Test-retest reliability, agreement and construct validity of the International Physical Activity Questionnaire short-form (IPAQ-sf) in people with COPD

Sofia Flora; Alda Marques; Nádia Hipólito; Nuno Morais; Cândida G Silva; Filipa Januário; Fátima Rodrigues; Bruno P Carreira; J Cruz

doi:10.1016/j.rmed.2022.107087

Test-retest reliability, agreement and construct validity of the International Physical Activity Questionnaire short-form (IPAQ-sf) in people with COPD

Respir Med. 2023 Jan:206:107087. doi: 10.1016/j.rmed.2022.107087. Epub 2022 Dec 7.

Authors

Sofia Flora¹, Alda Marques², Nádia Hipólito¹, Nuno Morais³, Cândida G Silva⁴, Filipa Januário⁵, Fátima Rodrigues⁶, Bruno P Carreira⁷, J Cruz⁸

Affiliations

¹ Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal.
² Lab 3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA) and Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal.
³ Center for Innovative Care and Health Technology (ciTechCare), Polytechnic Institute of Leiria; School of Health Sciences, Polytechnic Institute of Leiria, Centre for Rapid and Sustainable Product Development (CDRSP), Polytechnic Institute of Leiria, Leiria, Portugal.
⁴ Center for Innovative Care and Health Technology (ciTechCare), Polytechnic Institute of Leiria, School of Health Sciences, Polytechnic Institute of Leiria, Coimbra Chemistry Centre, Department of Chemistry, University of Coimbra, Coimbra, Portugal.
⁵ Physical Medicine and Rehabilitation Department, Leiria Hospital Center, Leiria, Portugal.
⁶ Institute of Health Environmental, Faculty of Medicine, University of Lisbon, Pulmonary Rehabilitation Unit, Hospital Pulido Valente, University Hospital Center North Lisbon, Lisboa, Portugal.
⁷ Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, School of Health Sciences, Polytechnic of Leiria - Leiria; Unidade de Saúde Familiar Pedro e Inês, ACES Oeste Norte, Alcobaça, Portugal.
⁸ Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria; School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal. Electronic address: Joana.cruz@ipleiria.pt.

PMID: 36525854
DOI: 10.1016/j.rmed.2022.107087

Abstract

Introduction: This study assessed the test-retest reliability/agreement and construct validity of the International Physical Activity Questionnaire short-form (IPAQ-sf) in patients with chronic obstructive pulmonary disease (COPD). It also explored differences in its validity according to age, sex and GOLD airflow obstruction levels.

Methods: 62 participants (68 ± 8 years, 53 males, FEV₁ 51 ± 23%pred) completed the Portuguese IPAQ-sf, wore an accelerometer for 7 days and completed a second IPAQ-sf. Test-retest reliability/agreement was assessed with Intraclass Correlation Coefficient (ICC_2,1), 95% Limits of Agreement (LoA), standard error of measurement (SEM) and minimal detectable change (MDC₉₅) for continuous variables, and percentage of agreement (%agreement) for categories ("active"/"inactive"). Validity was assessed with 95% LoA and Spearman's correlations (ρ) between IPAQ-sf 2 (METs-min/week, time in vigorous [VPA], moderate PA [MPA] and walking) and accelerometry (time in MVPA, VPA, MPA and step counts) for continuous variables; %agreement, Cohen's kappa, and sensitivity specificity and±predictive values for categories. Correlations were also performed for age, sex and GOLD airflow obstruction grades.

Results: Reliability was good (ICC_2,1 = 0.707) with wide LoA (-6446-6409 METs-min/week). SEM and MDC₉₅ were 1840 and 4971 METs-min/week, respectively. %agreement between the two IPAQ-sf was 84% (kappa = 0.660). Positive, moderate and significant correlations were found between IPAQ-sf and accelerometry (0.396 ≤ ρ ≤ 0.527, p < 0.001), except for VPA (p > 0.05). The strongest correlations were found in age (<65 years) and male (0.466 ≤ ρ ≤ 0.653, p < 0.05). %agreement between tools was 65% (kappa = 0.313), with high sensitivity (0.830) but low specificity (0.500).

Conclusions: The IPAQ-sf seems valid to be used in COPD but caution on its widespread use is recommended as its accuracy may be limited.

Keywords: Accelerometer; Chronic obstructive pulmonary disease; Physical activity; Psychometric properties; Validation study.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Exercise*
Humans
Male
Pulmonary Disease, Chronic Obstructive*
Reproducibility of Results
Surveys and Questionnaires
Walking