The Profession of Biokinetics in South Africa: The Need for Access to the Public Healthcare System

*Yvonne Paul, Terry J. Ellapen, Takalani C. Muluvhu and Makwena B. Ntjana*

## **Abstract**

This chapter reviews the efficacy of the only South African exercise therapy profession (Biokinetics) in the rehabilitation of non-communicable diseases (NCDs). Biokinetics is a South African exercise therapy profession established in 1983 and which operates in both the pathogenic and fortogenic healthcare paradigms. Unfortunately, the profession of Biokinetics is restricted to the South African private healthcare sector. This chapter describes the scope of the profession of Biokinetics, empirical studies illustrating the efficacy of the profession in addressing society's non-communicable disease epidemic, and the challenges inhibiting the profession from gaining access to the South African public healthcare sector. It is hoped that the presentation and critical appraisal of the empirical evidence which illustrates the contribution of the profession of Biokinetics to the rehabilitation of NCDs justifies the authors' claims for the inclusion of the aforementioned profession in the South African public healthcare sector.

**Keywords:** Biokinetics, exercise therapy, non-communicable diseases, healthcare

## **1. Introduction**

The profession of Biokinetics is a specialised application of clinical exercise therapy which developed from the South African Universities Physical Education Programme in 1983 [1]. The fundamental roots of the profession of Biokinetics date back to 1934 and form part of the history of the South African Defence Force [2]. In 1934, a resurgence in the study of Physical Education occurred in the South African Defence Force when senior military personnel found that South African recruits were in poor physical conditioning, with poor medical, dental, and psychological health [3–5]. As a result, the South African Defence Force established the *Physical Training Brigade*, a specialised unit aimed at rehabilitating military recruits experiencing medical, educational, dental, physical, social and/or psychological challenges [5, 6]. The multidisciplinary team responsible for the rehabilitation included medical doctors, educators, dentists, physical education instructors, physiotherapists, psychologists, and sociologists [5, 6]. Dr. Danie Craven was the inaugural director of the *Physical Training Brigade* [5]. This historical synopsis places the resurgence of the South African Physical Education programme in the context of military involvement in pioneering South African health and wellness efforts,

commemorating the inaugural establishment of the first of the South African multidisciplinary medical rehabilitation team, and the intuitive preliminary South African exercise therapeutic and research based approach to restoring an individual's health and well-being. Biokinetics was born out of the philosophy that *exercise is medicine*. The ground-breaking empirical research of Dr. Danie Craven, Dr. Ernst Jokl and Prof. Gert Lukas Strydom has led to the development of the profession of Biokinetics [1, 7]. Professor Gert Strydom is affectionately known as the *"Father of Biokinetics,"* due to his immense contribution to the establishment and continued advancement of the profession [8].

During the late 1960's a drastic change in the research philosophy of South African exercise rehabilitative medicine occurred, prompted by the inventive research of Gert Lukas Strydom [9]. In his doctoral thesis Mr. Gert Strydom investigated the impact of a habitual structured exercise regime as a therapeutic modality to rehabilitate the functional exercise physiological capacity of coronary heart disease patients [9]. The empirical evidence obtained from the study illustrated that habitual, structured exercise regimes could successful augment cardiac rehabilitation and improve patients' quality of life. The success of these findings encouraged other proponents of the Biokinetics profession, such as FJ Buys and JJ Cilliers, to pursue postgraduate exercise-based rehabilitation credentials in the newly emerging field of Biokinetics [4, 10]. FJ Buys investigated the effects of a structured exercise regime on pre-diabetic and diabetic patients [10], while JJ Cilliers reviewed the effects of structured exercise training on the post-medical rehabilitation of injured soldiers [4]. FJ Buys later became a professor at the Potchefstroom University for Christian Higher Education (now known as North-West University), with JJ Cilliers becoming a prominent professor at Tshwane University of Technology.
