|dc.description.abstract||Physical inactivity is a modifiable risk factor for cardiovascular diseases and other chronic diseases of life. In countries undergoing economic transition from underdeveloped to being developed, there is an increasing rate of physical inactivity. Accurate assessment of physical activity behaviours is important for determining the presence of physical inactivity, for setting goals for physical therapy interventions to increase physical activity and to utilize physical activity as an outcome measure for physical therapy interventions. There are different techniques used to measure physical activity, namely questionnaires, motion sensors (pedometers and accelerometers) and doubly labelled water. The most used method in large epidemiological research is questionnaires because of their affordability and feasibility. Limitations of physical activity questionnaires include the exclusion of house-hold activities, intensity of work done, bicycling, duration and frequency of leisure time activities. Motion sensors have been mostly used in developed and westernized countries. In the North West Province (NWP) of South Africa the only method that has been used to determine physical activity among the Tswana speaking people was the Transition of Health during urbanization physical activity questionnaire (THUSA-PAQ). The application of other methods such as the motion sensors has never been done.
Objectives: The study comprised two major objectives: The first objective was to determine the physical activity levels of the rural and urban Tswana speaking people of the NWP using the THUS A questionnaire and pedometers. The second objective was to determine whether there is a relationship in physical activity determined by the THUSA-PAQ, promotional pedometer and an accelerometer determined activity. Methods:
The participants recruited for this study form part of the larger prospective urban and rural epidemiology (PURE) longitudinal study running over 12 years which started in 2005. A subsample of 200 was randomly selected of which hundred and eighty signed the informed consent (90 urban and 90 rural) to participate in the study. The participants completed the THUSA-PAQ with the assistance help of the fieldworkers in their native language and wore pedometers for seven consecutive days. The number of steps taken per day distance travelled and energy expenditure were recorded in a logbook. Another thirty eight participants from a co-hort in the same geographical area were issued with accelerometers to wear simultaneously with pedometers for a period of twenty four hours and also completed the THUSA-PAQ. Results: The rural male and female participants reported higher average physical activity index (PAT) with the THUSA questionnaire (9.49 ± 3.67 and 8.10 ± 1.26) than urban male and female participants (8.13 ± 2.47 and 7.51 ± 1.65) respectively. The same trend was observed with the objectively determined physical activity with the pedometers. A partial correlation adjusted for age and gender showed no statistical significance between the subjectively determined physical activity index (PAT) and the objectively determined activity (average steps per day). Results from the co-hort participants indicated that both male and female participants spent a larger percentage of their time on sedentary activities (66.45 ± 15.84% and 70.13 ± 8.39%) respectively. Most of the participants, 64.7% females and 52.1% males, recorded fewer than 5000 steps per day with a pedometer and reported high PAI (9.61 ± 1.83 males and 7.79 ± 1.26 females) with the THUSA-PAQ. On this population partial correlation analyses that was adjusted for age and body mass index (BMT) showed a statistical significant relationship between (p<0.05) time spent on vigorous activities and commute index between male and female participants. There was no statistical significant relationship between the PAI (THUSA-PAQ), activity energy expenditure (AEE) determined with an accelerometer and the number of steps per day determined with a pedometer. Conclusion: The major conclusion that can be drawn from this study is that the participants did not meet the recommended physical activity levels (30 min moderate physical activity or 10 000 pedometer determined steps per day). The participants reported high subjective physical activity index (PAI) with the THXJSA-PAQ which did not correlate with the low objectively determined number of steps per day using the pedometer and AEE. Possible reasons for this include the influence of perception toward physical activity, social desirability, seasonal changes, reactivity and time of the year. Motion sensors gave a better indication of habitual physical activity among the Tswana speaking people of the NWP and should be considered for further research.||