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Exploring the role of exercise on thyroid function, postural control, and neuroplasticity in individuals with hypothyroidism
Thesis PhD (Sport Sc)--Stellenbosch University, 2022.
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| Format: | Thesis |
| Language: | English |
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Stellenbosch : Stellenbosch University
2022
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| _version_ | 1867613735452934144 |
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| access_status_str | Open Access |
| author | Watson-van Zyl, Jeanine |
| author2 | Welman, Karen Estelle |
| author_browse | Watson-van Zyl, Jeanine Welman, Karen Estelle |
| author_facet | Welman, Karen Estelle Watson-van Zyl, Jeanine |
| author_sort | Watson-van Zyl, Jeanine |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis PhD (Sport Sc)--Stellenbosch University, 2022. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/125075 |
| institution | Stellenbosch University (South Africa) |
| language | English |
| last_indexed | 2026-06-10T12:40:52.447Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2022 |
| publishDateRange | 2022 |
| publishDateSort | 2022 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/125075 Exploring the role of exercise on thyroid function, postural control, and neuroplasticity in individuals with hypothyroidism Watson-van Zyl, Jeanine Welman, Karen Estelle Sehm, Bernhard Exercise Neuroplasticity Neurotropin Hypothyroidism Cognitive balance UCTD Thesis PhD (Sport Sc)--Stellenbosch University, 2022. ENGLISH ABSTRACT: Introduction: While hypothyroidism is amongst the most common metabolic diseases globally, knowledge around the role of exercise in hypothyroid populations is scarce. Cardinal symptoms of hypothyroidism may be significant symptoms and become barriers to physical activity participation. Emerging evidence suggests that individuals with hypothyroidism may also present with postural control deficits. Exercise, including tele-exercise, is a known tool for improving several cardiometabolic disease outcomes, as well as enhancing postural control and inducing neuroplasticity. The study aimed to discover the role of exercise on thyroid function, postural control, and neuroplasticity in hypothyroid individuals. Study design: A single-blinded randomised exploratory exercise trial. Methods: A novel 12-week moderate intensity, asynchronous tele-exercise intervention was conducted, compared to an attention-matched control (AMC). Treated hypothyroid individuals were divided into the exercise group (n=7) and AMC group (n=9). Participants in the exercise group completed three sessions of exercise for 12 weeks in a remote setting. Sessions were approximately 60 minutes in duration. Participants in the AMC group completed three sessions of educational lectures for 12 weeks. Lectures were approximately 45 minutes in duration. Biochemical analysis for thyroid stimulating hormone (TSH), thyroxine (T4), and triiodothyronine (T3) was done following an overnight fast (Allinity, USA). Serum brain-derived neurotrophic factor (BDNF) was collected following an overnight fast (ElabScience, USA). Postural control was assessed through the mini-BESTest. Postural sway was further assessed using the modified Clinical Test for the Sensory Integration of Balance (mCTSIB; APDM Mobility LabTM). Hypothyroid specific health-related quality of life HRQoL was assessed (THYPRO-39), along with depressive mood (PHQ-9) and perceived fall risk (FES-I). Tests were performed at baseline and again post-interventionally. Results: No effects were found in TSH, T3, T4, and BDNF (p>0.05). Health-related quality of life, specifically Nervousness and Tension showed clinically significant improvements following the exercise intervention (g = 1.17; CI = -2.19, -0.15). Depressive mood showed clinically significant reductions in the exercise group over the intervention (-39.62%, minimal important clinical difference). Clinically significant improvements were shown in the Total score of the mini-BEST in the exercise group over the intervention (g = 0.56; CI = 0.44, 1.56). A small effect was found between groups for mean velocity of sway over the intervention (p=0.16; g = 0.31; CI = 0.02, 0.59) in favour of the AMC group. Interactions were identified in sensory weighting in the AMC group (p<0.01) and a trend toward significance in the exercise group (p=0.08). Conclusions: This study provides preliminary evidence that moderate intensity exercise may be a promising complimentary modality in treated hypothyroidism, by improving balance and elevating HRQoL. Further, this work introduces potentially divergent effects of exercise and AMC interventions on different aspects of postural control, in individuals with treated hypothyroidism. No effects were found on TSH, T3, T4, or BDNF. Recommendations: The findings of this study motivate larger trials with independent data to explore the role of exercise on thyroid hormones, BDNF, and postural control. Vast knowledge gaps remain in tele-exercise, and present exciting opportunities for future research. Future researchers can make use of innovative recommendations for asynchronous tele-exercise