This dissertation aimed to investigate the relationship between posture and reaching in both healthy and pathological conditions, approaching the trunk as a multi-segmented structure. For this purpose, neuromuscular and kinematic profiles were recorded from trunk and arm during seated reaches providing mid-rib vs pelvic levels of trunk support. Healthy adults with mature postural and reaching abilities displayed invariant arm kinematics during the reach. However, participants displayed increased anticipatory control and earlier activation of cervical muscles with mid-rib support. Participants also presented increased compensatory responses of paraspinal muscles when responding to the increased trunk balance demands with pelvic support. Children with moderate/severe cerebral palsy (CP) cannot maintain an upright sitting position and thus cannot create a stable postural frame around which upper limb movements are planned and executed. A second set of studies examined postural and reaching characteristics in these children, while applying axillae, mid-rib or pelvic levels of support. Participants were classified according to their intrinsic level of trunk control as mild, moderate and severe. With higher levels of support children with moderate to severe impairments in trunk control showed improvements of head and trunk control along with enhanced reaching performance. Participants with mild trunk dysfunction were able to sit independently and thus did not demonstrate significant changes in postural and reaching proficiency across levels of external trunk support. Electromyographic profiles were more variable depending on the severity of intrinsic trunk control. Overall, participants in the mild group presented more refined timing mechanisms for both anticipatory (closer to reaching onset) and compensatory (reduced latency) postural adjustments during the reach across all levels of support. Participants in the moderate group displayed earlier muscle onsets and more efficient arm/trunk muscle amplitudes with higher levels of support. Participants in the severe group showed very limited capability of anticipatory control of paraspinal muscles, delayed muscle onsets and variable muscle amplitudes across levels of support. These results emphasize the complex neuro-anatomical nature of trunk control during reaching. Also, they highlight that inefficient postural control while sitting significantly impacts children with CP and trunk dysfunction. This dissertation includes previously unpublished co-authored material.

Aim: To assess if there is an association between sitting time and obesity among adult Peruvian population, using three different anthropometric measurements. Methods: A secondary analysis using data from a population-based study, the National Household Survey (ENAHO, in Spanish), was conducted enrolling adults aged ≥18 years from the 25 regions of Peru using a multistage random sampling technique. The outcome of interest was obesity, determined by body mass index (BMI > 30 kg/m2), waist circumference (WC > 80 and >90 cm in women and men, respectively) and waist to height ratio (WHR > 0.5); while the exposure was sitting time, measured using the last domain of the International Physical Activity Questionnaire and then categorised in <4 hours/day, 4 to <8 hours/day and 8+ hours/day. Associations were estimated using Poisson regression models, reporting prevalence ratios (PRs) and their respective 95% CI. Results: Data from 8587 subjects were analysed; mean age was 38.4 (SD: 13.5) and 53.6% were females. The prevalence of obesity was 16.3% (95% CI: 15.2–17.5%) by BMI, 58.5% (95% CI: 56.9–60.0%) by WC, and 78.0% (95% CI: 76.5–79.3%) by WHR. In the multivariable model, subjects reporting a sitting time of 8+ hours/day were more likely to be obese than those reporting <4 hours/day according to BMI (PR: 1.38; 95% CI: 1.15–1.65), WC (PR: 1.20; 95% CI: 1.12–1.28) and WHR (PR: 1.05; 95% CI: 1.01–1.10). Conclusions: Subjects with greater sitting time were more likely to be obese, and this association was evident with three different anthropometric indicators. Findings suggest the need of generating public health actions to reduce sedentary behaviour. / Revisión por pares / Revisión por pares

With the ever-increasing rate of the integration of technology, and office workers making up the largest single sector of occupations, many workers are spending an increasingly large portion of their work time in the prolonged sitting or standing position and while on computer-based systems. Evidence-based research suggests that increased sedentary time is associated with diabetes, hypertension and other mortality causing diseases such as cardiovascular disease. There is a lack of occupational medicine considerations, specifically ergonomics, incorporated into the patient plan of care in the primary care setting. This is likely due to the decreased number of physicians specializing in occupational medicine (OM), and the lack of OM education in medical school curriculum. The current time constraints of the medical system may make the integration of additional screening seem unreasonable. With the introduction of occupational therapy as a contributing member of the primary care team, the burden of ergonomic training and education for at-risk patients can be reduced. Through participation in the Physicians’ Role in Patient Ergonomics workshop, a 20-minute online video aimed at explaining the connection between occupational risks and common health issues seen in the primary care setting, physicians can learn about the implications of occupational risks on patient health, and how to utilize brief screening questions and decision trees to efficiently determine which patients may benefit from ergonomic education and training.

