Saudi Cultural Missions Theses & Dissertations
Permanent URI for this communityhttps://drepo.sdl.edu.sa/handle/20.500.14154/10
Browse
10 results
Search Results
Item Restricted The Effectiveness and Feasibility of Neuromuscular Electrical Stimulation after Fragility Fracture(University of Nottingham, 2024) Alqurashi, Helal; Robinson, Katie; Gladman, John; Gordon, Adam; Masud, Tahir; Piasecki, MathewFrailty, the vulnerable state seen in older people due to the cumulative effects of ageing and disease, is characterised by loss of muscle mass and muscle strength (sarcopenia). Older people living with frailty are prone to falls and fragility fractures, which necessitate hospital admission, resulting in further muscle loss and eventually leading to further disability. Rehabilitation exercise can reduce these consequences but is not always possible or adequate due to factors such as pain and fatigue. An alternative or additional technique is Neuromuscular Electrical Stimulation (NMES), which stimulates muscle contractions via an electrical stimulus applied to the skin overlying the muscles. The aim of this PhD thesis was to investigate the feasibility and efficacy of NMES on neuromuscular function in patients after fragility fracture. To explore the evidence regarding the effectiveness of NMES in hospitalised patients, I conducted a systematic review and meta analysis. This is reported in Chapter 2. Across the 42 identified papers, NMES was proven to be safe, albeit with a small incidence of minor discomfort. The meta-analysis revealed that NMES had a small effect on muscle strength (moderate certainty) (SMD = 0.33; P < 0.00001), a moderate effect on muscle size (moderate certainty) (SMD = 0.66; P < 0.005), a small effect on walking performance (moderate certainty) (SMD = 0.48; P < 0.0001) and a small effect on functional mobility (low certainty) (SMD = 0.31; P < 0.05). There was a small and non-significant effect on health-related quality of life. However, the effects of NMES on length of hospital stay, and molecular and cellular biomarkers were unclear. These findings showed that NMES may be a promising intervention for rehabilitation after fragility fracture. I then contributed to and took over the management of a feasibility study of NMES in patients admitted to hospital due to fragility fractures. The main results of this are reported in Chapter 3. The aim of the study was to evaluate the feasibility and effectiveness of NMES in patients with fragility fractures. The objectives included assessing the willingness and ability of patients to receive NMES, examining compliance and acceptability of NMES treatment, and identifying recruitment parameters and suitable outcome measures for a randomised clinical trial with clinical outcomes. The study was conducted in two phases: 1) in the hospital only, and 2) hospital, rehabilitation centres, and participants’ homes. Patients with fragility fracture were randomised to receive NMES for 6 weeks/discharge either to the right or left leg, with the other leg serving as control. NMES was applied to quadriceps and tibialis anterior muscles for 30 minutes, 3 days/week. Sessions were progressed to achieve 60 minutes, 5-7 day/week. Feasibility outcomes included participant characteristics, recruitment rate, tolerability, and number of NMES sessions. Clinical outcomes included muscle strength, and ADL at six months. The findings showed that 1052 patients were identified, of whom 113 (11%) were eligible, and 29 (3%) were recruited (median Clinical Frailty Score 3, median Barthel ADL score 93/100). The recruitment rate was 0.45/week in phase 1 and 0.9/week in phase 2. 53% achieved the target of 24 NMES sessions. 5/29 withdrew due to intolerance of NMES. Leg muscle strength improved in both treated and untreated legs, with marginally greater improvement observed in the tibialis anterior of treated legs. It became clear during the feasibility study that hospital-based NMES was unlikely to be feasible, but that NMES might be more feasible if home-based NMES. In view of the limited use of this technique in fragility fracture patients at home, I utilised an action research iv approach to optimise the use of NMES in this group and setting whilst the feasibility study continued. The findings of this and those of semi structured interviews of participants reported in Chapter 4. The observational process highlighted issues related to the stimulation of tibialis anterior muscle, which could be overcome. Themes identified through interview included acceptability, safety, practicality, user experience, training, and support, and how and when. This sub-study reinforced the findings of the quantitative aspect of the feasibility study, confirming the safety and acceptability of NMES. In summary, my literature review has indicated that NMES is a potentially useful treatment to prevent and reverse the muscular consequences of hospitalisation for fragility fracture. Furthermore, the feasibility study has shown that trials of NMES in fragility fractures are feasible, albeit in a minority of mildly frail fragility fracture patients with little premorbid disability. I have argued that such trials should use home-based, self-administered NMES, and should consider this