Comparative Evaluation of Blood Pressure, Central Adiposity, and Physical Activity Patterns Between Wheelchair Users and Ambulatory Adults in a Rural South African Settings: A Cross-Sectional Study Protocol
- 1University of Zululand
Abstract
BackgroundHypertension is a major modifiable driver of cardiovascular disease in low- and middle-income countries, heavily driven by central adiposity and physical inactivity. Wheelchair users represent a structurally marginalized population facing heightened exposure to prolonged sitting and altered body composition. However, context-specific epidemiological data comparing cardiovascular risk profiles by mobility status in rural South Africa remain scarce.
ObjectiveThis study aims to compare blood pressure profiles, central adiposity (waist circumference), physical activity levels, and sedentary behavior between wheelchair users and ambulatory adults in the Thulamela Municipality, Limpopo Province, and to determine if mobility status is independently associated with hypertension.
MethodsThis study utilizes an analytical, community-based cross-sectional design. A sample of N = 210 adults (n = 70 wheelchair users; n = 140 ambulatory controls) will be recruited using purposive and convenience sampling strategies within rural networks. Assessments will feature seated blood pressure measurements and seated waist circumference metrics to standardize data collection across both groups. Physical activity and sedentary durations will be quantified using the Leisure Time Physical Activity Questionnaire for Spinal Cord Injury (LTPAQ-SCI) and the International Physical Activity Questionnaire Short Form (IPAQ-SF). Outcomes will be mathematically harmonized into weekly minutes of moderate-to-vigorous physical activity (MVPA).
AnalysisInter-group variations will be assessed using independent samples t-tests or Mann-Whitney U tests. Multivariate binary logistic regression models will isolate the independent association between mobility status and hypertension, controlling for confounding clinical and demographic factors.
Strengths and Limitations of This StudyO_LIStrength: Standardizes both hemodynamic (blood pressure) and anthropometric (waist circumference) measurements in a seated position to eliminate positional bias between wheelchair and ambulatory cohorts. C_LIO_LIStrength: Harmonizes two population-validated physical activity questionnaires (LTPAQ-SCI and IPAQ-SF) into a single continuous metric (MVPA) to bridge functional measurement gaps. C_LIO_LIStrength: Targets an epidemiologically under-researched, structurally marginalized population in rural, resource-constrained South African settings. C_LIO_LILimitation: The cross-sectional design limits the ability to establish causal relationships between mobility status, central adiposity, and the onset of hypertension. C_LIO_LILimitation: Relying on self-reported questionnaires for physical activity and sedentary behavior introduces potential recall and social desirability biases compared to device-based accelerometry. C_LI
Related
- Associations of Multidimensional Image-Derived Facial Skin Scores with Adiposity Measures in a Large Screening Cohort in Japan: A Cross-Sectional Study with Internal Temporal Evaluation
- Comparative Evaluation of Large Language Model Interfaces in Third Molar Surgery Complication Scenarios: Response Quality, Clinical Content, Potential Clinical Risk, Readability, and Externally Observable Response Latency—A Cross-Sectional Comparative Benchmark Study
- Comparative Clinical Outcomes Across Ambulatory Cardiac Monitoring Modalities
- Comparative evaluation of four large language models for postoperative patient education after septorhinoplasty: A bilingual cross-sectional study
- Professional group differences in general and abdominal adiposity: the roles of sex and age in a retrospective cross-sectional study
BibTeX
@misc{nefale2026comparative,
title = {{Comparative Evaluation of Blood Pressure, Central Adiposity, and Physical Activity Patterns Between Wheelchair Users and Ambulatory Adults in a Rural South African Settings: A Cross-Sectional Study Protocol}},
author = {T. Nefale and M. L. L. Mathunjwa and B. Shaw and G. Mukoma},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.16.26363280},
url = {https://www.medrxiv.org/content/10.64898/2026.09.16.26363280v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Comparative Evaluation of Blood Pressure, Central Adiposity, and Physical Activity Patterns Between Wheelchair Users and Ambulatory Adults in a Rural South African Settings: A Cross-Sectional Study Protocol
AU - T. Nefale
AU - M. L. L. Mathunjwa
AU - B. Shaw
AU - G. Mukoma
PY - 2026
DA - 2026/09/16
PB - medRxiv
DO - 10.64898/2026.09.16.26363280
UR - https://www.medrxiv.org/content/10.64898/2026.09.16.26363280v1
AB - BackgroundHypertension is a major modifiable driver of cardiovascular disease in low- and middle-income countries, heavily driven by central adiposity and physical inactivity. Wheelchair users represent a structurally marginalized population facing heightened exposure to prolonged sitting and altered body composition. However, context-specific epidemiological data comparing cardiovascular risk profiles by mobility status in rural South Africa remain scarce. ObjectiveThis study aims to compare blood pressure profiles, central adiposity (waist circumference), physical activity levels, and sedentary behavior between wheelchair users and ambulatory adults in the Thulamela Municipality, Limpopo Province, and to determine if mobility status is independently associated with hypertension. MethodsThis study utilizes an analytical, community-based cross-sectional design. A sample of N = 210 adults (n = 70 wheelchair users; n = 140 ambulatory controls) will be recruited using purposive and convenience sampling strategies within rural networks. Assessments will feature seated blood pressure measurements and seated waist circumference metrics to standardize data collection across both groups. Physical activity and sedentary durations will be quantified using the Leisure Time Physical Activity Questionnaire for Spinal Cord Injury (LTPAQ-SCI) and the International Physical Activity Questionnaire Short Form (IPAQ-SF). Outcomes will be mathematically harmonized into weekly minutes of moderate-to-vigorous physical activity (MVPA). AnalysisInter-group variations will be assessed using independent samples t-tests or Mann-Whitney U tests. Multivariate binary logistic regression models will isolate the independent association between mobility status and hypertension, controlling for confounding clinical and demographic factors. Strengths and Limitations of This StudyO_LIStrength: Standardizes both hemodynamic (blood pressure) and anthropometric (waist circumference) measurements in a seated position to eliminate positional bias between wheelchair and ambulatory cohorts. C_LIO_LIStrength: Harmonizes two population-validated physical activity questionnaires (LTPAQ-SCI and IPAQ-SF) into a single continuous metric (MVPA) to bridge functional measurement gaps. C_LIO_LIStrength: Targets an epidemiologically under-researched, structurally marginalized population in rural, resource-constrained South African settings. C_LIO_LILimitation: The cross-sectional design limits the ability to establish causal relationships between mobility status, central adiposity, and the onset of hypertension. C_LIO_LILimitation: Relying on self-reported questionnaires for physical activity and sedentary behavior introduces potential recall and social desirability biases compared to device-based accelerometry. C_LI
ER -