RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCE
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCE
BANGALORE
PROFORMA FOR REGISTRATION OF SUBJECTS FOR
DISSERTATION
| | | AVANTI. S.IRDE |
|1. |Name of the candidate and address |Flat B-35, Block I, 3rd Floor, Builders Apartments, Next to INTEL, |
| | |Airport Road, Bangalore-560017 |
| | | |
|2. |Name of the Institution | |
| | |Kempegowda Institute of Physiotherapy, Bangalore-560004 |
| | | |
|3. |Course of Study and Subject |M.P.T (Cardio-respiratory disorders and Intensive Care) |
| | | |
|4. |Date of Admission |9th June 2008 |
| | |
|5. |Title of the Topic: |
| |“Comparative study on effects of Swiss Ball and Conventional Floor Exercises for the reduction of Abdominal Fat in |
| |Postmenopausal Women.” |
|6. |Brief resume of the intended work |
| |6.1 Need for the study: |
| | |
| |The term ‘menopause’ is used for the last menstrual flow experienced by a woman. Menopause occurs at an age of 45-55 |
| |years, is defined as “a woman’s final menstrual period.”(1) It results from lack of endometrial stimulation by |
| |estrogen as the ovarian follicles become depleted. Prevalence of obesity worldwide is high and is presently |
| |increasing. (2) |
| | |
| |Prior to the actual menopause, when periods are erratic, a woman may be referred to as being premenopausal and |
| |following the menopause as postmenopausal. (1) |
| | |
| |It varies with race, economic status and nutrition. Postmenopausal women following the climacteric usually have low |
| |levels of estrogen and progesterone with little fluctuation and no cyclicity. (2) Symptoms and problems are due to |
| |hormonal changes of menopausal transition, while others result from the ageing process and adverse lifestyle factors,|
| |eg. Sedentary behaviour, cigarette smoking, poor diet. (2) |
| | |
| |Some women experience severe problems as follows- |
| |Physical problems- frequent hot flushes, night sweats, vaginal soreness, dyspareunia, urinary disorders, and dry |
| |skin. (1) |
| |Mental problems- reduced concentration, loss of memory, inability to make decisions, anxiety, mood swings, |
| |irritability, tiredness and depression. (1) |
| | |
| |Abdominal obesity has steadily risen from 13-38% in men and 19-60% in women during 1999-2000. As they age, they lose |
| |both muscle and bone mass and gain fat, especially abdominal fat due to hormonal changes. These changes occur within |
| |the first 3-5 years after menopause. (3) Studies have shown that women with a waist circumference more than 43.3 |
| |inches are at a very high health risk. (4) The loss of muscle mass reduces the basal metabolic rate (BMR) making |
| |metabolism less efficient and the buildup of fat stores a constant, which increases the risk for the Metabolic |
| |Syndrome leading to heart disease, stroke, cancer and diabetes. (3) |
| | |
| |Physical fitness is vital to woman’s health. Decreasing activity levels and metabolic changes can lead to weight gain|
| |at menopause. Regular exercise can make the transition through menopause easier and carries benefits that can make |
| |the postmenopausal years far healthier (5) and reduces the long-term risk of cardiovascular disease, osteoporosis and|
| |obesity associated diseases (2), |
| |preservation of muscle mass and stabilization of bone mass. (6) |
| | |
| | |
| |A Swiss ball is used for exercise and also posture sitting. (7) It was invented in Italy in 1950. It is also known as|
| |‘exercise ball’ or ‘pezzi ball.’ It is made up of elastic, soft polyvinyl chloride (PVC) with a diameter of 35-95cm. |
| |(8) A full range of stretching, strengthening, aerobic exercises can be integrated with the Swiss ball. (7) |
| | |
| |The lists of exercises that I am using in my thesis work are as follows: |
| |Floor exercises: |
| |Abdominal/ Baby crunches. |
| |Knees to chest. |
| |Floor bicycle movement. |
| |Hip roll. |
| |Bridging. |
| |Side Lifts. |
| |Abdominal Oblique exercise. |
| |Hands to knees. |
| | |
| |Swiss ball exercises: |
| |Ball crunches. |
| |Hip rolls. |
| |Bridging. |
