Indicators of adherence to physiotherapy attendance among Saudi female patients with mechanical low back pain: a clinical audit

Barriers and facilitators to physiotherapy among adult orthopedic patients at King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia: A cross-sectional study

OBJECTIVES

To identify barriers and facilitators to physiotherapy adherence in adult patients who attended an orthopaedic clinic and underwent physical therapy at King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia.

METHODS

This cross-sectional study was performed at KKUH between September 2022 and January 2023. After conducting a literature review, a survey questionnaire was created, and a pilot study was conducted to evaluate its validity and clarity. Patients were approached in the waiting areas of the outpatient clinics and provided with a consent form to participate in the study.

RESULTS

Ongoing pain, travel distance, and lack of transportation were common barriers while being given a choice in rehabilitation activities, regular assessments of progress and function, and regular goal setting with the physician were common facilitators. Living in rural areas and the belief that rehabilitation is important were associated with both higher barrier and facilitator scores.

CONCLUSION

A patient-centred approach to physical therapy, effective pain management, and regular evaluation of functional progress can increase adherence to physiotherapy. These findings have implications for physiotherapy providers, policymakers, and patients in promoting adherence to treatment for improved functional outcomes, reduced pain, and increased patient satisfaction.

Patient Compliance With Physical Therapy Following Orthopedic Surgery and Its Outcomes

BACKGROUND AND OBJECTIVES

Patient compliance is a major concern for the efficacy of physiotherapy amongst those that undergo orthopedic surgery. The substantial number of people who are non-compliant makes this an imperative issue to address. Our objectives were to quantify the percentage of patient compliance for physiotherapy after their surgery, to measure the association between compliance and the status of health, mobility, and pain, and to identify the causes of non-compliance.

METHODS

A cross-sectional study was conducted on post-orthopedic surgery patients attending physical therapy sessions at King Khalid University Hospital in Riyadh, Kingdom of Saudi Arabia, over a one-year period. The sample size of 359 was calculated and selected using simple random sampling. Our questionnaire was developed by adopting questions from two previously validated studies.

RESULTS

The majority of the participants (n=194; 54%) were male. One hundred and ninety-three (53.8%) participants had a diploma or higher. The age group 18-35 was found to be significantly associated with skipping physiotherapy sessions when they started to feel well (P= 0.016) and skipping due to other responsibilities (P=0.002). Single people skip physiotherapy when they start to feel well (P=0.023), due to other responsibilities (P=0.028), and due to poor timing (P=0.049). Self-reported compliance to physical therapy after surgery was 231 (64.3%). Patient status showed overall improvement.

CONCLUSION

There is a significant percentage of non-compliance and the patient's age, gender, marital status, and level of education play a role in the causes of non-compliance. In addition, the patient's status (health, pain, and mobility) is better in those who are compliant than in those who are not.

Cultural Adaptation, Reliability and Validation of the Arabic Örebro Musculoskeletal Pain Questionnaire in Patients with Low Back Pain

Background

The Örebro Musculoskeletal Pain Questionnaire (ÖMPQ) assesses the psychosocial factors in people with complaints of musculoskeletal disorders and predicts those likely to develop persistent symptoms.

Objective

To culturally-adapt and assess the validity of the ÖMPQ in an Arabic population with low back pain (LBP).

Methods

This was a prospective cohort validation study of the ÖMPQ. The Arabic-ÖMPQ was created by forward translation, translation synthesis and backward translation in an Arabic population. Participants were included if they were 18 years or older, had acute or chronic LBP and were fluent in Arabic. Eighty-four patients completed the questionnaires at baseline, 2 days later and 3 months follow-up. We assessed specific agreement and test-retest reliability using the interclass correlation coefficient (ICC). We assessed predictive validity using linear regression and relative risk. We assessed content validity by investigating the ceiling and floor effects.

Results

To construct validity, the Arabic-ÖMPQ had a moderate (r≥0.3, <0.5) to high (r≥0.5) correlation with pain, disability, fear-avoidance and catastrophizing questionnaires. The test-rest reliability was high ICC_2,1=0.92 (95% CI: 0.83-0.96). The Arabic-ÖMPQ score at baseline can significantly predict disability at 3 months F(1,82)=33.87, p<0.01; R²=0.29.

Conclusion

The translation of the Arabic-ÖMPQ into Arabic was successful. The Arabic-ÖMPQ showed very good reliability and proper validity and thus can be used to predict the risk of developing persistent disability amongst patients with LBP in an Arabic population.

