Assessing Measurement Properties of Self-Report Physical Activity Instruments for Osteoarthritis

The results of a systematic review published in Arthritis Care & Research identified several physical activity instruments that may provide help in choosing suitable treatment for individuals with osteoarthritis (OA). However, none of these instruments was sufficiently high quality across all domains of validity and reliability for recommendation in clinical settings.

Researchers performed a systematic review in 2 stages. The first stage identified all self-report physical activity instruments used in published trials involving adult patients (≥45 years) with joint pain attributable to OA in the feet, knee, hips, or hands. The second stage captured all published evidence on the measurement properties of the instruments identified in the first stage. The studies used in each stage were identified through electronic database searches of MEDLINE, EMBASE, and Web of Science. The Quality Assessment of Physical Activity Questionnaires checklist and the Consensus-Based Standards for the Selection of Health Measurement Instruments checklist were used as comprehensive quality assessment tools for each physical activity instrument.

The first stage identified 23 unique self-report physical activity instruments in 91 studies from an initial search return of 20,116 articles. The most common physical activity instruments described by selected studies were the Physical Activity Scale for the Elderly (PASE) and the International Physical Activity Questionnaire-Short Form (IPAQ-SF), mentioned in 34 and 17 articles, respectively. The majority of physical activity instruments were multi-item self-report questionnaires (n=17) and 5 were single item. The second stage identified 53 studies that evaluated the measurement properties of 13 of the 23 instruments described in the first stage. None of these instruments demonstrated “full adequacy” across all domains of reliability, validity, and responsiveness. According to interclass correlation coefficient, used as a reliability index, just 4 instruments demonstrated adequate reliability (interclass correlation coefficient ≥0.7). These instruments were the Modified Baecke questionnaire, the Human Activity Profile, IPAQ-SF, and PASE. According to construct validity assessments, the Baecke, IPAQ-SF, and PASE demonstrated low to moderate correlations with accelerometers, which were considered a direct measure of physical activity. The PASE and Modified Baecke were the only instruments with evaluated criterion validity and showed a moderate correlation with double-labelled water, which was considered the gold standard measurement for physical activity.

Although several instruments were identified in this systematic review, none was sufficient across all measured domains of reliability, validity, and responsiveness. Future research is necessary to identify a proper self-report physical activity instrument that may be recommended for use by patients with OA.

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Reference

Smith RD, Dziedzic KS, Quicke JG, Holden MA, McHugh GA, Healey EL. Identification and evaluation of self‐reported physical activity instruments in adults with osteoarthritis: A systematic review [published online October 15, 2018]. Arthritis Care Res. doi: 10.1002/acr.23787