Yes / Sedentary behaviour (SB) in childhood is a major public health concern. Little is known about ethnic differences in SB during school and holiday weeks among White British (WB) and South Asian (SA) children, which this study aims to address through investigating inclinometer measured SB and exploring reasons for child engagement in SB. A mixed methods study, comprising of a quantitative investigation with 160, 6-8 years old children and a qualitative study with a subsample of 18 children, six parents and eight teachers was undertaken. Children of WB and SA ethnicity in three schools were invited to wear inclinometers for seven school terms (summer/winter/spring) and seven holidays (winter/spring) days during July 2016-May 2017. Total SB, SB accumulated in bouts > 30 min and breaks in SB were explored using multivariate linear mixed effects models which adjusted for wear time, sex, deprivation, overweight status, season, term, weekday and school. Nine focus groups and two interviews were carried out using the Theoretical Domains Framework to explore SB perceptions among parents, teachers and children. Data were analysed using the Framework Approach. 104/160 children provided 836 valid days of data. Children spent on average eight hours of SB/day during term time and holidays, equating to 60% of their awake time, and had on average 111 SB breaks /day. SA children had 25 fewer SB breaks/ day when compared to WB (p / Funded by the NIHR Collaboration for Leadership in Applied Health Research and Care Yorkshire and Humber (NIHR CLAHRC YH).

abstract: Most studies that explored the health benefits of interrupting sitting time focused on using different modalities (i.e., comparing walking vs standing breaks)33,36,59. However, experimental studies that directly compare patterns of interrupting sitting time through standing only are needed to advance the field. This study aimed to (i) determine if there is a difference in glucose response between continuous sitting (CS) and two intermittent standing regimes (high frequency, low duration breaks (HFLD) and low frequency, high duration breaks (LFHD)) and (ii) to determine if there is a difference in glucose response between the two strategies (HFLD vs. LFHD). Ten sedentary employees (mean±SD age 46.8±10.6 years; 70% female) with impaired fasting glucose (mean glucose= 109.0±9.8 mg/dL) participated. Eligible participants were invited to three 7.5 hour laboratory visits where they were randomized to perform each study conditions: (i) CS, (ii) HFLD and (iii) LFHD. Standardized meals (breakfast and lunch) were given with each meal providing 33% of the participant’s total daily caloric needs following a typical American diet (50-60% carbohydrates, 25-30% fat, and 10-20% protein). Participants wore an activPAL device to measure compliance with the sit-stand condition and a continuous glucose monitor to measure post-prandial glucose response. Post-prandial mean glucose, incremental area under the curve and mean amplitude glycemic excursion between conditions were evaluated using linear mixed models. Participants demonstrated high compliance with the study condition. The results indicated that the mean glucose of the HFLD condition were significantly lower (p< .01) than the CS condition with mean difference of -7.70 (-11.98, -3.42) mg/dL·3.5h and -5.76 (-9.50, -2.03) mg/dL·7h for lunch and total time, respectively. Furthermore, the mean post-prandial glucose during lunch and total time were significantly lower in the HFLD condition compared to the LFHD condition with mean difference of -9.94 (-14.13, -5.74) mg/dL·3.5h and -6.23 (-9.93, -2.52) mg/dL·7h, respectively. No differences were found between the CS and LFHD conditions. This study provides evidence favoring the use of frequent interruptions in sitting time to improve glycemic control of prediabetic individuals. In contrast, less frequent, although longer bouts of standing resulted in similar post-prandial glucose profile to that of the continuous sitting condition despite total standing time being equal to the LFHD condition. / Dissertation/Thesis / Doctoral Dissertation Physical Activity, Nutrition and Wellness 2019

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2007. / The aim of this research was to investigate the relative effectiveness of manipulation versus core rehabilitation in the treatment of acute mechanical low back pain in sedentary patients. Recent research has found that dysfunction of the primary core stabiliser muscles is linked with an increasing number of the general population suffering from low back pain; this is thought to be due to the fact that people in general are living more sedentary lifestyles. The Aims and Objectives of this study were to determine the relative effect of manipulation and core rehabilitation in sedentary patients suffering from acute mechanical low back pain in terms of subjective findings, objective findings and to determine any correlations between these findings Thirty-two participants, with acute low back pain participated in the study. They received treatment over a period of three weeks, two treatments in the first week, two treatments in the second week and a follow up seven days later. Group A received a spinal manipulation while Group B received core rehabilitation exercises. Readings were taken at three time points, namely visit one, three and five before the treatment, they included the following readings: Numerical Pain Rating Scale, Algometer, Roland Morris Low Back Pain and Disability Questionnaire, Biofeedback Stabiliser and the Surface EMG. The results showed that there was no differential (p<0.05) treatment effect between the two Groups, and that both Groups showed a clinical improvement in their low back pain. In conclusion, it appears that even though both these treatment protocols have very different mechanisms of action, both can be effective treatment protocols and that core rehabilitation exercises when properly performed are as effective as manipulation in the treatment of acute low back pain.