intervention as an adjunct to, rather than a replacement of, a rehabilitation programme. Additionally, the findings derived from this thesis serve as valuable insights for designing future randomised controlled trials, which is a necessary step before NMES becomes a routine part of clinical care.11 0Item Restricted Exploring the Challenges and Opportunities Involved in Increasing Physical Activity among Children and Young People in Saudi Arabian Schools(The University of Sheffield, 2024-05) Alalawi, Abdullah; Goyder, Elizabeth; Blank, LindsayBackground: The growing global burden of noncommunicable diseases, exacerbated by insufficient physical activity (PA), is a significant health issue in the Kingdom of Saudi Arabia (KSA). Cultural and environmental factors limit opportunities for PA, especially among school children in urban areas. Aim: This study explores the challenges and opportunities for school-based PA to inform future interventions among schoolboys aged 13 to 15 years in KSA. Methods: Systematic reviews assessed international and Arabic country-specific evidence for school-based PA interventions. Qualitative data were collected through semi-structured interviews with 16 school staff, seven parents and workshops with 37 students in two contrasting schools one private and one public sector in Jeddah City, KSA. Follow-up interviews were conducted with a total of nine school staff members at both schools. Results: Review evidence identified promising interventions for increasing PA in schools including The Daily Mile, active breaks, active desks, and multi-component programmes. In Arabic countries, interventions focusing on PA, nutrition, and education showed potential to increase PA and decrease BMI. Primary research revealed that PA among adolescents is influenced by multiple factors. Individual-level motivators included enjoyment, competition, and health benefits, while barriers comprised academic pressures and sedentary preferences. Interpersonally, variable support from parents, friends, and teachers impacted PA levels. Organisationally, the school environment, facilities, and policies affected PA availability. Community-level insights indicated broader societal and policy interventions, including adapting international programmes to local contexts. Conclusion: This study underscores the need for a multi-dimensional approach to enhance PA among adolescents in Jeddah. Stakeholders should pilot and adapt effective international PA interventions, address school resource disparities, increase PA time in the curriculum, and enhance parental awareness about PA’s importance. These measures are crucial for creating an environment that supports PA to improve public health and enhance youth well-being in KSA.7 0Item Restricted Vision 2030 and Sports Policy in Saudi Arabia: Shaping National Development and Global Impact(Loughborough University, 2024-09) Turkistani, Saleh; Piggin, JoeThis study examines the evolution of Saudi Arabia’s sports policy under Saudi Vision 2030, focusing on three key areas: physical activity, sports infrastructure, and the hosting of sports mega-events (SMEs). The research aims to explore how these policies have developed to support economic diversification, enhance quality of life, and position Saudi Arabia as a global sports hub. Employing a qualitative approach, the study uses policy and documentary analysis guided by the Interpretative Policy Analysis (IPA) framework, along with concepts of soft power and nation-branding. The findings reveal that initiatives such as the Quality-of-Life programme (QOLP) and the Sports for All Federation (SFA) have effectively increased sports participation, particularly among women, while significant investments in sports infrastructure have facilitated community engagement and prepared the Kingdom to host major international events. Hosting SMEs, framed as part of Saudi Arabia's nation-branding strategy, is shown to contribute to economic growth and international recognition. This study highlights the interconnected nature of physical activity promotion, investment in sport infrastructure, and major event hosting, illustrating how sports policies are vital to achieving the objectives of Saudi Vision 2030. The research offers insights for policymakers, sports management professionals, and academics on the potential of sports as a tool for national development and global influence.12 0Item Restricted Exploring the Barriers to Physical Activity During Pregnancy in Saudi Arabia: A Systematic Review(Swansea University, 2024-09-30) Alhussain, Maha; Ikpeme, MoBackground: Engaging in regular physical activity (PA) during pregnancy is crucial for improving maternal and fetal health outcomes. Activities range from light exercises, like walking, to more structured moderate-intensity activities. Guidelines from the American College of Obstetricians and Gynecologists (ACOG) recommend pregnant women engage in at least 150 minutes of moderate-intensity PA per week, yet global adherence rates, particularly in Saudi Arabia, remain low due to various barriers. Methods: A comprehensive literature search was conducted across six databases, including Embase, Web of Science, Medline, PubMed, ASSIA, and APA PsycInfo. The review focused on