Racial and Ethnic Differences in Outcomes of a 12-Week Digital Rehabilitation Program for Musculoskeletal Pain: Prospective Longitudinal Cohort Study

BACKGROUND

Musculoskeletal (MSK) pain disproportionately affects people from different ethnic backgrounds through higher burden and less access to care. Digital care programs (DCPs) can improve access and help reduce inequities. However, the outcomes of such programs based on race and ethnicity have yet to be studied.

OBJECTIVE

We aimed to assess the impact of race and ethnicity on engagement and outcomes in a multimodal DCP for MSK pain.

METHODS

This was an ad hoc analysis of an ongoing decentralized single-arm investigation into engagement and clinical-related outcomes after a multimodal DCP in patients with MSK conditions. Patients were stratified by self-reported racial and ethnic group, and their engagement and outcome changes between baseline and 12 weeks were compared using latent growth curve analysis. Outcomes included program engagement (number of sessions), self-reported pain scores, likelihood of surgery, Generalized Anxiety Disorder 7-item scale, Patient Health Questionnaire 9-item, and Work Productivity and Activity Impairment. A minimum clinically important difference (MCID) of 30% was calculated for pain, and multivariable logistic regression was performed to evaluate race as an independent predictor of meeting the MCID.

RESULTS

A total of 6949 patients completed the program: 65.5% (4554/6949) of them were non-Hispanic White, 10.8% (749/6949) were Black, 9.7% (673/6949) were Asian, 9.2% (636/6949) were Hispanic, and 4.8% (337/6949) were of other racial or ethnic backgrounds. The population studied was diverse and followed the proportions of the US population. All groups reported high engagement and satisfaction, with Hispanic and Black patients ranking first among satisfaction despite lower engagement. Black patients had a higher likelihood to drop out (odds ratio [OR] 1.19, 95% CI 1.01-1.40, P=.04) than non-Hispanic White patients. Hispanic and Black patients reported the highest level of pain, surgical intent, work productivity, and impairment in activities of daily living at baseline. All race groups showed a significant improvement in all outcomes, with Black and Hispanic patients reporting the greatest improvements in clinical outcomes. Hispanic patients also had the highest response rate for pain (75.8%) and a higher OR of meeting the pain MCID (OR 1.74, 95% CI 1.24-2.45, P=.001), when compared with non-Hispanic White patients, independent of age, BMI, sex, therapy type, education level, and employment status. No differences in mental health outcomes were found between race and ethnic groups.

CONCLUSIONS

This study advocates for the utility of a DCP in improving access to MSK care and promoting health equity. Engagement and satisfaction rates were high in all the groups. Black and Hispanic patients had higher MSK burden at baseline and lower engagement but also reported higher improvements, with Hispanic patients presenting a higher likelihood of pain improvement.

Factors impacting adherence to an exercise-based physical therapy program for individuals with low back pain

Background/Objective

Exercise-based rehabilitation is a conservative management approach for individuals with low back pain. However, adherence rates for conservative management are often low and the reasons for this are not well described. The objective of this study was to evaluate predictors of adherence and patient-reported reasons for non-adherence after ceasing a supervised exercise-based rehabilitation program in individuals with low back pain.

Design

Retrospective observational study.

Methods

Data was retrospectively analyzed from 5 rehabilitation clinics utilizing a standardized exercise-based rehabilitation program. Baseline demographics, diagnosis and symptom specific features, visit number, and discontinuation profiles were quantified for 2,243 patients who underwent the program.

Results

Forty-three percent (43%) of participants were adherent to the program, with the majority (31.7%) discontinuing treatment prior to completion due to logistic and accessibility issues. Another 13.2% discontinued prior to the prescribed duration due to clinically significant improvements in pain and/or disability without formal discharge evaluation, whereas 8.3% did not continue due to lack of improvement. Finally, 6.0% were discharged for related and unrelated medical reasons including surgery. Individuals diagnosed with disc pathology were most likely to be adherent to the program.

Limitations

This study was a retrospective chart review with missing data for some variables. Future studies with a prospective design would increase quality of evidence.

Conclusions

The majority of individuals prescribed an in-clinic exercise-based rehabilitation program are non-adherent. Patient diagnosis was the most important predictor of adherence. For those who were not adherent, important barriers include personal issues, insufficient insurance authorization and lack of geographic accessibility.

