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Britz C.1, Hendricks C.1, Jelsma J.1
1University of Cape Town, Health and Rehabilitation Sciences, Cape Town, South Africa
Background: There is inadequate South African evidence regarding the inter-relationships between musculoskeletal disease (MSD), chronic diseases of lifestyle (CDL), obesity and physical activity levels. This highlights a gap in research as management may not be targeted appropriately at risk factors and thus may not reduce the high prevalence rates of MSD.
Purpose: To determine the patterns of onset and management of musculoskeletal diseases, chronic diseases of lifestyle and risk factors across gender and six age categories.
Methods: A descriptive, cross-sectional, analytical study design was used at primary health care level at a Community Health Centre (CHC) in the Cape Town, South Africa. All males and females, aged 18 years and older, except those who were pregnant or unable to answer the English, Afrikaans, or isiXhosa versions of questionnaires, were eligible to participate. The outcome measures were the Brief Pain Inventory (BPI), COPCORD , the EQ5D, the International Physical Activity Questionnaire (IPAQ), and anthropometric measures of weight, height, and waist and hip circumference. Data were collected via interview and responses were captured by online questionnaires on mobile devices using the Magpi application. Anthropometric measurements were taken as well. Data were exported to Excel spreadsheets for descriptive and inferential statistical analysis.
Results: This study recruited 1115 participants, with a mean age of 48.7 ± 16.8 years. A prevalence rate of 33.3% for acute MSD and 42.9% for chronic MSD was found, with a significant association found between gender and MSD (p 0.01). The most common sites of chronic MSD were knees (21.8%), low back/pelvis (15.3%), shoulders (15.2%), and hands/fingers (13.1%). Of those with MSD (37.4%), exercise was reported as the best management strategy for musculoskeletal pain. Hypertension was the most prevalent CDL in both genders, followed by diabetes mellitus type 2 and hypercholesterolaemia. All chronic diseases, except chronic obstructive airway disease (COAD), continually increased with age, while COAD and both acute and chronic pain peaked around the 50-59 year old age category and then decreased with age. Significant differences (p 0.01) were found between anthropometric measurements of those with MSD and those without. A significant association (p 0.01) was found between chronic MSD and physical activity levels. The odds ratio (OR) was greatest for those with COAD, as these participants were 2.6 times more likely to have joint pain. This was followed by having hypercholesterolaemia (OR=2.4) and hypertension (OR=1.8).
Conclusion(s): These findings highlight the co-existence of MSD and CDL in patients attending disadvantaged CHCs in Cape Town. These chronic diseases may influence the affected individuals health negatively as a lack of physical activity in individuals with MSD (due to a forced sedentary lifestyle caused by chronic pain, joint stiffness and limited function) could lead to secondary complications. Therefore, it is assumed that if MSD and CDL is not managed effectively, a cycle of secondary complications could occur.
Implications: These results imply that physiotherapists have a pivotal role in the management of MSD and CDL and should address risk factors associated to these diseases at primary health care level, thus reducing the burden of disease in South Africa.
Funding acknowledgements: NRF Thuthuka student support grant, The University of Cape Town Masters Research Scholarship and Yeoman bequest bursary.
Topic: Non-communicable diseases (NCDs) & risk factors
Ethics approval: Approved by the Human Research Ethic Committee of the University of Cape Town (HREC REF: 856/2014), South Africa.
All authors, affiliations and abstracts have been published as submitted.
