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Dissertation submitted in partial compliance with the requirements for the Masters’ Degree in Technology: Chiropractic, Durban University of Technology, 2013. / Background : Core strengthening may improve athletic ability by providing stability to the trunk, and as a result, stabilising the pelvis. The leverage from which cyclists generate power may be enhanced as a result of a stable pelvis, thereby improving the cyclist’s performance. In the popular, highly competitive sport of cycling, performance enhancement is much sought after. Despite its widespread use, research involving core strengthening in sporting situations is lacking, with studies investigating the effect of a core strengthening programme on cycling performance yet to be investigated. Objectives : To determine the participants’ cycling speed, power, cadence and completion time, and core strength in terms of objective findings, pre- and post- core strengthening intervention, in the whole sample and within the two age strata. To determine the participants’ heart rate in terms of objective findings, and the rate of perceived exertion in terms of subjective findings, pre- and post- core strengthening intervention, in the whole sample and within the two age strata. To determine the participants’ perception of change in speed, power and cadence post- intervention, in the whole sample and within the two age strata. Method : Forty-two asymptomatic cyclists performed two 1.5 km time trials, pre- and post- core strengthening intervention. Core strength assessments were performed pre- and post- intervention, using the Pressure Biofeedback Unit, and the maximum and average speed (km/hr), power (w) and cadence (rpm), and completion time (s) were recorded pre- and post- intervention, using the Computerised Electromagnetic Roller resistance Ergometer (Tacx Trainer). Heart rate and rate of perceived exertion (RPE) were recorded pre- and post- intervention, as well as the participant’s perception of change in speed, power, and cadence post- intervention. SPSS version 20 (SPSS Inc) was used to analyse the data, in the whole sample and stratified into two age strata. Results : ll cycling performance indicators, speed, power, cadence and completion time showed a significant improvement post- intervention, in the whole sample, and within the two age strata. Core strength indicators showed a significant improvement post- intervention, in the whole sample and within the two age strata. A significant decrease in rate of perceived exertion and corresponding heart rate measurements post- intervention was observed in the whole sample. Similarly, the younger age strata reflected a significant decrease in rate of perceived exertion, however heart rate measurements were not significant. In contrast, the older age strata showed significant changes in heart rate measurements, with no significance in rate of perceived exertion measurements. The majority of participants experienced an increased perception in all outcomes post- intervention. Conclusions: The results of this study found that core strengthening had a statistically significant effect (p < 0.001) on cycling performance, both in terms of objective and subjective findings. Future studies could address the effect of core strengthening in an endurance setting.

American maternal health is a concern and has even been described as a “crisis” (Gingrey, 2020). The US is an outlier in maternal health in comparison to other industrialized countries with more than a 50% increase in maternal death rates comparatively speaking (Taylor et al., 2022). A significant change in postpartum care must occur. Hope Health Today LLC, the proposed continuing education Limited Liability Company (LLC), will be the catalyst to this health care change. Hope Health Today LLC’s initial continuing education program will positively educate healthcare providers to better serve this at-risk population. Hope Health Today LLC will provide professional education for licensed occupational therapists, physical therapists, physicians, nurses, and midwives. The initial continuing education (CEU) course will be a holistic guide for Diastasis Recti Abdominis (DRA) recovery and postpartum care. The course will cover pelvic floor and deep core anatomy, a 20-week diastasis recti abdominis recovery program, postpartum body mechanics, breast feeding positions, roles and interpersonal relationships, signs of postpartum depression, and return to intimacy. HopeHealth Today LLC aims to make a positive impact for postpartum families. Making a change at the policy level through American College of Obstetrics and Gynecology (ACOG) to provide a 4-week pelvic floor therapy referral to all postpartum patients. Hope Health Today LLC will advance the profession of occupational therapy through advocating for a women’s health board certification through American Occupational Therapy Association (AOTA) and improving quality postpartum patient outcomes through providing research based continuing education for health care providers. HopeHealth TodayLLC will educate the public through social media. HopeHealth TodayLLC will advance the current state of postpartum care. The ambition of this company is to educate the public to know what to expect from their women’s health providers and what to ask for if care is not reaching appropriate standards.