Impact of home exercise program on self-efficacy and quality of life among primary knee osteoarthritis patients: a randomized controlled clinical study

Background

Knee osteoarthritis (KOA) is a common joint disorder in elderly individuals, causing pain, loss of physical functioning, disability, and reduction of life quality. Home exercise programs (HEP) serve as a crucial complement to outpatient rehabilitation therapy, as they save the cost of supervised physical therapy sessions, while also offering a high level of treatment. The aim of this study was to evaluate the effectiveness of the 6-month HEP on pain, quality of life, and self-efficacy in patients with primary KOA and to identify the adherence level to exercises and associations with patients’ characteristics and clinical outcomes.

Results

After 6 months of HEP, there were statistically significant differences between groups for self-efficacy (p ≤ 0.001, from 58.29 to 71.5) (p = 0.23, from 55.98 to 57.72), quality of life (p ≤0.001, from 60.1 to 72.2) (p = 0.074, from 60.35 to 60.92), and pain severity (P ≤0.001, from 58.29 to 41.4) (P = 0.88, from 61.2 to 60.9) in favor of exercise group.

Conclusions

Home-based exercise program improves pain score, self-efficacy, and quality of life in patients with knee osteoarthritis. Adherence level to the exercise program may have a positive impact on patient improvement.

Supplementary Information

The online version contains supplementary material available at 10.1186/s43166-021-00073-2.

Factors associated with stroke survivors' inconsistent uptake of physiotherapy interventions at Turton Community Health Centre, KwaZulu-Natal

Background

Stroke is one of the major causes of physical disability worldwide. Whilst physiotherapy interventions are important for the recovery of stroke survivors, the uptake remains inconsistent and factors contributing to these inconsistencies are not well documented, especially in South Africa.

Objectives

The overall objective was to determine the intrinsic and extrinsic factors associated with adult stroke survivors’ inconsistent uptake of physiotherapy interventions at Turton Community Health Centre, Ugu District, KwaZulu-Natal, South Africa.

Methods

This was a cross-sectional study involving 50 stroke survivors who missed one or more of their physiotherapy appointments and 25 who attended all their appointments (comparison group) within a 2-year period. A researcher-administered semi-structured questionnaire was used to collect data, which was captured and analysed using SPSS v25. Results were summarised using descriptive statistics. Pearson’s chi-square test was used for bivariate analysis.

Results

Only two intrinsic factors were significantly associated with the outcome variable, namely: believed in exercises recommended by physiotherapists (χ² = 3.86, p = 0.049) and improvements noted from the start of recommended exercises (χ² = 9.439, p = 0.007). Transportation, including hiring of private cars (74%) and being far away from the health facility (48%), were key extrinsic challenges affecting access to health facilities.

Conclusion

Personal reasons and the difficulty in accessing health facilities were main factors affecting stroke survivors’ uptake of physiotherapy interventions.

Clinical implications

Design of patient-tracking and family support systems may potentially improve the stroke survivors’ uptake of physiotherapy interventions.

The effect of innovative smartphone application on adherence to a home-based exercise programs for female older adults with knee osteoarthritis in Saudi Arabia: a randomized controlled trial

PURPOSE

To examine the effects of an Arabic smartphone application on adherence to home exercise programs (HEPs) and the effectiveness of mobile-based HEPs on pain, physical function, and lower-limb muscle strength among older women with knee osteoarthritis (OA).

MATERIALS AND METHODS

This randomised control trial (ClinicalTrials.gov: (NCT04159883) enrolled 40 women aged ≥50 years with knee OA who were randomised into the app group (experimental; n = 20) receiving HEPs using an Arabic smartphone application called "My Dear Knee", whereas the paper group (control; n = 20) receiving HEPs as hand-outs. Both groups had the same exercise program. Outcome measures were self-reported adherence, changes in the Arabic Numeric Pain Rating Scale, the Arabic version of the reduced Western Ontario, McMaster Universities Osteoarthritis Index-Physical Function subscale, and Five-Times Sit-To-Stand Test scores. All participants were assessed at baseline, at week 3 and week 6. Using completer-only analyses, the repeated measures ANOVA was used to compare the means of the outcome measures between the two groups.

RESULTS

At the end of week 6, the app group reported greater adherence to HEPs (p = .002) and significant reduction in pain (p = .015).

CONCLUSIONS

A smartphone application with motivational and attractive features could enhance adherence to HEPs in this patient cohort.IMPLICATIONS FOR REHABILITATIONOlder adults with knee OA may face many obstacles that prevent or limit their adherence to the prescribed HEP.Smart device apps supported with attractive and motivational features could be an effective strategy to enhance adherence to HEPs among older adults with knee OA.Using such remote technology appears to overcome the barriers that may limit the ability of older women to receive supervised physical therapy in a clinical setting.

