Individualized supervised resistance training during nebulization in adults with cystic fibrosis

Background and Objective: Since dyspnea limits exercise adherence and intensity in cystic fibrosis [CF] patients, engaging in resistance training [RT], which causes less dyspnea than other exercise modalities, while using nebulizers could not only overcome this barrier, but also enhance long-term adaptations to treatment. The objective of this study was to examine the effects of RT during nebulization on spirometry, anthropometry, chest wall excursion, respiratory muscle strength and health-related quality of life [HRQOL]

Methods:Fourteen male and female CF patients were assigned to a four-week, 20-minute, 5-day per week proof-of-concept RT group [RTG] [n=7] or non-exercising control group [CON] [n=7], with 3 CON patients later dropping out of the study. Patients performed whole body exercises for 3 sets of 10 reps using resistance bands, since such bands have previously demonstrated a greater effect on functional exercise capacity than conventional RT in lung patients

Results:The RTG displayed significant [p

Conclusion:This small scale proof-of-concept investigation demonstrates the multiple and simultaneous benefits of RT during nebulization in CF patients. The improvements in pulmonary measures are particularly promising especially since this study only made use of a four-week experimental period. This study provides an important alternative, time-saving treatment for the CF patient that does not add to the treatment burden of CF patients

Shoulder injury incidence and severity through identification of risk factors in rugby union players

This study aimed to analyze shoulder injury incidence and severity to reduce players' risk of sustaining injuries and missing playing time. Ninety-five South African Premier team rugby Union players [mean: 25 years of age] took part in the study with injury data collected through the use of injury reports. This study found that approximately two of every five participants sampled incurred a primary shoulder injury with dislocation being the most prevalent. Twenty-one [80.8%] of the participants that experienced a primary shoulder injury also sustained a secondary shoulder injury with rotator cuff tears being most predominant. Only three players were found to have suffered tertiary shoulder injuries. The injuries were mainly related to tackling during training and matches. Twenty players were found to have adhered to a strength and conditioning program prior to their injuries and 14 of the injured participants received or adhered to a prehabilitation program. Eight of the injured players also suffered from recurrent injuries with dislocations being the most common. Results indicated that specific positions in rugby are at higher risk of shoulder injuries than others and that with the correct preventive measures put in place, the severity of injuries can be reduced

Are rural South African children abdominally obese?

While available data exist on total body fat of rural South African children, as measured by body mass index, little is known concerning the abdominal obesity of rural South African children. The aim of this study was to determine the prevalence of abdominal obesity among rural South African children. Participants involved 1 172 rural black school children [541 boys and 631 girls] aged 10-16 years, residing in Mankweng and Toronto, both rural black settlements in Capricorn district, Limpopo province, South Africa. Height, weight and waist circumference were measured using standard techniques. Waist-to-height ratio [WHtR] was calculated. A WHtR /= 0.5 was 69 [12.8%], while girls were 92 [14.6%]. The highest proportion of WHtR occurs at age 11 in boys, while this proportionality increases with age in girls, peaking at ages 14-16 years. Overall, 161 [13.7%] children had central obesity. This study indicates that abdominal obesity as measured by WHtR is prevalent among rural black South African children. The prevalence of WHtR >/= 0.5 [13.7%] among the children is worrisome, as its signals the presence of obesity-related problems and the likely susceptibility of these sample children to future health risks. Therefore, interventions strategies are needed to reduce central obesity among children

Centripetal fat patterning in South African children

The waist-to-stature ratio [WSR] is newly developed index, proposed to be of greater value as a simple anthropometric indicator, for predicting abdominal obesity and related cardiovascular co-morbidities in adults and children. This study examined age and gender differences in waist-to-stature [WSR] as measure of centripetal fat patterning in a sample of children in Pretoria, South Africa. A cross-sectional study of 1136 schoolchildren [548 boys and 588 girls] aged 9-13 [11.2 +/- 1.3] years were studied. Anthropometric measurements included body mass, stature and waist circumference. WSR was calculated by dividing waist circumference [in cm] by stature [in cm]. Data were analysed using means and standard deviation. The parametric t-test was applied to examine sexual dimorphism in fat patterning among the children. The proportion of children with a WSR /= 0.5 was 47 [8.6%], while girls were 108 [18.4%]. The prevalence of central obesity [WSR >/= 0.5] was found at all age and sex categories with the highest prevalence rate found at age 13 in both sexes. The fact that WSR >/= 0.5 [13.6%] was found in these children, even among the youngest, is a cause for concern since obesity-related problems are likely to be present among the children. The need to design and implement appropriate intervention strategies at school and community levels is evident

