the further participants jumped, the faster they ran. Standing and seated height, weight and arm span improved statistically and practically significantly with age (p<.05; d>.2). All anthropometric variables, except for leg length, had a positive medium correlation (r=.335 to r=.439) with balance errors and this was only in 12 year olds. The throw for distance product scores had a medium correlation to seated height (r=.32) and arm span (r=.33). The run for speed had a medium correlation (r=.313) with mass. According to the IOTF classifications 24.67 percent of children were overweight and 7.49 percent of children were obese. Statistically significant differences were found for the run for speed (df=224; f=27.07; p=2.9E-11) and standing long jump (df=224; f=15.68; p=4.2E-07) when comparing product scores to normal weight, overweight and obese participants. These differences were furthermore found to be of medium to large practical significance between the normal and obese participants for the run for speed (d=0.61 to d=1.77) and Standing Long Jump (d=0.40 to d=1.33). On average 50 percent and 55 percent of participants partook 60 minutes or more of PA after school on week days and on weekend’s respectively. This PA consisted mostly of running and ball games. Only 10 percent of participants had commenced with menarche Conclusion Findings have highlighted the need for specifically targeted FMS interventions at an early age in female learners from previously disadvantaged communities. Both a product and process FMS assessment is warranted as this facilitates deductions about movement proficiency levels. A FMS proficiency assessment protocol is needed for South African children which is internationally comparable. Childhood overweight and obesity impacts FMS proficiency and should be addressed in future research. Cultural norms, gender stereotypes and sport management structures at primary school level seem to be affecting FMS proficiency and should be addressed in future research