Faculty of Health Sciences
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Item Exploring the interrelationships between physical function, functional exercise capacity, and exercise self-efficacy in persons living with HIV(SAGE Publications, 2024) Nokes, Kathleen M.; Sokhela, Dudu G.; Orton, Penelope Margaret; Samuels, William Ellery; Phillips, J. Craig; Tufts, Kimberly Adams; Perazzo, Joseph D.; Chaiphibalsarisdi, Puangtip; Portillo, Carmen; Schnall, Rebecca; Hamilton, Mary Jane; Dawson-Rose, Carol; Webel, Allison R.While physical activity can mitigate the metabolic effects of HIV disease and HIV medications, many HIV-infected persons report low levels of physical activity. Purpose: To determine if there were differences between the subjective and objective assessments of physical activity while controlling for sociodemographic, anthropometric, and clinical characteristics. Setting/sample: A total of 810 participants across eight sites located in three countries. Measures: Subjective instruments were the two subscales of Self-efficacy for Exercise Behaviors Scale: Making Time for Exercise and Resisting Relapse and Patient-Reported Outcomes Measurement Information System, which measured physical function. The objective measure of functional exercise capacity was the 6-minute Walk Test. Analysis: Both univariate and multivariant analyses were used. Results: Physical function was significantly associated with Making Time for Exercise (β = 1.76, p = .039) but not with Resisting Relapse (β = 1.16, p = .168). Age (β = −1.88, p = .001), being employed (β = 16.19, p < .001) and race (βs = 13.84–31.98, p < .001), hip–waist ratio (β = −2.18, p < .001), and comorbidities (β = 7.31, p < .001) were significant predictors of physical functioning. The model predicting physical function accounted for a large amount of variance (adjusted R2 = .938). The patterns of results predicting functional exercise capacity were similar. Making Time for Exercise self-efficacy scores significantly predicted functional exercise capacity (β = 0.14, p = .029), and Resisting Relapse scores again did not (β = −0.10, p = .120). Among the covariates, age (β = −0.16, p < .001), gender (β = −0.43, p < .001), education (β = 0.08, p = .026), and hip–waist ratio (β = 0.09, p = .034) were significant. This model did not account for much of the overall variance in the data (adjusted R2 = .081). We found a modest significant relationship between physical function and functional exercise capacity ( r = 0.27). Conclusions: Making Time for Exercise Self-efficacy was more significant than Resisting Relapse for both physical function and functional exercise capacity. Interventions to promote achievement of physical activity need to use multiple measurement strategies.Item Development of a policy framework for the establishment of physical exercise programmes in reducing non-communicable diseases in the Province of Kwazulu-Natal, South Africa(2022-09-29) Gumede, MusaBackground This study follows a mixed method methodology, and researched tenets of physical exercise beneficial to health. The study took place in eThekwini Municipality among members of physical exercise clubs, trainers and administrators. The study population comprised of urban, township and rural areas. The participants included scholars, the youth, and elderly populations. The participants were questioned as to whether they had pre-existing chronic cardiac disease, or related non-communicable diseases. Aim The aim of this study was to develop a policy framework for physical activity in adult communities in the province of KwaZulu-Natal, South Africa. Methodology The study follows an exploratory, sequential mixed methods approach that begins with a qualitative phase, where experts, trainers, and government officials were interviewed on their observations and role in supporting the physical exercise programmes. The interviews were conducted on a one-to-one basis and took an average of forty-five (45) minutes. This was followed by the quantitative phase that involved conducting a survey by questionnaire on participants in physical exercise programmes. Fifteen participants consisting of two government officials, eight trainers and five experts were interviewed during the qualitative phase and a total of 364 participants participated in the survey, with 224 females and 140 males, where 25% of the participants were students. A proportion of 15.6% of the participants came from rural areas, whereas 43% came from urban areas, with the remainder residing in townships and informal areas. Findings The results indicated that 84% of the respondents participated in physical exercise programmes or sport while at school, 89% participated in exercise or sporting programme while at school, with a value of p<.001. A proportion of 93% of participants did not suffer from chronic heart disease or hypertension and 60% were not offered health check-ups by facilities whereas a significant 68% of facilities ONLY offered for a health check-up when participants were ill or injured, p<.001. Using a one sample t-test, there was significant agreement that facilities were adequate and in good condition, p<.001; and