Forbidden to stand aims to provide a comprehensive account of how participation in sitting volleyball (SV) has impacted upon the lives of players with impairments. To achieve this aim, this study uses capabilities approach, a theoretical and methodological framework unexplored in sport contexts but widely appraised in political philosophy as one of the most comprehensive approaches to well-being and quality of life. One of the implications of the use of capabilities approach was the compulsory need to pay attention not only to personal capabilities per se, but also to the contextual elements of the individuals experience in SV. As such, whilst identifying, describing and assessing the main personal capabilities in which participation in SV had a significant impact, the present study presents simultaneously an anthropological account of the SV field in the United Kingdom (UK) as it developed. In connecting capabilities approach and disability sport for the first time, this study contributes to our understanding of the impact of sport on the whole lives of people and to the development of a holistic tool to measure personal development, helping to address an acknowledged omission of such instruments in the academic field of adapted physical activity. In order to respect the pluralism and complexity of capabilities approach, an ethnographic methodological design was used due to its flexibility in combining a plurality of theoretical insights; data sources and perspectives. During the study the researcher performed different roles within the SV community facilitating empirical data collection using the ethnographic tool kit. A key development in this process was the definition of an analytical thematic framework which directed the extensive analysis of the whole data set. A set of ten relevant capabilities were then identified as the most relevant for SV players with impairments, and SV impact on those capabilities described. This study reveals that while the potential to enact and promote capabilities is present in SV context in the UK, it is very dependent upon influential factors operating at a personal, cultural and environmental levels. At a personal level, the enjoyment and expansion of capabilities in players with impairments was very much influenced by the possession of substantial financial resources and previous sporting capital; thus the players who have expanded their capabilities the most were individuals who already possessed a good level of capabilities enjoyment. At the cultural level, while SV field detains important qualities to promote capabilities enjoyment such as an equalisation of the social worth between people with and without impairments, these were often overridden by the political and cultural dominance of an able-bodied volleyball ethos. At an environmental level, the overdependence of Volleyball institutions from the funding allocated by national sport agencies such as UK Sport, as well as the incipient development of SV grassroots stream clearly placed SV in a vulnerable position in relation to external political forces. The most important outcomes of the present study is the identification of life dimensions that are significantly affected by participation in SV as well as the identification of the most important factors mediating such impact. Beyond the fields of disability sport and adapted physical activity, a theoretical/methodological symbiotic relation between capabilities approach and social sciences of sport would encourage those involved in sport to refocus their mission on people and human development instead of on economic and institutional benefits.

Two different weight training programs were compared to determine which was most effective in improving strength. The experiment was conducted with the bench press, leg press, and sitting press for a period of fifteen weeks.

Orientador: Abílio Garcia dos Santos Filho / Banca: João Candido Fernandes / Banca: Célia Aparecida Stellutti Pachioni / Resumo: Essa pesquisa teve como objetivo fazer um estudo dos problemas ergonômicos da posição sentada em um departamento de apoio às agências em bancários, na cidade de Bauru. Devido à evolução do sistema bancário, à centralização do processo administrativo e à utilização da informática, foi constatado que esta população de trabalhadores permanece a maior parte do tempo na posição sentada. A revisão bibliográfica deu definições do sistema bancário e fez uma síntese da história dos bancos e do trabalho bancário no Brasil. Foi feita uma investigação dos problemas ergonômicos, o mobiliário, as recomendações das normas técnicas e o que há de moderno em termos de mobiliário e equipamentos para se trabalhar diante de um computador. A análise da postura sentada foi realizada de forma a relacioná-las aos riscos que os funcionários estão correndo a permanecer nesta postura por longos períodos e de forma inadequada. A metodologia constou da aplicação de um questionário, para obter informações sobre o mobiliário, equipamentos de adaptação, postura adotada na posição sentada e dores (apontadas por meio do diagrama de Corllet e Manenica, 1980). Foram utilizados também registros fotográficos dos postos de trabalho e dos funcionários em suas respectivas atividades laborais na tentativa de identificar inadequações posturais e layout do ambiente. Foi feita uma pesquisa descritiva, pela qual se realizou um estudo de caso em departamento bancário onde foram pesquisados todos os funcionários do local. O estudo de caso permitiu identificar as condições do posto de trabalho, analisar o mobiliário, averiguar a postura adotada e mapear as dores corporais apontadas pelos sujeitos. Os principais resultados mostraram que 81,63% dos entrevistados disseram que o monitor estava na mesma altura dos olhos... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: This research had as its objective to assumed by the ergonomic problems caused by the ergonomic problems caused by the sitting position in an agencies support department bank employees, in the city of Bauru - SP. Due to the evolution of the banking system, to the centralization of the administrative process and the use of computer science, it was verified that this population of workers remains stays most of the time sitting. The bibliographical review gave definitions of the banking system and offered made a synthesis of the history of banks and theirs workers in Brazil. It was make an investigation of the ergonomic problems, the furniture, and the recommendations of the technical norms and of update furniture terms and equipments to work before a computer. The analysis of the sitting posture was accomplished to relate them to the risks that the employees are running by staying in this position for long periods and in an inadequate way. The methodology consisted of an application of a questionnaire, to obtain information on the furniture, adaptation equipments, position adopted in the sitting position and pains (pointed through the diagram of Corllet and Manenica, 1980). And there were used photographic registrations of the workstations and of the employees in their respective working activities in the attempt to identify inadequate position and layout of the environment. It was make a descriptive research, it in which a case study in a banking department was performed where all the employees of the place were researched. The case study made it possible to identify the conditions of the workstation, to analyze the furniture, to discover the adopted position and to map the pointed corporal pains for the subjects. The main results showed that 81,63% of the interviewees said that the monitor was at the same height of their eyes... (Complete abstract click electronic address below) / Mestre