studies addressing barriers to PA among pregnant women in Saudi Arabia. The SPICE framework guided the search strategy, and the Joanna Briggs Institute (JBI) Critical Appraisal Checklist was used to assess study quality. Results: Out of 1,138 studies identified, five were included in the final review. Key barriers identified included sociodemographic factors such as age, education, and number of pregnancies. Cultural beliefs and lack of knowledge were significant barriers, with many women believing exercise could harm their pregnancies. Social influences, particularly family discouragement, and environmental factors, such as lack of access to safe exercise facilities, further hindered PA. Additionally, women cited fatigue, lack of time, and motivation as major personal barriers to engaging in regular exercise during pregnancy. Conclusion: The review identified several barriers that prevent pregnant women in Saudi Arabia from engaging in regular PA. Cultural beliefs, social norms, and limited knowledge about the benefits of PA contribute to these challenges. Environmental factors and personal barriers like fatigue and time constraints also play a significant role in reducing PA levels during pregnancy. Addressing these barriers through education and access to resources may help improve PA participation rates and enhance maternal health outcomes.8 0Item Restricted Gestational Diabetes Mellitus and Physical Activity: Exploring the Issues among Asian Population in the UK and Advocating for Policy Change: A Mixed-Method Study(University of Nottingham, 2024-07) Alaslani, Hadeel; Adams, Gary; Shaw, IanBackground and aim: Gestational Diabetes Mellitus (GDM), a glucose intolerance disorder resulting in hyperglycaemia, affects approximately one in every 23 pregnancies in the United Kingdom (UK). Compared to other ethnic groups in the UK, Asian-born women have a higher rate of GDM (5.8%). Physical activity is reported to have numerous benefits for both the expectant mother and foetus, such as improving insulin sensitivity and reducing the risk of developing GDM. This study examines the patterns of physical activity that impact GDM occurrence among Asian pregnant women living in the UK by: 1) assessing the association between patterns of physical activity engagement by Asian pregnant women and GDM occurrence; 2) gaining insight into Asian women’s knowledge of GDM and identifying barriers to and enablers of physical activity during pregnancy. Method: This research employed an explanatory sequential mixed method design comprising two phases. Data for the first phase were collected from 75 participants using a Pregnancy Physical Activity Questionnaire (PPAQ). In the second phase, semi-structured interviews were conducted with 13 participants. Findings: Chi-squared test and logistic regression analysis revealed no significant association between physical activity based on different variables during pregnancy and GDM occurrence in the first phase. However, sports/exercise, occupational, and light-intensity physical activities indicated a protective effect against GDM. Thematic analysis in the second phase identified four themes aligned with the socioecological model framework underpinning the study context. Both quantitative and qualitative findings were integrated into a joint display table to enable an in-depth evaluation of the interactions among intrapersonal, interpersonal, and environmental factors influencing changes in physical activity behaviour among pregnant Asian women. Conclusions and recommendations: This thesis has made a unique contribution to existing knowledge on physical activity during pregnancy and the occurrence of GDM among Asian women in the UK. Application of the socioecological model provided evidence of changes in physical activity behaviour and the influence of individual, social, and environmental factors. These findings are significant for various domains, including public health, and groups such as policy health advisors, and healthcare professionals concerned with female prenatal health. Future studies should support practice in culturally appropriate strategies for promoting physical activity by ensuring that solutions are culturally relevant rather than a one-size-fits-all approach. Understanding Asian culture will allow healthcare providers to effectively address the specific requirements of this demographic of pregnant women rather than simply adopting current guidelines, which may be inadequate.9 0Item Restricted Association Between Chronic Airflow Obstruction and Physical Activity in A Multinational Study(Imperial College London, 2024) Alharbi, Talal; Amaral, AndreBackground Several studies have suggested that poor respiratory health may strongly impact physical activity. The aim of this study was to investigate whether people with chronic airflow obstruction are more or less likely to be physically active and to examine variations in this association across regions, sexes, and smoking statuses. Methods The data used in this study were from the general population-based Burden of Obstruction Lung Disease (BOLD) follow-up, collected from 18 different sites worldwide. A total of 3,372 participants answered the core questionnaire, provided high-quality lung function