A Comparison Between Selected Noncommunicable Disease Mortality Rates Between 2010 and 2016 Among Selected Southern African Countries

Researchers have identified cancer, diabetes mellitus, cardiovascular, and respiratory diseases as being the principal pathologies of increased aged standardized death rates (ASDRs) among noncommunicable diseases (NCDs). The objective of this study was to compare the change in the ASDR of these principal NCDs between the years 2010 and 2016 in Botswana, Mozambique, Namibia, South Africa, and Zimbabwe. ASDR data were collected from the 2016 Global Health Estimate. Among the selected Southern African countries for both 2010 and 2016, the order of prevalence of NCDs linked to increased ASDR was cardiovascular diseases (both cardiac and stroke), cancer, diabetes mellitus, and chronic respiratory diseases. The percentage of the total number of NCDs linked to increased ASDR in relation to total deaths increased from 43.8% (in 2010) to 51.0% (in 2016) from (p < .0001). The percentage of principal NCDs in relation to total ASDR increased from 33.0% (in 2010) to 38.2% (in 2016; p < .0001).

Ergonomic Principles as an Adjunct to the Profession of Biokinetics

Work-related injuries date back to antiquity. Attempts to resolve these work-related challenges have, inter alia, led to the establishment of the professions of Ergonomics, Occupational Therapy, Physiotherapy, Occupational Hygiene, and Biokinetics. The objective of this article is to illustrate the value of Ergonomic principles as an adjunct to the profession of Biokinetics. Insofar as Ergonomics addresses the physical and environmental risks which predispose and precipitate injuries, the profession of Ergonomics is primarily concerned with the practice of eradicating work-related challenges that impede human-machine interfacing, and which adversely influence work productivity and employee health. While Occupational Therapy and Biokinetics, by rehabilitating work-related injuries, assist in improving working conditions, little is known about the exact interface between the professions of Ergonomics and Biokinetics. The Google Scholar database was consulted in order to determine the relationship between Ergonomics and Biokinetics. The key words used were ergonomics and biokinetics and lead to the identification of 545 records, none of which pertained to the aforementioned subject. A subsequent search was conducted using the key words work-related musculoskeletal injuries and biokinetics. This search identified 925 records, the number of which were reduced to 42 (4.76%) after the exclusion of patents (n = 24), citations (n = 3), and nonbiokinetic work-related injury research (n = 856). Given that many work-related injuries are managed through the use of biokinetic rehabilitation, knowledge of the physical ergonomic risk factors at play will afford biokineticists an enhanced understanding of the etiology of work-related injuries, thereby helping to improve the vigor of the rehabilitation.

Are There Sufficient Number of Exercise Therapists in South Africa In Order To Equitably Manage the Noncommunicable Disease Epidemic?

The mortality of South African noncommunicable diseases (NCDs) is rising. One of its primary contributors is physical inactivity. Therefore, South African National Health Plan included exercise therapy as part of their strategy to inhibit the NCDs upsurge. This study aimed to determine whether the number of South African exercise therapists is sufficient to equitably manage this NCD epidemic. The 2013 and 2017 Health Professions Council of South Africa reports identified the number of physiotherapists, biokineticists, and their respective students-in-training. In 2012, 10,623,820 people were identified with NCDs; however, South African Department of Health only treated 6,058,186 patients (57.0%) ( p < .05). South African Health Review has estimated a 28.7% increase in the number of NCDs patients treated from 2012 (6,058,186) to 2025 (7,799,770) ( p < .05). The average yearly growth of practicing physiotherapists (3.4%) and the physiotherapy student-in-training (2.2%) is inequitable to manage this NCD epidemic. In 2012, the extrapolated physiotherapist-to-NCD patient ratio was 1:5667. The South African Department of Health should consider including biokineticists to aid in the management of the NCD epidemic.

The benefits of hydrotherapy to patients with spinal cord injuries

Background

Many patients with spinal cord injury (PWSCI) lead sedentary lifestyles, experiencing poor quality of life and medical challenges. PWSCI don’t like to participate in land-based-exercises because it’s tedious to perform the same exercises, decreasing their rehabilitative compliance and negatively impacting their well-being. An alternative exercise environment and exercises may alleviate boredom, enhancing compliance.

Objectives

Discuss the benefits of hydrotherapy to PWSCI concerning underwater gait-kinematics, thermoregulatory and cardiovascular responses and spasticity.

Methodology

A literature surveillance was conducted between 1998 and 2017, through the Crossref meta-database and Google Scholar, according to the PRISMA procedures. Key search words were water-therapy, aquatic-therapy, hydrotherapy, spinal cord injury, rehabilitation, human, kinematics, underwater gait, cardiorespiratory, thermoregulation and spasticity. The quality of each paper was evaluated using a modified Downs and Black Appraisal Scale. The participants were records pertaining to PWSCI and hydrotherapy. The outcomes of interest were: hydrotherapy interventions, the impact of hydrotherapy on gait-kinematics, thermoregulation during water submersion and cardiorespiratory function of PWSCI. Omitted records included: non-English publications from before 1998 or unrelated to hydrotherapy and PWSCI. The record screening admissibility was performed as follows: the title screen, the abstract screen and the full text screen.