Made available in DSpace on 2016-06-02T20:18:22Z (GMT). No. of bitstreams: 1 5701.pdf: 2066003 bytes, checksum: 5344bcd37b00f565ce8af8ebbe8103de (MD5) Previous issue date: 2014-01-22 / Financiadora de Estudos e Projetos / Osteoarthritis is the most common disease among the elderly ostemioarticular, being of great relevance for public health and for studies related to aging processes. In this context, the muscle strengthening becomes important as a major strategy in the rehabilitation of individuals with osteoarthritis. Much research in the area have been developed, but there are few studies that have advanced the timely investigation of the effects of exercise for muscle strengthening in key local and systemic manifestations of osteoarthritis. Therefore, the aim of this thesis was to investigate the possible effects of a protocol for muscle strengthening in the main manifestations of knee osteoarthritis in rats. To achieve this goal, 3 studies were developed: Physical exercises in animal models of osteoarthritis: a literature review; Influence of muscle strengthening on knee osteoarthritis in rats according to the recommendations for the histological evaluation of OARSI (Osteoarthritis Research Society International); Effect of muscle strengthening on knee osteoarthritis biomarkers of rats. Based on our main findings, we identified the lack of studies in the area to investigate the effect of exercise on muscle strengthening animal models of osteoarthritis. This result that spurred our investigation. It was also identified that exercise muscle building became the evolution of slower disease, to a lesser extent of degeneration and cartilage damage. Finally, complementing our initial findings, muscle strengthening reduced the local expression of biomarkers such as caspase-3, metalloproteinase-1, matrix metalloproteinase-13 and interleukin-6. He also served in the systemic expression of interleukin-6, demonstrating a protective effect for biomarkers of cartilage catabolism investigated. Therefore, exercise muscle strength building has the potential to act on the principal manifestations of osteoarthritis, whether local or systemic. The application of this type of exercise with care and support in the literature, but also recommended the development of new studies that investigate the effect of muscle strengthening in other manifestations of osteoarthritis. / A osteoartrite é a afecção ostemioarticular mais frequente entre os idosos, sendo de grande relevância para a saúde pública e para os estudos relacionados aos processos de envelhecimento. Nesse contexto, o fortalecimento muscular torna-se importante como uma das principais estratégias na reabilitação de indivíduos com osteoartrite. Muitas pesquisas na área têm sido desenvolvidas, mas são poucos os estudos que avançaram na investigação pontual dos efeitos do exercício de fortalecimento muscular nas principais manifestações locais e sistêmicas da osteoartrite. Logo, o objetivo dessa Tese foi investigar os possíveis efeitos de um protocolo de fortalecimento muscular nas principais manifestações da osteoartrite de joelho de ratos. Para alcançar esse objetivo, foram desenvolvidos 3 estudos: Exercícios físicos em modelos animais de osteoartrite: uma revisão da literatura; Influência do fortalecimento muscular na osteoartrite de joelho de ratos segundo as recomendações para a avaliação histológica da OARSI (Osteoarthritis Research Society International); Efeito do fortalecimento muscular nos biomarcadores da osteoartrite de joelho de ratos. Baseado em nossos achados principais, identificou-se a ausência de estudos na área que investigassem o efeito do exercício de fortalecimento muscular em modelos animais de osteoartrite. Resultado esse que impulsionou nossa investigação. Também foi identificado que o exercício de fortalecimento muscular tornou a evolução da doença mais lenta, com menor extensão da degeneração e lesão da cartilagem. Por fim, complementando nossos achados iniciais, o fortalecimento muscular reduziu a expressão local de biomarcadores como a caspase-3, metaloproteinase-1, metaloproteinase-13 e interleucina-6. Também atuou na expressão sistêmica da interleucina-6, demonstrando um efeito protetor para os biomarcadores do catabolismo da cartilagem investigados. Portanto, o exercício de fortalecimento muscular tem potencial para atuar sobre as principais manifestações da osteoartrite, sejam elas locais ou sistêmicas. Recomenda-se a aplicação desse tipo de exercício físico com cautela e respaldo na literatura da área, como também se recomenda o desenvolvimento de novos estudos que investiguem o efeito do fortalecimento muscular em outras manifestações da osteoartrite.