Predicting treatment adherence and outcome to outpatient multimodal rehabilitation in chronic low back pain

BACKGROUND

There is a growing need to identify patient pre-treatment characteristics that could predict adherence and outcome following specific interventions.

OBJECTIVE

To identify predictors of adherence and outcome to outpatient multimodal rehabilitation in chronic low back pain (CLBP).

METHODS

A total of 273 CLBP patients participated in an exercise-based rehabilitation program. Patients who completed ⩾ 70% of the treatment course were classified as adherent. Patients showing a post-treatment reduction of ⩾ 30% in Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) back pain intensity scores were assigned to the favorable outcome group.

RESULTS

Multivariate logistic regression revealed that higher age, higher ability to perform low-load activities, and higher degrees of kinesiophobia increased the odds to complete the rehabilitation program. By contrast, lower levels of education and back pain unrelated to poor posture increased the odds for non-adherence. Furthermore, a favorable outcome was predicted in case the cause for LBP was known, shorter symptom duration, no pain in the lower legs, no difficulties falling asleep, and short-term work absenteeism.

CONCLUSIONS

Assessment and consideration of patient pre-treatment characteristics is of great importance as they may enable therapists to identify patients with a good prognosis or at risk for non-responding to outpatient multimodal rehabilitation.

Do sociodemographic features, pain sensitivity or pain catastrophizing relate to clinic-based adherence to physiotherapy in people suffering from chronic spinal pain? Secondary analysis of a randomized clinical trial

PURPOSE

Examining whether socio-demographic variables, pain or functionality are related to the degree of clinic-based therapy adherence in patients suffering from nonspecific chronic spinal pain (nCSP).

DESIGN

Secondary analysis of a randomized clinical trial.

SETTING

University hospital of Ghent and Brussels.

METHODS

Dutch speakers, 18-65 years old, experiencing nCSP for at least 3 months. 120 participants were randomly allocated to two interventional groups, of which 94 completed all therapy sessions.

MAIN OUTCOME MEASURES

Degree of clinic-based adherence, defined as the amount of completed therapy sessions.

RESULTS

Demographic data (sex, age or education) were not significantly associated with adherence in the total sample or the neuroscience group. For the traditional physiotherapy group, educational level was associated with attendance of at least 50% of the therapy sessions. Regarding pain-, belief- and function-related measures, only the association between change in kinesiophobia and adherence was significant for the traditional physiotherapy group.

CONCLUSIONS

Factors related to therapy adherence in the total group or the neuroscience group could not be found. Educational level and change in kinesiophobia were however related to therapy adherence in the traditional physiotherapy group.

Multidimensional prognostic factors for chronic low back pain-related disability: a longitudinal study in a Saudi population

BACKGROUND CONTEXT

Chronic low back pain (CLBP) is a major health problem. Identifying prognostic factors is essential for identifying people at risk of developing CLBP-related disability.

PURPOSE

To examine associations between CLBP-related disability at 12-month follow-up and individual, psychosocial and physical factors at baseline, as well as treatment-related factors between baseline and 12-month follow-up among a Saudi population. Additionally, associations between pain intensity and general perceived efficacy (GPE) at 12 months were examined with the aforementioned factors.

DESIGN

A prospective cohort study.

PARTICIPANTS

One hundred Saudi participants over 18 years with a history of LBP greater than 3 months' duration.

MAIN OUTCOME MEASUREMENTS

The primary outcome variable was CLBP-related disability measured by the Arabic Oswestry disability index. Secondary outcome measures were pain intensity over the prior week measured by the VAS and the participant's global perceptions of recovery (general perceived efficacy [GPE]) at 12 months.

METHODS

At baseline (n=115), participants completed questionnaires covering demographics, disability, pain intensity, back beliefs, fear avoidance, psychological distress, and physical activity. They performed standardized physical performance tests, including assessment of pain behaviors using a pain behavior scale. After 12 months, participants (n=100) completed questionnaires on disability, pain intensity, GPE and provided treatment-related information during the previous year. Predictors of disability, pain, and GPE were explored using univariate and multivariate regression analyses.

RESULTS

The prognostic model for moderate-severe CLBP-related disability at 12 months explained 53.0% of the variance. Higher pain intensity, higher fear-avoidance work, and older age predicted higher disability. Having no additional somatic symptoms predicted lower disability. Pain intensity at 12-month follow-up was explained by higher disability at baseline, while not being in paid employment appeared protective (25.7% of variance explained). As univariate associations were weak between predictor variables and GPE, multivariate analysis was not conducted.