spirometry and had no missing data on relevant variables. The level of physical activity was classified into moderate, vigorous, and walking activity. We conducted comprehensive analytic modules using meta-analysis and logistic regression across different sites. The analysis assessed the impact of physical activity on the risk of airflow obstruction in both sexes, with further stratification by sexes. Result Overall, people with chronic airflow obstruction are 33% less likely to report moderate physical activity (OR: 0.67, 95% CI: 0.48 to 0.93), as compared to people without obstruction. Remarkably, the association was significant in females (OR: 0.59, 95% CI: 0.37 to 0.95) but not in males (OR: 0.78, 95% CI: 0.48 to 1.27). These results were consistent across all sites. We found no significant association between vigorous physical activity and chronic airflow obstruction. Conclusion Chronic airflow obstruction seems to have a strong effect on physical activity, particularly in females. However, it is not clear from the data whether participants with chronic airflow obstruction were already less active before developing obstruction. Anyway, integrating pulmonary rehabilitation into clinical intervention for people with chronic airflow obstruction may be important as a way to improve their health outcomes and quality of life.18 0Item Restricted Understandings and Experiences of Sports, Physical Activity and Related Digital Campaigning Among Saudi Young Women in Saudi Arabia(Saudi Digital Library, 2023-12-06) Almohammadi, Nuha; Vicari, Stefania; Weiner, KateThis thesis explores the way social media sports campaigning contributes to Saudi women’s understandings of physical activity and sports in relation to gender norms in Saudi Arabia. It also investigates how these campaigns are received by Saudi women who are exposed to these activist messages. Through eight focus group discussions with 32 female university students at King Abdul-Aziz University, Jeddah, Saudi Arabia, this study explores the participants’ understandings and experiences of physical activity and sports. It also examines their views about digital campaigning. Furthermore, through 11 semi-structured interviews that used the scroll-back method, this study explores the participants’ personal experiences of social media use and of different forms of digital sports campaigns in relation to femininity and dress codes. The study identifies the role of place, Islam, traditions and society’s beliefs, family influence and structural issues, and the intersections of these issues in relation to Saudi women’s understandings and experiences of physical activity and sports. It suggests that the way in which Saudi young women understand physical activity and sports is not entirely dictated by these issues; rather they are exerting their agency in ways that enable them to counter or negotiate these influences. The study also shows how digital sports campaigning is significant for Saudi women at a personal and individual level. In particular, social media influencers, celebrities, and sportswomen seem to be critically important in contributing to the understanding of femininity and dress codes. The study overall is contributing to scholarship on intersectional feminism, particularly in the Saudi Arabian context. It illuminates the way intersectionality works in shaping experiences and understandings of digital campaigning in Saudi Arabia.22 0Item Restricted Comprehensive assessment of myocardial ischaemia: from vessel to patient.(Saudi Digital Library, 2023-10-12) Albaraikan, Abdulaziz Mohammed; Gunn, JulianChronic coronary syndrome (CCS) is accompanied by angina and limitation to the patient’s life. The significance of coronary blood flow reduction is currently best assessed by fractional flow reserve (FFR) as a guide to intervention. The beneficial effect of percutaneous coronary intervention (PCI) in these patients has been challenged, and therefore fresh evaluation of the changes in response to PCI is needed. Using real-world data from 40 patients, detailed examination of coronary anatomy and physiology, using FFR and computational fluid dynamics (CFD) to assess absolute coronary flow, was conducted. Patients not undergoing PCI due to FFR negative lesions comprised the ‘control’ group. A novel method to assess the myocardial ischemic burden and address the global flow reduction named ‘cumulative FFR’ (FFRCUM) was developed. Fitness trackers monitored everyday physical activity, and six-minute walk tests were performed, before and three months after the procedure. Questionnaires were used to evaluate the change as reported by the patients. I found a clear and significant physiological improvement following PCI in FFR, hyperaemic stenosis resistance (HSR), microvascular resistance (MVR), absolute flow (which increased 80%) and FFRcum (which increased from 0.72 to 0.83). The change in FFRcum was a predictor of the change in quality of life at follow up. Improvement in spontaneous and observed physical activity, which was highly variable between patients, was minimal, with similar findings in PCI and ‘control' patients. This was also observed with questionnaires in all domains except angina frequency. Taken together, this work