presented in this work. AFRIKAANSE OPSOMMING: Inleiding: Alhoewel hipoteriose siekte een van die mees algemene metabolise kondisies ter wêreld is, is kennis rondom die rol van oefening skaars. Kardinale simptome van hipotireose kan beduidende simptome en hindernisse vir deelname aan fisiese aktiwiteit wees. Opkomende bewyse dui ook daarop dat individue met hipotireose met posturale beheertekorte kan voorkom. Oefening, insluitend tele-oefening, is 'n bekende hulpmiddel vir die verbetering van verskeie kardiometaboliese siekte-uitkomste, sowel as om posturale beheer en neuroplastisiteit te verbeter. Die doel van die studie was om die rol van oefening op skildklierfunksie, posturale beheer en neuroplastisiteit by hipotiroïed individue te ontdek. Studie ontwerp: Enkele-blind ewekansige verkennende oefen-proefneming. Metodes: 'n Oorspronklike matige intensiteit tele-oefening intervensie van 12 weke, wat asinchroniese is uitgevoer word, was vergelyk met 'n gelyke-aandag kontrolegroep. Behandelde hipotiroïed individue was verdeel in die oefengroep (n=7) en aandaggepasde kontrole- of AMC-groep (n=9). Deelnemers aan die oefengroep het drie sessies van oefening vir 12 weke in 'n afgeleë omgewing voltooi. Sessies was ongeveer 60 minute lank. Deelnemers aan die AMC-groep het drie sessies van opvoedkundige lesings vir 12 weke voltooi. Lesings was elk ongeveer 45 minute lank. Biochemiese ontleding vir tiroïedstimulerende hormoon (TSH), tiroksien (T4) en trijodotironien (T3) is gedoen na 'n oornagvas (Allinity, VSA). Serum brein-afgeleide neurotrofiese faktor is ook ontdleet na 'n oornag vas (ElabScience, VSA). Posturale beheer is geassesseer deur die mini-BESTE. Posturale wieging is verder geassesseer deur die modified Clinical Test for the Sensory Integration of Balance (mCTSIB; APDM Mobility LabTM). Hipotiroïedspesifieke gesondheidsverwante lewenskwaliteit (THYPRO-39) is geassesseer, saam met depressiewe bui (PHQ-9) en waargenome valrisiko (FES-I). Toetse is uitgevoer by basislyn en weer na die intervensie. Resultate: Onbeduidende effekte was gesien in TSH, T3, T4 en BDNF (p>0.05). HRQoL, spesifiek Senuweeagtigheid en Spanning, het kliniese beduidende verbeteringe getoon in die oefenintervensie (g = 1.17; CI = -2.19, -0.15). Depressiewe buie het klinies beduidende afnames in die oefengroep getoon (-39.62%, MIDC). Klinies beduidende verbeteringe is getoon in die totale telling van die mini-BEST toets in die oefengroep (g = 0.56; CI = 0.44, 1.56). ‘n Klein effek is gevind in gemiddelde wiegsnelheid tussen die groepe, na die intervensie (p=0.16; g = 0.31; CI = 0.02, 0.59). Geen betekenisvolle veranderinge is gevind tussen groepe vir posturale swaai (p>0.05). Beduidende interaksies is geïdentifiseer in sensoriese gewig in die AMC-groep (p<0.01) en 'n neiging tot beduidendheid in die oefengroep (p=0.08). Gevolgtrekkings: Hierdie studie verskaf voorlopige bewyse dat oefening met matige intensiteit moontlik ‘n komplimentêre modaliteit in die behandeling van mense met hipotireose kan wees, deur HRQoL te verhoog en depressiewe buie te verminder. Verder, stel hierdie werk potensiele uiteenlopende effekte van oefening en gelyke aandag intervensies op verskillende aspekte van posturale beheer in individue met behandelde hipotireose bekend. Voorstellings: Die bevindinge van hierdie studie motiveer groter proewe met onafhanklike data om hierdie gevolgtrekkings te bevestig. Daar bly groot kennisgapings in tele-oefening, en bied opwindende geleenthede vir toekomstige navorsing. Toekomstige navorsers kan gebruik maak van die innoverende aanbevelings vir asinchroniese tele-oefening wat in hierdie werk aangebied word. Doctoral 2022-02-18T15:35:24Z 2022-04-29T12:52:53Z 2022-12-22T03:00:11Z 2022-12 Thesis http://hdl.handle.net/10019.1/125075 en Stellenbosch University xix, 178 pages : illustrations application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Exercise Neuroplasticity Neurotropin Hypothyroidism Cognitive balance UCTD Watson-van Zyl, Jeanine Exploring the role of exercise on thyroid function, postural control, and neuroplasticity in individuals with hypothyroidism |
| title | Exploring the role of exercise on thyroid function, postural control, and neuroplasticity in individuals with hypothyroidism |
| title_full | Exploring the role of exercise on thyroid function, postural control, and neuroplasticity in individuals with hypothyroidism |
| title_fullStr | Exploring the role of exercise on thyroid function, postural control, and neuroplasticity in individuals with hypothyroidism |
| title_full_unstemmed | Exploring the role of exercise on thyroid function, postural control, and neuroplasticity in individuals with hypothyroidism |
| title_short | Exploring the role of exercise on thyroid function, postural control, and neuroplasticity in individuals with hypothyroidism |
| title_sort | exploring the role of exercise on thyroid function postural control and neuroplasticity in individuals with hypothyroidism |
| topic | Exercise Neuroplasticity Neurotropin Hypothyroidism Cognitive balance UCTD |
| url | http://hdl.handle.net/10019.1/125075 |
| work_keys_str_mv | AT watsonvanzyljeanine exploringtheroleofexerciseonthyroidfunctionposturalcontrolandneuroplasticityinindividualswithhypothyroidism |