that the usage of these facilities and what was found to be on offer was acceptable/good, p<.001. In terms of physical exercise intensity, the findings indicated that a significant 86% of participants took part in mild exercise regularly, and a significant number took up to 90 minutes a day, p<.001. A significant 67% of participants performed moderate exercise regularly for up to 90 minutes a day. Whereas a significant 82% participated in vigorous exercise regularly, for 45-90 minutes a day, p<.001. The conclusion of the study is that early initiation of PE in schools contributed to long term health benefits like a lower number of participants with NCDs such as obesity and chronic heart diseases, lower incidents of NCDs were found in physically active individuals and the health benefits are not dependent on intensity of exercise but on consistent exercise whether mild, moderate or vigorous. The study identified a gulf in urban-rural infrastructure availability and usage. The study results are important and contribute to the introduction of physical exercise programmes in schools as part of health promotion, to lobby for development of community recreational facilities and training facilities in rural and urban areas.Item Determining the normative value of the Functional Movement Screen™ in weightlifters in participating gyms within the eThekwini municipality, and its association to injury(2021-12-01) Singh, Shaista; Sobuwa, Simpiwe; Bruijns, StevanBackground: Weightlifting is an increasing popular form of fitness. Weightlifters train exceptionally hard in their daily training regimes, as well as for competitions. Despite the popularity of this high intensive and explosive training, there is no normative value determined for weightlifters in the eThekwini Municipality, South Africa, to compare themselves against and track their progress or regression or to use as a benchmark when beginners adopt a new training programme. The Functional Movement Screen (FMS™) is a pre-participation assessment which analyses the movements of its participants according to seven exercises, which form the basics of fundamental movement patterns. This assessment allows an analysis of dysfunctional movement patterns to be identified. Aims: The aim of this study has been to assess weightlifters according to the Functional Movement Screen™ (FMS™), to determine a normative value and examine their FMS™ score in relation to prior injury or musculoskeletal dysfunction. Methods: The methodology of this study included assessing 89 weightlifters from participating gym on the FMS™ in order to achieve a normative score of weightlifters within the eThekwini Municipality. Thereafter, participants were contacted telephonically and asked to provide information about their age, height, weight, number of years training, and an injury profile, including how long ago any injury occurred, how long the injury took to heal, the severity of the injury according to the pain rating numerical scale and what form of treatment they received for their injury. The mean FMS™ was then determined for the weightlifters within the eThekwini Municipality and an analysis was made between FMS™ score and injury sustained to determine whether the FMS™ is able to predict injury in this population. Results: The sample population of 89 revealed that the mean FMS™ score for weightlifters in participating gyms within the eThekwini Municipality is 13.88 out of 21. There is no correlation made between FMS™ score and injury and therefore there is no association to injury and FMS™ score in this sample population. There are significant findings in the scoring of the FMS™ exercises showing that weightlifters adapt their own lifting technique in order to lift their desired weight at the velocity expected. The most common recorded injuries are to the shoulder, followed by the knee. The most common injury sustained is musculature in nature and the most common treatment received for injury was physiotherapy. Conclusion: The normative value for weightlifters in participating gyms within the eThekwini Municipality is 13.88 out of 21 for the FMS™. It has been established that weightlifters deviate from the ideal movement pattern to develop stability and strength to lift their desired weights at explosive outputs. There was no link found between FMS™ score and injury and no correlation made between age, height, weight and number of years training and the FMS™ score.Item Sagittal spinal alignment in long-term surfers of eThekwini(2021-12-01) Mudge, Alexander; Pillay, Julian D.Background: Sagittal spinal alignment and posture deteriorate with age, but may be affected by physical activity. Surfers catch and ride breaking waves using a surfboard, which they paddle while prone with their spine extended. Spinal extension exercise is generally beneficial to postural development with age. This study aimed to investigate whether an association exists between long-term surfing and the progression of sagittal spinal alignment and posture i.e. cervical lordosis (C-angle (flex and Cobb)), thoracic kyphosis (T-angle (flex and Cobb)), lumbar lordosis (Langle (flex and Cobb)), and sagittal posture (Posture