shows that physiological improvement (FFR and FFRcum), and absolute flow restoration, are achieved with FFR-guided PCI. However, that does not necessarily result in measured improvement in everyday physical activity, or self-reported general health status, but it does result in improved angina status, at three months. Overall, these findings indicate that physiological improvements in myocardial perfusion produced by PCI tend not to lead to a major change in objective measures of activity or wellbeing in everyday life, but are worth pursuing in terms of angina, specifically13 0Item Restricted The effects of physical activities on preventing falls among old adults (aged 65- 70) in the community(2023-01-06) ALHAMILI, Raghad; MARCHBANK, AlisonBackground: The world's aging population is growing as life expectancy rises. Older adults are particularly vulnerable to injury and death from falls, which can result in significant medical expenses. Mobility restrictions of older adults can have a significant impact on quality of life. Fall incidents are one of the most serious problems that older people face is falling. Falls- related injuries could be physical or psychological, affecting individual's ability to carry out daily living activities. Physical activity could reduce the rate of falls. Physical activity has a positive impact on bone and muscle health positive impact on preventing falls among older adults. Aims To investigate and examine the research demonstrating how exercise and physical activity might decrease falls in community-dwelling older individuals And determine how physical activity could assist community-dwelling older adults prevent falls. Methods This study will provide a narrative review of evidence. A comprehensive literature search was performed accessing online biomedical databases including; Pubmed, Scopus, MEDLINE and CINHAL. Search terms included; physical activities, falls, older adults, aged >65, falls prevention. Inclusion criteria were studies related to the topic, published between 2014 and 2022 and were written in English. Results Once the publication data was limited to 2014 to 2022, the literature search largely produced 120 articles. After eliminating duplicate content, (n=45) and eliminating other articles for other reasons (n=33). 12 suitable and relevant study papers were chosen as full text reviews, and complete copies of those papers were collected for analysis. Conclusions This review determined an extensive number of recent literatures on falls prevention. Exercise and physical activity can help prevent falls, falls-related injuries, and recurrent falls. By putting into place different exercises and physical activity programmes, such home-based exercise, older individuals who live in the community may be preserved from falls. An investigation of the included reviews and trials revealed that well-designed exercise programs effectively reduced the likelihood of falls in older adults. Some researchers suggested for additional studies regarding the role physical activity plays in preventing falls among older adults. More studies needed to focus on specific populations, such as females.9 0Item Restricted Does Physical Activity Lower the Risk of Developing Asthma for Children?(Saudi Digital Library, 2016) Aldaadi, Abdullah; Russell, Melissa; Cassim, Raisa; Lowe, AdrianBackground: Asthma is the leading cause of chronic diseases in children, and its prevalence has been increasing in many countries especially for children. It is the one of the leading factors contributing to school absenteeism and has a sizable impact on health care expenditure. Physical activity was suggested as a protective factor against asthma incidence, with a recent review finding a marginally significant odds ratio supporting this claim for adults. However, there is only one study of this association for children that did not find a significant association. We aim to perform our own analysis of this association on Australian children. Methods: We used two waves of data from the longitudinal study of Australian children, a study that is representative of all Australian children with some exceptions. This study used a double staged clustered design, choosing postcodes before choosing children from those postcodes and they collected data in a cross sectional manner every two years. Children with asthma at baseline were excluded since we are looking at incidence, with the remaining children with complete data entering a multivariable logistic regression. Results: The unadjusted and adjusted analyses found no effect of physical activity on asthma incidence in this study sample of Australian children with an odds ratio of about one and a 95% confidence interval that crosses the null value. There is a possibility that the remaining sample size did not have enough power to detect an effect size of this association, and that there was a misclassification of exposure and outcome. Conclusion: The results of this study do not provide us with enough evidence to support the hypothesis that physical activity is protective against asthma incidence. Further research specific to this association is needed preferably with a larger sample size and objective measures of physical activity and asthma.15 0