Introduction: Obesity during pregnancy is linked to many negative health effects for mothers and offspring. The majority of interventions with obese pregnant women based on physical activity have had limited success suggesting alternative approaches are needed. Sedentary behaviour is defined as waking activities that expend very low energy, 1.5 metabolic equivalents or below, while reclining, lying or sitting. Spending too much time sedentary has been identified as a risk factor for health, regardless of physical activity levels. We hypothesised that targeting sedentary behaviour may be a suitable alternative to reduce health risks during gestation among pregnant women who are morbidly obese (defined as body mass index, BMI > 40 Kg/m²). Aim and objectives: The aim was to explore sedentary behaviour among obese pregnant women and to propose an intervention to reduce the time obese pregnant women spend sedentary, through an active sitting exercise intervention. To conduct a systematic review of the literature to determine the proportion of time spent in sedentary behaviour among pregnant women, and the association of sedentary behaviour with pregnancy outcomes in mothers and offspring. To estimate total energy expenditure, and energy expended in sedentary activities in morbidly obese and lean pregnant women. To assess the feasibility of an active sitting exercise intervention for morbidly obese pregnant women, designed using a patient involvement in research method. Systematic Review: A systematic review of the literature reporting sedentary behaviour during pregnancy and its effects on pregnancy outcomes was conducted. Twenty six publications were included in the systematic review up until October 2015, and a further 18 were identified in the update completed in April 2018. Pregnant women spent at least 50% of their time in sedentary activities. Associations between increased time sedentary and higher risk of macrosomia, higher risk of pre-eclampsia, higher risk of developing gestational diabetes mellitus, and larger new-born abdominal circumference were observed, as the main findings. Most of included studies scored an intermediate quality, only two of the 44 studies scored a good quality. Cross-sectional study. A cross-sectional study was conducted, using the Pregnancy Physical Activity Questionnaire (PPAQ), and the Actical accelerometer, to assess energy expenditure, and energy expended in sedentary behaviour. Based on the PPAQ, women who were morbidly obese expended significantly more energy per day, as total expenditure, than lean pregnant women, which was confirmed by the Actical. During sedentary behaviour lean pregnant women expended significantly less energy than morbidly obese pregnant women, based on the PPAQ. No differences were observed between lean and morbidly obese pregnant women in the proportion of time spent in sedentary activities, nor in time sedentary. Exercise Intervention Design A patient involvement in research approach was used to design an active sitting exercise intervention for morbidly obese pregnant women. Twenty three women took part in the design of the intervention, enabling design of a final protocol including six exercises, to be performed in two sets of 10 repetitions. Active sitting exercise intervention An intervention based on active sitting exercises for morbidly obese pregnant women to reduce sedentary time was conducted to assess the feasibility. Thirty morbidly obese pregnant women were recruited of whom 20% completed the exercise intervention. The main reason not to complete the intervention was lack of time. Conclusion: A better understanding of sedentary behaviour is needed for the design of effective interventions to help to reduce the adverse effects of morbid obesity on pregnancy, especially as prevalence is growing. More time spent in light intensity activities rather than in sedentary behaviour may play a role as contributing to reduce those risks associated with obesity during pregnancy, and to reduce time spent sedentary. Participants have shown real interest in helping to design an effective exercise intervention. Involving and empowering participants in how to take care of themselves as part of the intervention helps to increase their commitment. Giving participants the tools to take care of their own health and their babies' should be considered as part of the intervention with very obese pregnant women. Providing the information in how and why exercise might help, and basing the intervention in giving participants easy and realistic tasks that they could do on their own and around their own environment, will help to increase their commitment. This appears to be a feasible and effective strategy.