In 2011, the United Kingdom (U.K.) physical activity (PA) guidelines were updated. The adult moderate-to-vigorous intensity PA (MVPA) recommendation changed to reflect that different frequency and intensity permutations lead to equivalent health benefits. New recommendations were added for muscle strengthening activities (MSA) and the reduction of sedentary time (ST). Those over 65 years were also recommended to undertake balance and co-ordination activities (BCA). Despite these new additions, Scottish PA policy still concentrated on MVPA, with considerable resources allocated to sport and some exercise activities. Since 2012, the Scottish Health Survey (SHeS) has collected data relating to these new recommendations annually, but few analyses have been undertaken. This thesis contains the most comprehensive analyses of the 2012-15 SHeS PA and ST data to date, and a review into whether the method produces valid and reliable estimates. The aim of this thesis was to inform Scottish PA and sedentary behaviour policy by producing research to support the incorporation of these new recommendations and the promotion of non-sport-related MVPA policies. It also aimed to inform any future developments to PA and ST surveillance in Scotland. The first three studies of this thesis are cross-sectional analyses of the updated recommendations for adults in Scotland. They present prevalence and participation data in specific domains, activities, and behaviours by age and sex. The main findings were that (1) sport was a minority contributor to the total MVPA of adults in Scotland, regardless of sex, age, or activity status (never more than 20%), (2) compliance with the MSA recommendation was approximately half that of the MVPA recommendation (31% of men and 24% of women), and compliance with the BCA recommendation amongst those over 65 years was very low (19% of older men and 12% of older women), and (3) middle-aged adults in work reported a comparable amount of weekday ST to adults over 75 years (7-8 hours per day). The fourth study was a review of the available evidence into whether the PA and ST estimates produced by the 2012-15 SHeS were valid and reliable. The SHeS was found to be fit for purpose, but recommendations were made regarding the analysis and interpretation of the data to minimise areas of concern. These were (1) analyse MVPA data with and without the domain of occupational MVPA, (2) make it clear that only sport and exercise activities can contribute to achieving the MSA and BCA recommendations under the SHeS method, and (3) focus on the comparisons between groups in relation to ST, rather than on the absolute values. The fifth study used the findings from the previous four to inform the design of a prospective cohort study that will investigate the joint effects of MVPA and total ST on all-cause mortality, cardiovascular disease, cancer, and diabetes. This thesis contains the results of the preliminary analyses. This study is designed to inform policy by providing novel information on how the combination of these behaviours affects health outcomes in a representative sample of Scottish adults. There is clear evidence that this work has already informed policy and surveillance. The work on the relative contribution of the domains of MVPA is regularly cited in evidence briefings for the Scottish Government and the Scottish Parliament. This has increased the awareness amongst key policy-makers that sport is not a major contributor to the total MVPA of adults in Scotland. The work on MSA, BCA, and ST was a catalyst for a proposal to include indicators relating to these recommendations on the national PA monitoring framework. The work on MSA and BCA has also been a key reference text in preparation for the next update to the U.K. PA guidelines, stressing the need to consider surveillance at an early stage. In summary, the novel analyses of SHeS data undertaken for this thesis have demonstrably informed PA and sedentary behaviour policy and surveillance in Scotland.