Number) in ostensibly healthy males over the age of 50. The objectives of this study included: 1) Assessing the. C, T, L-angles, and Posture Numbers in long-term male surfers and physically active non-surfer ; 2) Determining whether any significant differences exist between the selected sagittal spinal alignment and posture parameters within or between the surfing and non-surfing groups; and 3) Determining the association, if any, between age, years of surfing and selected spinal alignment parameters. Methodology: 52 males over the age of 50 underwent a case history and postural examination. Their C, T, and L-angles were plotted onto graph paper to analyse using BiomechFlex. Anterior and lateral full-body photographs were taken to analyse using Posture Pro version 8. The generated statistics were analysed using STATA version 16. The summary measures used included the mean, median, standard deviation, range and percentiles of spinal angle and posture variables, as well as the age, anthropometric variables, activity hours per week and activity years. Results: The mean body mass index (BMI) of the S group (24.9kg/m²) was significantly lower than the 27.6kg/m² mean of the NS group, p=0.00. The average time spent on activities per week was over 3 hours in both groups (S group - 3.28hrs and NS groups - 4.67hrs, p=0.0004). On average, the S group (45.6 years) had been practising surfing for significantly more years than the NS group (32 years) had been practising their respective primary activities, p=0.0008. There were no significant differences between the S and NS groups in terms of C- (flex p=0.6234), T- (flex p=0.5758 and Cobb p= 0.5518), or L-angles (flex p=0.6171 and Cobb p=0.6142), or Posture Number (p=0.5348). The T-angles (flex and Cobb) obtained from both NS and S groups were greater than 40⁰, which is classified as hyperkyphotic. There was a positive correlation between age and Posture Number in the S group (r = 0.4307 and p-value = 0.0316), but not the NS group. There was a significant association between Posture Number and T-angle (flex p=0.027 and Cobb p=0.026). The NS group had a 2.15⁰ (flex) and 2.09⁰ (Cobb) greater T-angles for any given posture Number. The NS group had an average of 2.9⁰ (flex) and 2.23⁰ (Cobb) lower Langles than the S group for any given BMI. Thus, surfing may suggest benefit of surfing to sagittal spinal alignment and posture. Conclusion: The results of this study show that long-term surfing is beneficial to the aging individual in terms of body composition. However, it is no more effective at mediating the effect of age on sagittal spinal alignment and posture than other forms of physical activity included in this study. Nevertheless, slight differences between the NS and S groups were present, which may indicate that the biomechanical or even postural effects/adaptations of long-term surfing differ from those of other activities. These subtle differences indicate the need for further research around physical activity, sagittal spinal alignment and posture.Item The physical activity levels of students at a University of Technology in South Africa(2021-05-27) Hewer, Gareth; Haffejee, Firoza; Pillay, JulianIntroduction Physical activity (PA) has been shown to play an important role in an individuals’ health. Physically active individuals have a lower risk of acquiring chronic health diseases such as coronary heart disease, type 2 diabetes mellitus and hypertension. Physical activity is a compulsory component of the school curriculum in South Africa (SA), incorporated into the subject “Life Orientation”. However, in tertiary institutions PA is not included within the university curriculum and is only available as an additional extramural activity that not many students utilise. PA levels have been shown to decline with age in adulthood. University students are mostly young adults and it has been shown that individuals who practice healthy lifestyles when they are younger are more likely to continue those practices when they get older. Consequently, ensuring habitual PA during university years is an important and useful consideration. Knowing the physical activity levels of students provides a useful basis for intervention in this regard. Aim To compare self-reported and objectively measured physical activity patterns of students at the Durban University of Technology. Methodology This study used a cross sectional design, in a quantitative paradigm. The study was conducted among students at the Durban University of Technology from March 2019 to September 2019. The study was divided into two components. In the first, participants (n= 430) were randomly selected to complete the International Physical Activity Questionnaire (IPAQ) to ascertain their self-reported PA levels. The second part of the study involved objectively measuring the PA levels by wearing a pedometer for a period of at least seven days to determine the number of steps taken. The study further involved an aerobic fitness assessment using the Harvard step test and the recording of anthropometric measures such as body mass index, waist to hip ratio and body fat percentage. As only 60 participants were required