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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