Dissertation submitted in partial compliance with the requirements for the Masters’ Degree in Technology: Chiropractic, Durban University of Technology, 2013. / Background : Core strengthening may improve athletic ability by providing stability to the trunk, and as a result, stabilising the pelvis. The leverage from which cyclists generate power may be enhanced as a result of a stable pelvis, thereby improving the cyclist’s performance. In the popular, highly competitive sport of cycling, performance enhancement is much sought after. Despite its widespread use, research involving core strengthening in sporting situations is lacking, with studies investigating the effect of a core strengthening programme on cycling performance yet to be investigated. Objectives : To determine the participants’ cycling speed, power, cadence and completion time, and core strength in terms of objective findings, pre- and post- core strengthening intervention, in the whole sample and within the two age strata. To determine the participants’ heart rate in terms of objective findings, and the rate of perceived exertion in terms of subjective findings, pre- and post- core strengthening intervention, in the whole sample and within the two age strata. To determine the participants’ perception of change in speed, power and cadence post- intervention, in the whole sample and within the two age strata. Method : Forty-two asymptomatic cyclists performed two 1.5 km time trials, pre- and post- core strengthening intervention. Core strength assessments were performed pre- and post- intervention, using the Pressure Biofeedback Unit, and the maximum and average speed (km/hr), power (w) and cadence (rpm), and completion time (s) were recorded pre- and post- intervention, using the Computerised Electromagnetic Roller resistance Ergometer (Tacx Trainer). Heart rate and rate of perceived exertion (RPE) were recorded pre- and post- intervention, as well as the participant’s perception of change in speed, power, and cadence post- intervention. SPSS version 20 (SPSS Inc) was used to analyse the data, in the whole sample and stratified into two age strata. Results : ll cycling performance indicators, speed, power, cadence and completion time showed a significant improvement post- intervention, in the whole sample, and within the two age strata. Core strength indicators showed a significant improvement post- intervention, in the whole sample and within the two age strata. A significant decrease in rate of perceived exertion and corresponding heart rate measurements post- intervention was observed in the whole sample. Similarly, the younger age strata reflected a significant decrease in rate of perceived exertion, however heart rate measurements were not significant. In contrast, the older age strata showed significant changes in heart rate measurements, with no significance in rate of perceived exertion measurements. The majority of participants experienced an increased perception in all outcomes post- intervention. Conclusions: The results of this study found that core strengthening had a statistically significant effect (p < 0.001) on cycling performance, both in terms of objective and subjective findings. Future studies could address the effect of core strengthening in an endurance setting.

Objectives: We sought to examine the gender differences between C - reactive protein (CRP) and muscle strengthening activity (MSA) in U.S. adults (≥20 years of age) Background: Elevated levels of CRP have been shown to be associated with an increase in risk of cardiovascular disease (CVD). Studies analyzing the relationship between physical activity (PA) and CRP by gender have produced mixed results. Methods: The sample (n=9,135) included participants in the 1999-2004 National Health and Nutrition Examination Survey (NHANES). Three categories of reported MSA participation were created: no MSA (referent group), some MSA (≥1 to/wk), and meeting the 2008 Department of Health and Human Services (DHHS) recommendation (>2 d/wk). The dependent variable was elevated CRP (>3 to 10 mg/L). Results: Gender stratified analysis revealed significantly lower odds of having elevated CRP for women reporting some MSA (OR 0.61; 95% CI 0.45-0.83, P=0.0023), or volumes of MSA meeting the DHHS recommendation (OR 0.66; 95% CI 0.54-0.82, P=0.0004). Significantly lower odds of men having elevated CRP was observed in those reporting MSA volumes meeting the recommendation (OR 0.73; 95% CI 0.61-0.88, P=0.0011). Following adjustment for waist circumference (WC) these odds remained significant in men but not women. Conclusions: Women reporting any MSA were found to have lower odds of having elevated CRP when compared to those reporting no MSA prior to adjustment for WC. Significantly lower odds in men were only observed in those meeting the recommendation. These results suggest that WC may mediate the associations between MSA and CRP and this relationship may be stronger in women.