Browsing by Author "Fryer, Bradley James"

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    A community-based lifestyle intervention program for adults with type 2 diabetes mellitus in a low socio-economic status community
    (Stellenbosch : Stellenbosch University, 2016-03) Fryer, Bradley James; Terblanche, Elmarie; Stellenbosch University. Faculty of Education. Dept. of Sport Science
    ENGLISH ABSTRACT : The prevalence, and associated burden of type-two diabetes mellitus (T2DM), is rapidly increasing globally, and in South Africa, with men and women of all ages being affected. While there has been an extensive research into the pathophysiological mechanisms, and to some extent, the management of T2DM, healthcare systems are still not able to adequately deal with the increasing number of patients being diagnosed with the disease. Professional- and community-led lifestyle interventions have recently showed the most promise in combating T2DM. There is however, a paucity of data on comprehensive lifestyle interventions in communities of low socio-economic status (SES), where the incidence of T2DM and its related complications is high. The primary aim of this study was to determine the effectiveness of a community-based, 10-week lifestyle intervention on physiological, psychological and health-related outcomes in adults suffering with T2DM in a low SES community. Forty-three participants completed the study (age 59.5 ± 12.2 years, 25 Women; 18 Men), of which 23 made up the experimental group (EXP; BMI: 33.8 ± 7.5; HbA1c: 8.8 ± 2.1) and 20 made up the control group (CON; BMI: 34.4 ± 9.7; HbA1c: 9.4 ± 2.3). The control group completed a pre- and post-testing session, while experimental completed an additional post-testing retention session. The experimental group participated in a 10-week comprehensive lifestyle intervention. A number of anthropometric, cardiovascular and functional measurements were carried out, and questionnaires related to health-related quality of life (HRQoL), social support, dietary habits and lifestyle behaviours, as well as health professional usage were also administered. Following the 10-week comprehensive lifestyle intervention, there was a positive change in the outcome variables measured. There was a statistically significant decrease (p < 0.05) in body fat percentage, diastolic blood pressure and HbA1c, with a statistically significant increase in the total distance walked during the six-minute walk test (6MWT) (p < 0.05). Furthermore, there was a statistically significant improvement (p < 0.05) in all but three of the HRQoL domains. Dietary habits and lifestyle behaviours improved significantly (p < 0.05), with the exception of eating times where there was no change. The frequency at which the participants actively sought professional assistance with the management of their T2DM did not change significantly (p > 0.05). The results from the retention period, obtained 10-weeks after the conclusion of the intervention, suggest that the changes as a result of the program were maintained, however, it is uncertain if those results can be attributed to the use of the post-intervention guide. The findings of this study indicate that a 10-week comprehensive lifestyle intervention is effective in improving physiological, psychological and health-related outcomes in adults with T2DM living in a low SES community. The use of a post-intervention guide as an assistive device to maintain these improvements requires further investigation and revision. Furthermore, this study reveals the opportunity for community-based interventions to assist the primary healthcare sector in the management and prevention of T2DM.
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    The relationship between task complexity and cerebral oxygenation in stroke patients
    (Stellenbosch : Stellenbosch University, 2013-03) Fryer, Bradley James; Terblanche, Elmarie; Stellenbosch University. Faculty of Education. Dept. of Sport Science.
    ENGLISH ABSTRACT: There are a growing number of men and women world-wide who are suffering strokes due to poor lifestyle-related habits. While there is evidence of the differences in cerebral haemodynamics between stroke patients and both elderly and young healthy individuals, limited evidence has examined the effect of rehabilitation on cerebral haemodynamics. Furthermore, most studies have examined changes in cerebral haemodynamics during cognitive and functional tasks in isolation, with no literature published on them simultaneously. The primary aim of this study was to examine whether differences in cerebral haemodynamics exist between stroke patients and healthy elderly individuals while performing a simple and complex cognitive task. Thirty two men and women (age 75 ± 8 years) volunteered to participate in the study and were split into an experimental (n = 14) group consisting of stroke patients and a control (n = 18) group consisting of healthy individuals. Each participant was required to attend one testing session where measurements of oxyhaemoglobin (O2Hb), deoxy-haemoglobin (HHb), tissue oxygenation index (TOI) and total haemoglobin index (THI) were obtained. Measurements were obtained with the participants at rest, while performing the Mini Mental State Exam (MMSE) and the modified Stroop Task as cognitive tests, and the Timed Up-and-Go (TuG) and six minute walk test (6MWT) or Toe Taps (TT) as the functional tests. Furthermore, the outcome scores of the various tests were also recorded. Change in O2Hb levels were lower in the experimental group than in the control group, especially in the left prefrontal cortex (LPFC) while HHb values were higher in the right prefrontal cortex (RPFC) (p > 0.05). There were almost no differences in TOI between the two groups in either the LPFC or RPFC, however, statistically significant differences were seen in THI in the RPFC during the MMSE (p = 0.03), rest period 2 (p = 0.03), the first modified Stroop Task (p = 0.04), as well as the TuG (p = 0.02). Furthermore, significant differences were seen between the two groups with respect to the time taken to complete the TuG, with the experimental group completing it much faster (p = 0.04). The experimental group participants who had received regular rehabilitation performed consistently better across most of the testing phases, with a number of practically significant findings. The results show that definite differences exist between stroke patients and healthy elderly individuals when performing a simple and complex task. The positive effect of low intensity exercise on task performance was clearly seen in both groups, and holds a great deal of practical significance for the development of exercise programmes for healthy individuals, as well as stroke patients. Furthermore, rehabilitation following a stroke has obvious benefits as shown by the positive results of the current study, however, limited research exists to validate these findings, highlighting the need for further research in this area.