Faculty of Health Sciences
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Item Factors related to functional exercise capacity amongst people with HIV in Durban, South Africa(AOSIS, 2021-04-29) Orton, Penelope Margaret; Sokhela, Dudu Gloria; Nokes, Kathleen M.; Perazzo, Joseph D.; Webel, Allison R.BackgroundPeople with HIV (PWH), who engage in regular physical activity, have improved fitness, muscular strength, body composition, health-related quality of life and mental health symptoms, but PWH have amongst the lowest physical activity levels of those with any chronic health condition. Furthermore, there is scant evidence examining these relationships in PWH in Africa.Aim
To address these critical gaps, this cross-sectional descriptive research study examined the relationships between demographic, HIV-related, anthropometric factors, neighbourhood walkability and physical activity, amongst PWH in Durban, South Africa.Setting
Respondents (N = 100) were receiving primary healthcare in six eThekwini nurse-run municipal clinics.Methods
Self-reported socio-demographic data were collected, and HIV-related medical data were extracted from respondent's medical charts. Height and weight were measured to calculate the body mass index (BMI, kg/m2); neighbourhood walkability was measured on the Neighbourhood Environment scale; and physical activity, specifically functional exercise capacity, was measured by the 6-min walk test (6MWT).Results
On average, respondents were black African, female, approximately 38 years old and unemployed; men were of normal weight whilst women were overweight. Only 65% of the respondents reached the age- and sex-predicted distance during the 6MWT. Correlational analyses did not reveal any significant relationships between the functional exercise capacity and socio-demographic, HIV-related factors or anthropometric measures.Conclusion
South African PWH do not reach their predicated walking distance on the 6MWT. Engaging community agencies to promote walking as both a means of transportation and leisure physical activity may decrease the risks of a sedentary lifestyle and improve progression towards recommended physical activity targets.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 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 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.Item Calories and steps! How many days of walking/hiking in the Himalayas does ONE Christmas lunch translate to?(Health & Medical Publishing Group, 2015) Pillay, Julian David; Brown, W.Background. The festive season is a time when people are at risk of overeating and weight gain. An active break during this time can help maintain energy balance. Objectives. To determine steps taken during a walk/hike to Everest Base Camp and back and compare estimated activity-related energy expenditure to a typical Christmas lunch. Methods. Five adults (39-70 years) completed an 11-day walk/hike. Pedometer-measured steps were recorded at two cadences: ‘aerobic’ (>100 steps/minute for 10 consecutive minutes) or ‘slower’ steps. Activity-related energy expenditure was estimated using generic values for walking uphill/downhill at each cadence. Energy intake of a typical Christmas lunch was estimated. Results. Participants accumulated a total of 143 770 steps, or 13 070 (SD 8 272) steps/day, 20% of which were ‘aerobic’. Total walk-related energy expenditure was estimated at 22 816 kcals, or 1 901 (SD 580) kcals/day. Conclusion. Estimated energy intake in one Christmas lunch equates to 1.7 days of walking/hiking.Item Steps that count! : The development of a pedometer-based health promotion intervention in an employed, health insured South African population(BioMed Central, 2012-10-17) Pillay, Julian David; Kolbe-Alexander, Tracy; Mechelen, Willem; Lambert, Estelle V.Physical activity (PA) has been identified as a central component in the promotion of health. PA programs can provide a low cost intervention opportunity, encouraging PA behavioral change while worksites have been shown to be an appropriate setting for implementing such health promotion programs. Along with these trends, there has been an emergence of the use of pedometers as a self-monitoring and motivational aid for PA. This study determines the effectiveness of a worksite health promotion program comprising of a 10-week, pedometer-based intervention (“Steps that Count!”), and individualized emailbased feedback to effect PA behavioral change.Methods The study is a randomized controlled trial in a worksite setting, using pedometers and individualized email-based feedback to increase steps per day (steps/d). Participant selection will be based on attendance at a corporate wellness event and information obtained, following the completion of a Health Risk Appraisal (HRA), in keeping with inclusion criteria for the study. All participants will, at week 1 (pre-intervention), be provided with a blinded pedometer to assess baseline levels of PA. Participants will be provided with feedback on pedometer data and identify strategies to improve daily PA towards current PA recommendations. Participants will thereafter be randomly assigned to the intervention group (INT) or control group (CTL). The INT will subsequently wear an un-blinded pedometer for 10 consecutive weeks. Individualized feedback messages based on average steps per day, derived from pedometer data (INT) and general supportive/motivational messages (INT+CTL), will be provided via bi-weekly e-mails; blinded pedometer-wear will be conducted at week 12 (post-intervention: INT+CTL). Discussion The purpose of this paper is to outline the rationale behind, and the development of, an intervention aimed at improving ambulatory PA through pedometer use, combined with regular, individualized, email-based feedback. Pedometer-measured PA and individualized feedback may be a practical and easily applied intervention.