CONCLUSION

The study results supported the multifactorial nature of CLBP and reported an important prognostic model in the Saudi population.

Pain, disability and adherence to home exercises in patients with chronic neck pain: long term effects of phone surveillance. A randomized controlled study

BACKGROUND

Effectiveness of phone surveillance and other communication technologies in the management of neck pain patients have been evaluated previously only at the suspension of the service.

AIM

To verify whether a phone surveillance program can improve pain, disability, and adherence to home exercises in neck pain patients, and whether the improvement achieved continues to be maintained also after suspension of the support.

DESIGN

This is a randomized controlled study.

SETTING

Outpatients of Rehabilitation Unit.

POPULATION

84 out of 100 outpatients consecutively randomized (by blocks of four) to Phone group (N.=42, performing a 6-month home-based phone surveillance program) or to Control group (N.=42, with the only recommendation to continue exercising at home without phone surveillance) were considered. The home-based phone surveillance program consisted of 12 scheduled phone calls, each performed every fortnight by a nurse-tutor with expertise in rehabilitation for the first six months of the study. At the end of phone surveillance period, Phone patients were encouraged to continue home exercises for a further 6 months period.

METHODS

Pain severity (assessed with Pain VAS), disability (Neck Disability Index), and adherence to exercises performed at home (classified as: ≥5 sessions/week, 2-4 sessions/week, occasional or no sessions) were outcome measures. Pain severity and disability were assessed at entry, at 6 and 12 months, while adherence to exercises was self-reported and recorded at 6 and 12 months. Differences between groups were analyzed with χ2 test, Student's t-test or ANOVA.

RESULTS

At 6 months, Pain VAS (P=0.013) and Neck Disability Index scores (P=0.012) were lower in Phone patients than Controls. At 12 months, Neck Disability Index scores (P=0.026) continued to be lower in Phone patients than Controls. At 6 months, 97.6% of Phone patients and 80.9% of Controls performed rehabilitation at home with a range of 2 to 7 sessions/week; while at 12 months, the respective percentages of Phone and Control patients were 92.9% and 73.8%. Adherence to home exercises was higher in Phone patients than in Controls at 6 (P=0.013) and 12 months (P=0.019).

CONCLUSIONS

In patients with chronic neck pain, the positive effects of phone surveillance on the neck disability and adherence to home exercises still persist 6 months after the suspension of the support.

CLINICAL REHABILITATION IMPACT

This knowledge can be useful for physicians to plan home rehabilitation of neck pain patients.

Who seeks physiotherapy or exercise treatment for hip and knee osteoarthritis? A cross-sectional analysis of the English Longitudinal Study of Ageing

OBJECTIVES

To determine the characteristics of individuals with hip and/or knee osteoarthritis who are recommended to seek physiotherapy or exercise treatment, and to explore which people are more or less likely to follow such recommendations.

METHODS

All data were obtained from Wave 4 of the English Longitudinal Study of Ageing (ELSA) cohort (2008-2009), a prospectively collected community-based dataset. Eligibility was justified by a patient-reported diagnosis of hip and/or knee osteoarthritis with a visual analog scale (VAS) pain score of 1 or above. Data were collected from a self-completed questionnaire and nurse assessment visit. Prevalence of being recommended to physiotherapy or exercise (or not) and then the actioning of this recommendation (or not) were calculated and presented as 95% confidence intervals (CI). Data on characteristics of those recommended (or not) were explored using univariate analyses and then a forward selection logistic regression model.

RESULTS

In total, 1262 and 1877 individuals with hip and/or knee osteoarthritis pain were analyzed. This included 41% (95% CI: 0.38-0.44) who had been recommended to seek physiotherapy or exercise treatment. Subsequently, 83% of those recommended sought these treatments. Individuals who presented with isolated knee pain, those who reported "fair" self-reported general health and were younger had a greater chance of being recommended for physiotherapy or exercise treatment, respectively (P ≤ 0.02).

CONCLUSION

Encouragement should be given to formal and informal care providers of older people to highlight this inequality. This may then improve current and future access to evidence-based treatments for this population.

Effect of Kinesio Taping on Pain and Functional Disability in Chronic Nonspecific Low Back Pain: A Randomized Clinical Trial

STUDY DESIGN

A randomized controlled trial with 2-week Kinesio taping intervention.