Results

Literature search identified 1080 records. Upon application of the exclusion criteria, 92 titles, 29 abstracts and 17 full text records were eligible. Only 15 records were selected to be included in this clinical commentary. Evidence shows a paucity of randomised control trials (RCT) conducted in this field.

Conclusion

Hydrotherapy improves PWSCI underwater gait-kinematics, cardiorespiratory and thermoregulatory responses and reduces spasticity.

The health benefits and constraints of exercise therapy for wheelchair users: A clinical commentary

BACKGROUND

There are approximately 1 billion people living with chronic lower limb disability, many of whom are wheelchair users.

OBJECTIVES

Review cardiometabolic and neuromuscular risk profiles of wheelchair users, benefits of regular exercise and the causes of neuromuscular upper limb and hip injuries that hinder regular adherence.

METHOD

Literature published between 2013 and 2017 was adopted according to the standard practices for systematic reviews (PRISMA) through Crossref Metadata and Google Scholar searches. Individual paper quality was evaluated using a modified Downs and Black Appraisal Scale.

RESULTS

The literature search identified 16 600 papers which were excluded if they were non-English, non-peer-reviewed or published before 2013. Finally, 25 papers were accepted, indicating that sedentary wheelchair users have poor cardiometabolic risk profiles (PCMRP) because of a lack of physical activity, limiting their quality of life, characterised by low self-esteem, social isolation and depression. Their predominant mode of physical activity is through upper limb exercises, which not only improves their cardiometabolic risk profiles but also precipitates neuromuscular upper limb overuse injuries. The primary cause of upper limb injuries was attributed to poor wheelchair propulsion related to incorrect chair setup and poor cardiorespiratory fitness.

CONCLUSION

Wheelchair users have a high body mass index, body fat percentage and serum lipid, cholesterol and blood glucose concentrations. Empirical investigations illustrate exercise improves their PCMRP and cardiorespiratory fitness levels. Although literature encourages regular exercise, none discusses the need to individualise chair setup in order to eliminate wheelchair pathomechanics and upper limb neuromuscular injuries. Wheelchair users must be encouraged to consult a biokineticist or physiotherapist to review their wheelchair setup so as to eliminate possible incorrect manual wheelchair propulsion biomechanics and consequent overuse injuries.

The challenges of underweight and overweight in South African children: are we winning or losing the battle? A systematic review

Underweight and overweight are adverse effects of malnutrition and both are associated with negative health consequences in children and adolescents. In South Africa, the burden of economic and social disparity coexists with malnutrition in children. The purpose of this study was to review available South Africa studies regarding the comprehensive summary of prevalence of underweight and overweight and evaluates government policies in addressing undernutrition and overnutrition in South African children and adolescents. We searched subject-specific electronic bibliographic databases of observational studies published on malnutrition, undernutrition, overnutrition, underweight and overweight in South African boys and girls from birth to 20 years of age in studies published on or after 1990. A total of sixteen cross-sectional, three longitudinal studies and one report met the criteria for inclusion in this review. Descriptive data synthesis revealed the small number of longitudinal studies highlights the dearth of research in tracking undernutrition and overnutrition in South African children. In this review, 0.7%-66% of underweight was reported among children in rural areas compared to a 3.1%-32.4% of overweight in urban areas. All studies reported a higher rate of underweight in boys than girls who were significantly more likely to have higher body fat. The data indicated that both underweight and overweight were positively related with health-related physical activity and psychological health problems such as low activity, low fitness, low self-image and self-esteem. Numerous recommendations were made in the reviewed studies, however effective strategic programs in eradicating both underweight and overweight are minimal. It is evident from the reviewed studies that the burden of underweight and overweight are still a problem in South African children. The most highly affected by underweight are rural children, while children in urban areas in transition are faced with burden of overweight. There is little evidence to suggest that government strategic programs are effective in addressing underweight and overweight in South African children. Based on these findings, sustainable school-based feeding schemes and physical education programmes are needed for optimal benefits in children and adolescents.

Epidemiological reference ranges for low-density lipoprotein cholesterol and apolipoprotein B for identification of increased risk of ischaemic heart disease

Although there is widespread acceptance that total cholesterol (TC) value reference ranges should be based on epidemiological rather than statistical considerations, the epidemiological action limits for low-density lipoprotein cholesterol (LDL-C) are still incomplete and only statistical reference ranges for apolipoprotein B (Apo-B) levels are available. The combined use of epidemiological reference ranges for TC and incomplete or statistical reference ranges for LDL-C and Apo-B is illogical, since these parameters may fall into discordant risk categories that will hamper and complicate the management of hypercholesterolaemia. Based on a study of lipograms obtained from +/- 3,000 inhabitants of two industrialised Transvaal towns, the age-related epidemiological reference ranges for LDL-C and Apo-B were established. A comparison with published observational studies of other populations, in which comparable lipid, lipoprotein and apolipoprotein methodologies were used, reflected the severity of these lipid-related abnormalities in white South Africans, especially after the age of 30 years. In addition, the serum TC values found in this survey were not significantly different from those obtained 10 years ago.