for this aspect of the study, those who completed the questionnaire were invited to participate in this aspect and sampling continued until a total of 60 participants was reached. Descriptive statistics used for calculation in the study included means, standard deviations, medians and range. The relationships between variables were determined by using statistical tests such as chi-squared tests, post hoc tests and Pearsons’ correlation test where a p value less than 0.05 was considered significant. Results Of the 430 questionnaires that were distributed, a total of 394 completed questionnaires were received, yielding a response rate of 91.6%. The mean age of the respondents was 21.7 ± 4 years with an even spread between gender. Most respondents were Black African (76.6%). Questionnaire data showed that most students (76.6%) reported a high level of PA. Pedometer and aerobic fitness assessment results showed that most students were either only moderately active or sedentary. It was also shown that males reported higher levels of PA in the questionnaire and had higher levels of ambulatory PA (p=0.038) and aerobic fitness (p=0.331) compared to females. In addition, males (17.9%) had a lower prevalence of obesity compared to females (47.6%; p<0.001). Conclusion Self-reported PA levels appear to be over-estimated when compared to the more objective estimates obtained through the pedometer wear and aerobic fitness assessment in the study population. More than recommending the need interventions to increase PA in university students, the need to exercise caution in the use of self-reported measures as an absolute estimate of PA is noted. Adjusting such data through more objective measures in sub-samples may be a useful approach towards cost-effective approaches for gathering data.Item Physical activity patterns and aerobic fitness of academic staff at a University of Technology in South Africa(2020-06-10) Roelofse, Valeska; Pillay, Julian David; Haffejee, FirozaBackground: Physical activity (PA) has a significant effect on well-being and should be an essential component of healthy living. An active lifestyle has been found to aid weight management and provide protection against chronic lifestyle diseases. Physical inactivity of white-collar office workers has been shown to decrease work productivity and increase work absenteeism. Consequently, academic staff may experience these effects due to physical inactivity. Despite the many international studies performed on the PA of white-collar office and administration workers, few studies have focussed on office workers in a South African setting. Moreover, studies investigating PA of academic staff in a South African setting are limited. This study therefore aimed to determine the PA patterns and aerobic fitness of academic staff at a university in South Africa (SA). Objectives: The objectives of this study were: to determine self-reported PA levels of academic staff using the IPAQ; to objectively measure PA patterns of academic staff using pedometers; to compare pedometer-measured data with self-reported data; to establish aerobic fitness through an aerobic fitness assessment; and to determine the association, if any, between the pedometer-measured steps and aerobic fitness. Method: A cross sectional study in a quantitative paradigm consisted of a descriptive component involving the completion of the IPAQ and 7-day pedometer wear. An experimental component in the form of an aerobic fitness assessment (Harvard Step Test) was performed and measurements including Physical Efficiency Index (PEI) percentage body fat (PBF), Body Mass Index (BMI) and waist-to-hip ratio were taken. This was administered to 61 full-time, non-contract academic staff members at the Durban University of Technology (DUT). IBM SPSS version 25.0 was used to analyse the data. Continuous data was described using median and inter-quartile ranges overall and per group as the variables were not normally distributed. Non-parametric Kruskal-Wallis tests were used to compare medians across physical activity groups at a 0.05 level of significance. Where an overall significant result was obtained, Bonferroni-adjusted multiple comparison tests were Background: Physical activity (PA) has a significant effect on well-being and should be an essential component of healthy living. An active lifestyle has been found to aid weight management and provide protection against chronic lifestyle diseases. Physical inactivity of white-collar office workers has been shown to decrease work productivity and increase work absenteeism. Consequently, academic staff may experience these effects due to physical inactivity. Despite the many international studies performed on the PA of white-collar office and administration workers, few studies have focussed on office workers in a South African setting. Moreover, studies investigating PA of academic staff in a South African setting are limited. This study therefore aimed to determine the PA patterns and aerobic fitness of academic staff at a university in South Africa (SA). Objectives: The objectives of this study were: to determine self-reported PA levels of academic staff using the