OBJECTIVE

The aim of the study was to investigate the effectiveness of Kinesio taping application on pain, functional disability, and trunk flexion range of motion (ROM) in patients with chronic nonspecific low back pain (chronic NSLBP).

SUMMARY OF BACKGROUND DATA

Kinesio taping is a therapeutic tool used for treatment of chronic NSLBP. However, there is little scientific evidence that describes its clinical efficacy.

METHODS

Forty-four patients with chronic NSLBP were randomized into experimental group (n = 21) and placebo group (n = 23). The experimental group was treated with Erector Spinae Taping, whereas the placebo group was treated with placebo taping. The primary endpoint was pain intensity on visual analog scale. Secondary endpoints were functional disability on Arabic version of Oswestry disability index (ODI) and trunk flexion ROM on Modified Schober's test. All measurements were recorded at baseline (W0), after 2-week intervention (W2), and at 4-week (W4) follow-up.

RESULTS

Both group were comparable at baseline (P > 0.05). The experimental group had a greater decrease in pain than the placebo group after W2 of intervention (mean between-group difference 2.05 cm, 95% confidence interval [CI] = 1.38-2.71 points). This was maintained to W4 follow-up (2.25 cm, 95% CI = 1.67-2.82 points). At W2, the experimental group had significantly greater improvement in disability, by 3.90 points (95% CI = 1.68-8.54 points). This effect was significant at W4 follow-up (5.6, 95% CI = 2.65-8.54 points). Similarly trunk flexion ROM was significantly better at W2 (-0.71 cm, 95% CI = -0.85 to -0.56) and W4 follow-up (-0.73 cm, 95% CI = -0.88 to -0.58).

CONCLUSION

Kinesio taping reduces pain and disability and improves trunk flexion ROM after 2 weeks of application. However, thesis effects were very small to be considered clinically relevant and meaningful when compared with placebo taping.

LEVEL OF EVIDENCE

2.

Gender-dependent associations between socioeconomic status and metabolic syndrome: a cross-sectional study in the adult Saudi population

Background

To determine the gender-dependent association of socio-economic status variables with the prevalence of metabolic syndrome (MetS) in the adult Saudi population.

Methods

A total of 9164 adult Saudis (aged 18–70 years) were included in this cross-sectional study. Marital status, income, education, and occupation were used as socio-economic indicators while behavioral factor like physical exercise was also taken into account. MetS was defined using the criteria based from the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III).

Results

In males, the odds ratio (OR) of harboring MetS was higher in married [OR1.6 (Confidence Interval (CI) 1.1, 2.4); p < 0.03], and high income class [OR 2.3(CI 1.5, 3.5); p < 0.001] and lowest in retired and unemployed individuals [1.4(1.0, 1.9); p < 0.04, 0.61(0.45, 0.82); p < 0.001] respectively. In females, MetS was inversely related to high income [OR 0.70 (CI 0.46, 1.1); p < 0.09] and education level [OR 0.38 (CI 0.26, 0.56); p < 0.001], and was significantly higher in the unemployed class [OR 1.6 (CI 1.2, 2.2); p < 0.004].

Conclusions

The prevalence of MetS is significantly high among retired, married and high-earning Saudi males while in females, high earners and high education seem to confer a protective effect against MetS.

Physical Activity and Health Beliefs among Saudi Women

Background. Physical activity (PA) is associated with health benefits and disease prevention and is often prescribed in managing many health conditions. Understanding the cultural influences is relevant in order to effectively promote PA. The objective of this study was to assess the level of PA among Saudi women, measured by daily step count, and the association between PA and health beliefs. Methods. A total of 161 eligible participants were asked to complete two questionnaires to assess health beliefs: Health Locus of Control (HLC) and Self-Efficacy Assessment Scale. Each participant was given a pedometer and a diary to record their daily PA for two weeks. Results. One hundred and five participants completed the two weeks pedometer data (mean age 26.3 ± 7.1 years, BMI 25 ± 4.2 kg/m²). The average pedometer score over two weeks was 5114 ± 2213 steps. Step count had strong correlation with self-efficacy (r_s = 0.75), mild correlation with internal HLC (r_s = 0.42), and mild negative correlation with external HLC (r_s = −0.35). Conclusion. The study demonstrates high level of inactivity among Saudi females in reference to the international recommendation for minimum activity. The data also reveal an association between PA and health beliefs. Ultimately, such information can be used to design gender- and culture-sensitive interventions that could enhance adherence to PA.