Criterion validity of The International Physical Activity Questionnaire-Short Form (IPAQ-SF) for use in clinical practice in patients with osteoarthritis

Abstract

Background To tailor physical activity treatment programs for patients with osteoarthritis, clinicians need valid and feasible measurement tools to evaluate habitual physical activity. The widely used International Physical Activity Questionnaire-Short Form (IPAQ-SF) is not previously validated in patients with osteoarthritis. Purpose To assess the concurrent criterion validity of the IPAQ-SF in patients with osteoarthritis, using an accelerometer as a criterion-method. Method Patients with osteoarthritis (n = 115) were recruited at The Division of Rheumatology and Research at Diakonhjemmet Hospital (Oslo, Norway). Physical activity was measured by patients wearing an accelerometer (ActiGraph wGT3X-BT) for seven consecutive days, followed by reporting their physical activity for the past 7 days using the IPAQ-SF. Comparison of proportions that fulfilled physical activity recommendations as measured by the two methods were tested by Pearson Chi-Square analysis. Differences in physical activity levels between the IPAQ-SF and the accelerometer were analyzed with Wilcoxon Signed-Rank Test and Spearman rank correlation test. Bland-Altman plots were used to visualize the concurrent criterion validity for total- and intensity-specific physical activity levels. Results In total, 93 patients provided complete physical activity data, mean (SD) age was 65 (8.7) years, 87% were women. According to the IPAQ-SF, 57% of the patients fulfilled the minimum physical activity recommendations compared to 31% according to the accelerometer (p = 0.043). When comparing the IPAQ-SF to the accelerometer we found significant under-reporting of total physical activity MET-minutes (p = < 0.001), sitting (p = < 0.001) and walking (p < 0.001), and significant over-reporting of moderate-to-vigorous physical activity (p < 0.001). For the different physical activity levels, correlations between the IPAQ-SF and the accelerometer ranged from rho 0.106 to 0.462. The Bland-Altman plots indicated an increased divergence between the two methods with increasing time spent on moderate-to-vigorous intensity physical activity. Conclusion Physical activity is a core treatment of osteoarthritis. Our finding that patients tend to over-report activity of higher intensity and under-report low-intensity activity and sitting-time is of clinical importance. We conclude that the concurrent criterion validity of the IPAQ-SF was weak in patients with osteoarthritis.

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“…The International Physical Activity Questionnaire (IPAQ-SF) was used to assess PA in its short form. It followed the classification indicated in several studies ( 24 – 28 ) and agreed with the official IPAQ classification protocol (www.ipaq.ki.se) ( 29 ), in which individuals are classified in three PA levels. These levels are calculated based on the duration (minutes), frequency per week, and MET intensity (MET.min/week); this value is obtained through a weighted approximation of the total PA performed during 1 week ( 27 ).…”

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“…However, our study population included elderly people over 70 years old. This data collection tool has only recently been used in clinical practice to evaluate this age group ( 27 , 28 ). Fourth, the COVID-19 infection rate was lower and measures employed in the study area less stringent than those in Western countries and other regions with government-enforced lockdowns and quarantines.…”

Effects of Protein-Rich Nutritional Composition Supplementation on Sarcopenia Indices and Physical Activity during Resistance Exercise Training in Older Women with Knee Osteoarthritis

“…The IPAQ-SF comprises seven open-ended questions concerning individuals’ recollection of their physical activity during the last 7 days [ 79 ]. One study confirmed the validity and reliability of the IPAQ-SF for older adults with osteoarthritis [ 80 ]. Each type of activity was transformed into a metabolic equivalent (MET) score, which was defined elsewhere [ 81 ].…”