IPAQ; to objectively measure PA patterns of academic staff using pedometers; to compare pedometer-measured data with self-reported data; to establish aerobic fitness through an aerobic fitness assessment; and to determine the association, if any, between the pedometer-measured steps and aerobic fitness. Method: A cross sectional study in a quantitative paradigm consisted of a descriptive component involving the completion of the IPAQ and 7-day pedometer wear. An experimental component in the form of an aerobic fitness assessment (Harvard Step Test) was performed and measurements including Physical Efficiency Index (PEI) percentage body fat (PBF), Body Mass Index (BMI) and waist-to-hip ratio were taken. This was administered to 61 full-time, non-contract academic staff members at the Durban University of Technology (DUT). IBM SPSS version 25.0 was used to analyse the data. Continuous data was described using median and inter-quartile ranges overall and per group as the variables were not normally distributed. Non-parametric Kruskal-Wallis tests were used to compare medians across physical activity groups at a 0.05 level of significance. Where an overall significant result was obtained, Bonferroni-adjusted multiple comparison tests were iv performed to identify the groups which differed. Relationships between continuous variables were assessed using Spearman’s rank correlation coefficient. Results: Key findings: 49.1% of participants were classified as being moderately active, 31.9% were classified as highly active and 19.0% were classified as low or physically inactive according to the IPAQ. Participants mostly engaged in moderate intensity physical activity (MPA) during the week (1800 MET minutes/week). The largest volume of PA was spent performing domestic and gardening/yard activities (1120 MET-minutes/week). A significant difference in self-reported fitness level was found across the PA classifications (p = 0.003), with the most significant differences observed between the high and low groups (p = 0.01) and moderate and high groups (p = 0.04). A trend was found which indicated that as PA measured with the IPAQ increased, so did all the median values of the pedometer measure data. An overall significant difference between the PA groups (highly active, moderately active and low activity groups) in terms of average aerobic steps (p = 0.028) and average aerobic walking time (p = 0.033) was present. The majority of participants (62.3%) were classified as having a poor Physical Efficiency Index (PEI), followed by 31.1% of participants having a low-average PEI and only 6.6% were found to have a high-average PEI. Strong negative correlations were found between PEI and Percentage body fat (PBF) (r = -0.369, p = 0.003). Another negative correlation was present between PEI and Body Mass Index (BMI) (r = -0.308, p = 0.016). A strong positive correlation was found between BMI and PBF (r = 0.789, p = < 0.001). BMI was negatively correlated with average daily steps (r = -0.296, p = 0.020), average daily aerobic steps (r = -0.244, p = 0.059) and average distance covered (r = -0.236, p = 0.067). Significant relationships were found between PEI and average kilocalories (r = 0.295, p = 0.021) as well as with average distance (r = 0.293, p = 0.022). PBF was negatively correlated with average aerobic steps (r = -0.416, p = 0.001), average aerobic walking time (r = -0.409, p = 0.001) and average daily steps (r = -0.380, p = 0.003). A trend was found where total PA MET-minutes/week increased from Groups A to B to C. There was a significant difference (p < 0.001) across the three participation groups regarding PA level where high activity was more likely to be present in Group C and low activity more likely to be present in Group A. Conclusion: The results of this study revealed that almost half of the participants were at least moderately active according to self-reported data. This is higher than previous studies performed nationally and globally on office workers and healthcare workers. Despite this, most participants exhibited poor aerobic fitness when performing the aerobic fitness assessment and the pedometer data measurements were lower than previous studies conducted. The study therefore illustrates the need for academic staff members to improve their aerobic fitness as well as to improve their step count and aerobic walking time on a daily basis. Additionally, increasing daily step count and aerobic walking time will benefit the health of academic staff. This was seen with the strong negative correlations found between step counts and aerobic walking time with BMI and PBF as well as between PEI and PBF. By increasing step count and aerobic walking time, staff could potentially maintain a healthy BMI and PBF which could reduce risk of co-morbid pathologies. This would contribute to a healthy lifestyle which should be encouraged. Therefore, it is recommended that employers and management of tertiary institutions consider these findings and use them to implement worksite PA programmes in order to improve PA of workers and academic staff which could ultimately positively impact well-being and consequent work performance.