| |Seated circles. |
| |Sit-ups. |
| |Oblique crunches. |
| |Scissor leg reverse curl. |
| |Reverse twist. |
| | |
| |The following tools can be used to estimate the abdominal fat: |
| |Skinfold caliper (eg. Harpenden, Holtain, Slimglide, Lange, Omega). |
| |Measuring tape. |
| | |
| |From the above listed measuring tools, I will be considering Omega’s skinfold caliper and measuring tape for my |
| |thesis work. |
| | |
| |Hypothesis: |
| | |
| |Null Hypothesis: It may be seen that Swiss ball exercises or floor exercises may not be effective for reducing |
| |abdominal fat in postmenopausal women. |
| | |
| |Alternate Hypothesis: It may be seen that Swiss ball exercises may be more effective than floor exercises for |
| |reducing abdominal fat in postmenopausal women. |
| |6.2 Review of Literature: |
| | |
| |Jennifer L.Kuk (2007) studied the association between abdominal adiposity, exercises and waist circumference and |
| |concluded that regular exercises reduced the waist circumference. |
| | |
| |Few researchers in International Journal of Obesity (2006) conducted a study on women who walked and did exercises 3 |
| |times a week for 20 weeks and found that abdominal fat reduced by 18% amongst those women. |
| | |
| |S. J. Kay et al (2006) reviewed the relationship between excess abdominal tissue, visceral fat and the influence of |
| |physical activity on these and concluded that physical activity reduced the abdominal and visceral fat in overweight |
| |and obese subjects. |
| | |
| |Karen Richardson et al (2006) conducted a 5 year study if exercises helped in reducing abdominal cells in |
| |postmenopausal women and concluded that the people who did exercises regularly had 18% decrease in the size of their |
| |abdominal cells and fat. |
| | |
| |Sternfeld Barbara et al (2004) conducted a study on the relationship between physical exercises to weight and waist |
| |circumference in 3,064 women aged 42-52 years and concluded that exercise only prevents weight gain and maintains the|
| |waist circumference. |
| | |
| |Rosario et al (2003) compared between early and older postmenopausal women using strength training exercises and |
| |concluded that it increased muscle and bone mass in any person and reduces the abdominal fat. |
| | |
| |Dr. Anne McTiernan et al (2003) assessed the effect of exercises on overall and intra-abdominal obesity in |
| |postmenopausal women and concluded that exercise effectively reduces intra-abdominal fat. |
| | |
| |Cosio-Lima et al (2003) studied the effects of Physioball and conventional floor exercises on early phase adaptations|
| |in back and abdominal core stability and balance in women and concluded that physioball exercises reduced abdominal |
| |fat and improved core stability. |
| | |
| |Mary A. Shephard (2003) evaluated the effects of a year-long exercise program in 173 postmenopausal women who were |
| |not taking hormones, and concluded that exercise helped sedentary postmenopausal women lower their BMI, total and |
| |intra-abdominal fat percentages. |
| | |
| | |
| | |
| |Mayo M. J et al (2003) conducted study to see if abdominal fat is reduced in response to substantial weight loss |
| |induced by exercise and concluded that large exercise-induced weight loss was associated with preferential reduction |
| |in abdominal fat. |
| | |
| |R. Ross et al (2001) conducted study on whether exercise-induced weight loss was associated with corresponding |
| |reductions in total, abdominal and visceral fat in a dose response manner and concluded that increasing physical |
| |activity is associated with reduction in abdominal and visceral fat. |
| | |
| |Gaspard U et al (2001) conducted a study on the multiple benefits of physical exercise in postmenopausal women and |
| |concluded that exercises decreased total body fat mass and abdominal fat. |
| | |
| |Mona M. Shangold (1996) stated that aerobic and resistance exercises are most effective ways to reduce abdominal fat |
| |and treat weight gain. |
| | |
| |Rauramaa (1984) found that increased exercise is directly related to symptom reduction for abdominal obesity. |