Static standing posture and pulmonary function in moderate-persistent asthmatics following aerobic and diaphragmatic breathing training

The present study evaluated and compared the effects of aerobic and diaphragmatic breathing training on static standing posture and its relation to effort-dependant pulmonary function in moderate-persistent asthmatics. Sixty-six inactive, moderate-persistent asthmatics were matched and randomly assigned to an eight-week, three times weekly aerobic training [At], diaphragmatic breathing training [Db] or as part of a non-exercise control [No] group. At walked and jogged at 60%HR[max]. Db performed diaphragmatic breathing combined with inspiratory resistive breathing at varying inspiration, expiration ratios while control group received no structured exercise. Following At and Db, significant improvement were found in FVC [At:p=0.001;Db:p=0.000], FEV[1] [At:p=0.000;Db:p=0.000], PEF [At:p=0.012; Db: p=0.000] and IVC [At:p=0.006;Db:p=0.000]. Only At improved MVV [p=0.000]. At and Db did not significantly change the position of their knee [At:p=0.296;Db:p=0.247], hip [At:p=0.236;Db:p=0.383], shoulder [At:p=0.289;Db:p=0.509] and anterior auditory meatus [At:p=0.207;Db:p=0.198]. Both At and Db improved pulmonary function in asthmatics despite no changes in posture suggesting that both modes may be a useful adjuvant therapy in moderate-persistent asthmatics for optimized asthma management

Diagnosis and eradication of helicobacter pylori in patients with duodenal ulceration in the community

To determine the value of Helicobacter pylori [Hp] serology in diagnosis of active Hp infection in patients with documented duodenal ulcer [DU] and to directly compare the efficacy and side-effects profiles of metronidazole or tinidazole in a triple therapy regimen to eradicate active Hp infection. Prospective, single-blinded, randomised trial. One hundred patients from General Practice with documented DU and Hp seropositivity had a C14 Urea Breath Test [UBT]. Those who tested positive were randomised to receive one-week, twice daily omeprazole 20 mgs and clarithromycin 250 mgs in combination with metronidazole 400 mgs [OCM] or tinidazole 500 mgs [OCT]. Eradication was confirmed by a repeat UBT. Eighty five sero-positive patients had a positive pre-treatment UBT. On intention to treat basis, OCT [100%] had a significantly better eradication rate than OCM [87.8%], p = 0.023. There was no difference in side effects. [1] Positive Hp serology in patients with DU does not always mean active infection and [2] for patients in the community with active Hp and DU disease OCT is significantly better than OCM for eradicating Hp

Impact of helicobacter pylori eradication on dyspeptic symptoms in the community

Eradication of Helicobacter pylori [Hp] will cure most Hp positive duodenal ulcers [DU]. However, after such treatment, patients often continue to get dyspeptic symptoms. The effects of Hp eradication in patients with proven DU on gastro-oesophageal reflux disease [GORD] symptoms are controversial. Aims: To study any changes in patient's symptoms following eradication of Hp in the setting of chronic DU and its effects on the need for continuing treatment for acid suppression. Eighty out of 85 patients [94%] from general practice with documented successfully eradicated Hp with a week long triple therapy regimen. Their symptoms and requirement for acid suppression treatment were studied at enrolment and after successful eradication of Hp for a median of 17 months. Eighty one% patients had improvement in ulcer-type symptoms. 21% developed new GORD symptoms. 68% discontinued long-term acid-suppression treatment. 79% requiring continued acid suppression therapy had new or continued GORD symptoms. Patients in the community with Hp positive DU disease after eradication, 81% patients got symptomatic improvement, two third discontinued their acid suppressing therapy but 21% developed new GORD symptoms. Among those who required continued acid suppression, 79% had GORD symptoms