Stream: Abstract - Education and Integrated Care.

Topic: Physical activity and sedentary behavior.

Abstract title: Use of a locally developed Physical Activity Level Calculator to assess physical activity level.

Co-authors: M.O. Qaisar1, R. Hakeem1.
1Baqai Institute of Diabetology and Endocrinology, Academics, Karachi, Pakistan.

Abstract body:

Background: 
Physical activity is very important for control blood sugar level. It is very important to assess the PAL accurately so we can judge how the subject is improving his/her PAL.

Aim:
This study aimed at the development   and evaluation of a simple local  Physical Activity Level Calculator (PALC)    for assessing physically activity level to assess its usefulness for dieticians, diabetes educators and people with diabetes. 

Method:
A short researcher-administered questionnaire was used to collect data from patients attending the Diabetes Clinic, over a consecutive period of one month. Exclusion criteria were age less that 7 or more than 80 years and inadequate understanding of Urdu.  Subjects were asked questions about their self perception of their Activity level as Sedentary or being active and about number of hours they spend in bed, sitting, light activities and heavy activities each day. Using an application (PALC: Physical Activity Level Calculator) in Urdu designed by researchers PAL was calculated on the basis of PAR, and time spent in each category of activity. Subjects were categorising as active if their PAL was 2 or more. Information about dietician assessment of activity level was retrieved from hospital records that are usually determined by asking questions about time spent in exercise each week. Association between three methods of assessing PAL and between PAL and BMI were explored.

Results:
Seventy percent of subjects had PAL less that 2 and were categorised as less active. Mean PALC assessed PAL was 1.87 for males and1.92 for females and difference was statistically non significant.  No significant gender differences were seen in activity level either on the basis of self assessment or dietician assessment.
Considering PALC assessment as an arbitrary standard, dietician similarly estimated 53% of subjects, underestimated 24 % of subjects overestimated 23% of subjects; whereas 
 68% of subjects similarly estimated, 7% underestimated and 25% overestimated their activity level. 
Association between self-assessed activity level and PALC-assessed-PAL (r=.419 P <0.001) and between Dietician assessed PAL and Self-assessed PAL (r=.233 P =0.019) was stronger as compared to association between Dietician-assessed PAL and PALC-assessed-PAL (r=.035 P =0.733). BMI had low and marginally non-significant negative association with PAR-based-PAL (r=.187 P <0.063) and Self-assessed PAL (r=.174 P =0.083).

Discussion:
Seventy percent of subjects had PAL less that 2 and were categorised as less active. Mean PALC assessed PAL was 1.87 for males and1.92 for females and difference was statistically non significant.  No significant gender differences were seen in activity level either on the basis of self assessment or dietician assessment.
Considering PALC assessment as an arbitrary standard, dietician similarly estimated 53% of subjects, underestimated 24 % of subjects overestimated 23% of subjects; whereas 
 68% of subjects similarly estimated, 7% underestimated and 25% overestimated their activity level. 
Association between self-assessed activity level and PALC-assessed-PAL (r=.419 P <0.001) and between Dietician assessed PAL and Self-assessed PAL (r=.233 P =0.019) was stronger as compared to association between Dietician-assessed PAL and PALC-assessed-PAL (r=.035 P =0.733). BMI had low and marginally non-significant negative association with PAR-based-PAL (r=.187 P <0.063) and Self-assessed PAL (r=.174 P =0.083).