| | |
| | |
| |6.3 Objective of the Study: |
| | |
| |To compare the effects of Swiss ball and conventional floor exercises for the reduction of abdominal fat in |
| |postmenopausal women as measured by skinfold caliper. |
| |To compare the effects of Swiss ball and conventional floor exercises for the reduction of abdominal fat in |
| |postmenopausal women as measured by measuring tape. |
| | |
|7. |Materials and Methods |
| | |
| |7.1 Study Design: Comparative Evaluation Study. |
| | |
| |Sample Size: 40 postmenopausal women. |
| |Sample Method: Simple Random Sampling. |
| | |
| | |
| |7.2 Source of Data: |
| | |
| |Postmenopausal women who are fulfilling inclusion and exclusion criteria residing in Builders Apartments, Bangalore. |
| | |
| | |
| |7.3 Methods of Collection of Data: |
| | |
| |a) Materials Used: |
| |1. Exercise Mats. |
| |2. Swiss Ball. |
| |3. Measuring Tape. |
| |4. Omega Skinfold Caliper. |
| |5. Stopwatch. |
| | |
| |b) Inclusion Criteria: |
| |1. Healthy postmenopausal women from the period of menopause till a period of 2 years after attaining menopause. |
| |2. 45-55 year old females. |
| |3. Women who have not had menstrual flow for a continuous of 6 months. |
| |4. Postmenopausal women with a waist circumference more than 40 inches. |
| | |
| |c) Exclusion Criteria: |
| |Lower Backache/ Lumbar problems. |
| |Women who have had a recent Hysterectomy. |
| |Women who have had any recent abdominal surgery. |
| |Rheumatoid Arthritis. |
| |Fractures of lower limbs. |
| |Sciatica (bilateral or unilateral involvement). |
| |Cardiac patients. |
| | |
| | |
| |7.4 Does the study require any investigation or interventions to be conducted on Patients or other humans or animals?|
| |If so, please describe briefly: |
| |Yes, an intervention on human subjects is required. |
| | |
| | |
| | |
| |Methodology: |
| | |
| |40 healthy postmenopausal women will be recruited for the studies that are fulfilling the inclusion and exclusion |
| |criteria. |
| | |
| |Subjects will be divided into 2 groups. |
| | |
| |Group ‘A’ and Group ‘B’ with each group consisting of 20 volunteers. |
| | |
| |Group ‘A’ will consist 20 postmenopausal women who will perform abdominal exercises on a Swiss ball 3 times a week |
| |for a period of 12 weeks which are as follows: |
| | |
| | |
| | |
| | |
| |Sl. No. |
| | |
| |Name of the exercise. |
| | |
| |No. of sets. |
| | |
| |No. of repetitions. |
| |Interval between the sets. |
| | |
| |1. |
| |Exercise ball crunches. |
| |2 |
| |15 |
| |20 sec |
| | |
| |2. |
| |Hip rolls. |
| |2 |
| |10 |
| |20 sec |
| | |
| |3. |
| |Bridging. |
| |2 |
| |12 (3-5sec hold) |
| |20 sec |
| | |
| |4. |
| |Seated circles |
| |1 |
| |15 |
| |- |
| | |
| |5. |
| |Sit-ups. |
| |2 |
| |10 (3-5sec hold) |
| |20 sec |
| | |
| |6. |
| |Oblique crunches. |
| |2 |
| |15 |
| |20 sec |
| | |
| |7. |
| |Scissor leg reverse curl. |
| |1 |
| |12 (3 sec hold) |
| |- |
| | |
| |8. |
| |Reverse twist. |
| |2 |
| |10 on each side |
| |20 sec |
| | |
| | |
| |Group ‘B’ will consist 20 postmenopausal women who will perform abdominal exercises on exercise mats3 times a week |
| |for a period of 12 weekswhich are as follows: |
| |Sl. No. |
| | |
| |Name of the exercise. |
| | |
| |No. of sets. |
| | |
| |No. of repetitions. |
| |Interval between the sets. |
| | |
| |1. |
| |Abdominal crunches. |
| |2 |
| |10 |
| |20 sec |
| | |
| |2. |
| |Hip rolls. |
| |2 |
| |10 |
| |20 sec |
| | |
| |3. |
| |Bridging. |
| |2 |
| |10 (3-5sec hold) |
| |20 sec |
| | |
| |4. |
| |Knees to chest. |
| |2 |
| |10 |
| |20 sec |
| | |
| |5. |
| |Hands to knees. |
| |2 |
| |10 (3 sec hold) |
| |20 sec |
| | |
| |6. |
| |Side lifts. |
| |2 |
| |10 |
| |20 sec |
| | |
| |7. |
| |Floor bicycle movement. |
| |2 |
| |15 |
| |20 sec |
| | |
| |8. |
| |Oblique exercise. |
| |2 |
| |10 on each side |
| |20 sec |
| | |
| | |
| |The abdominal fat will be recorded using measuring tape for waist measurements and Omega skinfold caliper. |
| | |
| |The waist circumference and skinfold measurement will be recorded on the first day and at the end of 2nd, 4th, 6th, |
| |8th, 10th and 12th week. |
| | |
| | |
| |Duration of the study: 1 Year. |
| | |
| | |
| |Statistical analysis: |
| |Student ‘t’ test (independent). |
| |Student ‘t’ test (dependent). |
| |Effect SBC (Bias corrected due to Hedges). |
| | |
| | |
| |7.5 Has Ethical clearance been obtained from your institution in case of 7.3? |
| |Yes |
|8. |List of references: |
| | |
| |Margaret Polden, Jill Mantle. Physiotherapy in Obstetrics and Gynaecology. Jaypee Brothers; 1990. p. 281-82. |
| | |
| |Mona M. Shangold. An active menopause: using exercise to combat symptoms. Phys Sportsmed 1996 Jul;24(7) |
| | |
| |Rosario, E.J, Villani, R.G, Harris, J et al. Comparison of strength-training adaptations in early and older |
| |postmenopausal women. J Aging Phys Act 2003;11:2 |
| | |
| |Welborn T A, Satvinder S Dhaliwal, Stanley A Bennett. Waist-hip ratio is a dominant risk factor predicting |
| |cardiovascular death in Australia. Med J Aust 2003;179(11) |
| | |
| |Archived Research: On the benefits of exercise for women. [Online]. Available from: URL: |
| | |
| | |
| |Ruth Sapaford Aua, Joanne Bullock-Saxton, Sue Markwell. Women’s Health: A textbook for Physiotherapists. Harcourt |
| |Brace & Company Asia PTE Ltd. Singapore; 1998. p. 319-21 |
| | |
| |Simonc. Swiss ball. [Online]. Available from: URL: |
| | |
| |Exercise ball. [Online]. Available from: URL: |
| | |
| |Jennifer L. Kuk. A study of associations between abdominal adiposity, exercise, morbidity and mortality [PhD Thesis].|
| |Ontario (Canada): Queen’s University. |
| | |
| |Ludmila M. Cosio-Lima, Katy L Reynolds, Christa Winter, Vincent Paolone, Margaret T. Jones. Effects of Physioball and|
| |Conventional Floor Exercises on Early Phase Adaptations in Back and Abdominal Core Stability and Balance in Women. J |
| |Strength Cond Res 2003 Nov;17 |
| | |
| |Irwin ML, Yasui Y, Ulrich CM, Bowen D, Rudolph RE, Schwartz RS et al. Effects of exercise on total and |
| |intra-abdominal body fat in postmenopausal women: a randomized controlled trial. JAMA 2003 Jan 15;289(3) |
| | |
| |Mary A. Shepard. Exercise-induced weight loss in postmenopausal women. Journal Watch Women’s Health 2003 Mar 5 |
| | |
| |S. J. Kay, M. A. Fiatarone Singh. The influence of physical activity on abdominal fat: a systemic review of the |
| |literature. Obes Rev 2006 May;7(2) |
| | |
| |Elizabeth Quinn. The Best and the Worst Ab Exercises. [Online]. 2008 May 11. Available from: URL: |
| | |
| | |
| |Ned D’Agostino. Four Simple Abdominal Exercises for Women. [Online]. 2008 Mar 21. Available from: |
| |URL: |
| | |
| |Kristen Woodward. Exercise melts a hidden peril: fat deep within the abdomen. [Online]. 2003 Jan 16. Available from: |
| |URL: |
| | |
| |R. Ross, I. Janssen. Physical activity, total and regional obesity: dose-response considerations. Med Sci Sports |
| |Exerc 2001 June;33(6) |
| | |
| |Karen Richardson, Karin Murphy, Mary Lyles, Jamehl Demons, Leon Lenchik, Barbara Nicklas. Exercise important in |
| |reducing size of abdominal fat cells. Int J Obes 2006. Aug |
| | |
| |Abdominal exercises. [Online]. Available from: URL: |
| | |
| |Skinfold measurement. [Online]. Available from: URL: |
| | |
| |Abdominal fat- Exercise is proven to reduce abs fat. Int J Obes 2006;30 |
| | |
| |Gaspard U, Buicu C, Creutz V. Multiple benefits of physical exercise in menopausal women. Rev Med Liege 2001 |
| |Apr;56(4) |
| | |
|9. |Signature of the candidate: Avanti. S. Irde |
| | |
|10. |Remarks of the guide: |
|11 Names and Designation Of: |
| | |Prof. R. Balasaravanan. M.P.T |
|11.1 |GUIDE: |Principal, K.I.P.T |
| | | |
|11.2 |SIGNATURE: | |
| | |Dr. Yogita. V |
|11.3 |CO-GUIDE: |M.B.B.S, M.S (OBG) |
| | |Lecturer/ Asst. Prof., KIMS |
| | | |
|11.4 |SIGNATURE: | |
| | |Prof. R. Balasaravanan. M.P.T |
|11.5 |HEAD OF THE DEPARTMENT: |Principal, K.I.P.T |
| | | |
|11.6 |SIGNATURE: | |
| | |
|12. |Remarks of the Chairman and Principal: |
| | |
| | |
| | |
| |12.2 Signature: |
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