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Physical Activity Characteristics across GOLD Quadrants Depend on the Questionnaire Used.

ABSTRACT: BACKGROUND:The GOLD multidimensional classification of COPD severity combines the exacerbation risk with the symptom experience, for which 3 different questionnaires are permitted. This study investigated differences in physical activity (PA) in the different GOLD quadrants and patient's distribution in relation to the questionnaire used. METHODS:136 COPD patients (58±21% FEV1 predicted, 34F/102M) completed COPD assessment test (CAT), clinical COPD questionnaire (CCQ) and modified Medical Research Council (mMRC) questionnaire. Exacerbation history, spirometry and 6MWD were collected. PA was objectively measured for 2 periods of 1 week, 6 months apart, in 5 European centres; to minimise seasonal and clinical variation the average of these two periods was used for analysis. RESULTS:GOLD quadrants C+D had reduced PA compared with A+B (3824 [2976] vs. 5508 [4671] steps.d-1, p<0.0001). The choice of questionnaire yielded different patient distributions (agreement mMRC-CAT ? = 0.57; CCQ-mMRC ? = 0.71; CCQ-CAT ? = 0.72) with different clinical characteristics. PA was notably lower in patients with an mMRC score ?2 (3430 [2537] vs. 5443 [3776] steps.d-1, p <0.001) in both the low and high risk quadrants. CONCLUSIONS:Using different questionnaires changes the patient distribution and results in different clinical characteristics. Therefore, standardization of the questionnaire used for classification is critical to allow comparison of different studies using this as an entry criterion. CLINICAL TRIAL REGISTRATION:ClinicalTrials.gov NCT01388218.

SUBMITTER: Demeyer H

PROVIDER: S-EPMC4790973 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Physical Activity Characteristics across GOLD Quadrants Depend on the Questionnaire Used.

Demeyer Heleen H Gimeno-Santos Elena E Rabinovich Roberto A RA Hornikx Miek M Louvaris Zafeiris Z de Boer Willem I WI Karlsson Niklas N de Jong Corina C Van der Molen Thys T Vogiatzis Ioannis I Janssens Wim W Garcia-Aymerich Judith J Troosters Thierry T Polkey Michael I MI

PloS one 20160314 3

<h4>Background</h4>The GOLD multidimensional classification of COPD severity combines the exacerbation risk with the symptom experience, for which 3 different questionnaires are permitted. This study investigated differences in physical activity (PA) in the different GOLD quadrants and patient's distribution in relation to the questionnaire used.<h4>Methods</h4>136 COPD patients (58±21% FEV1 predicted, 34F/102M) completed COPD assessment test (CAT), clinical COPD questionnaire (CCQ) and modified ...[more]

PMID: 26974332

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Project description:PurposeTo determine whether respondents share researchers' understandings of concepts and questions frequently used in the assessment of usual physical activity (PA) behavior.MethodsAs part of On the Move, a study aimed at reducing measurement error in self-reported physical activity (PA), we conducted cognitive interviews with 19 men and 21 women, ages 45-65, regarding their responses to the PA questionnaires used in two large, population-based studies, Life After Cancer Epidemiology and California Men's Health study. One questionnaire asks about the frequency, the duration, and the perceived intensity of a range of specific activities in several different domains over the past 12 months. The second questionnaire asks about frequency and duration of specific, mostly recreational activities, grouped by intensity (i.e., moderate or vigorous) over the past 3 months. We used verbal probing techniques to allow respondents to describe their thought processes as they completed the questionnaires. All interviews were tape-recorded and transcribed, and the transcripts were then analyzed using standard qualitative methods.ResultsCognitive interviews demonstrated that a sizable number of respondents understood "intensity" in terms of emotional or psychological intensity rather than physical effort. As a result, the perceived intensity with which a participant reported doing a specific activity often bore little relationship to the MET value of that activity. Additionally, participants often counted the same activity more than once, overestimated work-related PA, and understood activities that were grouped together in a single category to be definitive lists rather than examples.ConclusionCognitive interviews revealed significant gaps between respondents' interpretations of some PA questions and researchers' assumptions about what those questions were intended to measure. Some sources of measurement error in self-reported PA may be minimized by additional research that focuses on the cognitive processes required to respond to PA questionnaires.

Project description:BACKGROUND: Physical activity patterns of a population remain mostly assessed by the questionnaires. However, few physical activity questionnaires have been validated in Asian populations. We previously utilized a combination of different questionnaires to assess leisure time, transportation, occupational and household physical activity in the Singapore Prospective Study Program (SP2). The International Physical Activity Questionnaire (IPAQ) has been developed for a similar purpose. In this study, we compared estimates from these two questionnaires with an objective measure of physical activity in a multi-ethnic Asian population. METHODS: Physical activity was measured in 152 Chinese, Malay and Asian Indian adults using an accelerometer over five consecutive days, including a weekend. Participants completed both the physical activity questionnaire in SP2 (SP2PAQ) and IPAQ long form. 43 subjects underwent a second set of measurements on average 6 months later to assess reproducibility of the questionnaires and the accelerometer measurements. Spearman correlations were used to evaluate validity and reproducibility and correlations for validity were corrected for within-person variation of accelerometer measurements. Agreement between the questionnaires and the accelerometer measurements was also evaluated using Bland Altman plots. RESULTS: The corrected correlation with accelerometer estimates of energy expenditure from physical activity was better for the SP2PAQ (vigorous activity: r = 0.73; moderate activity: r = 0.27) than for the IPAQ (vigorous activity: r = 0.31; moderate activity: r = 0.15). For moderate activity, the corrected correlation between SP2PAQ and the accelerometer was higher for Chinese (r = 0.38) and Malays (r = 0.57) than for Indians (r = -0.09). Both questionnaires overestimated energy expenditure from physical activity to a greater extent at higher levels of physical activity than at lower levels of physical activity. The reproducibility for moderate activity (accelerometer: r = 0.68; IPAQ: r = 0.58; SP2PAQ: r = 0.55) and vigorous activity (accelerometer: 0.52; IPAQ: r = 0.38; SP2PAQ: r = 0.75) was moderate to high for all instruments. CONCLUSION: The agreement between IPAQ and accelerometer measurements of energy expenditure from physical activity was poor in our Asian study population. The SP2PAQ showed good validity and reproducibility for vigorous activity, but performed less well for moderate activity particularly in Indians. Further effort is needed to develop questionnaires that better capture moderate activity in Asian populations.

Project description:ObjectivesThe use of brief screening tools to identify inactive patients is essential to improve the efficiency of primary care-based physical activity (PA) programs. However, the current employment of short PA questionnaires within the Spanish primary care pathway is unclear. This study evaluated the validity of the Spanish version of a Brief Physical Activity Assessment Tool (SBPAAT).MethodsA validation study was carried out within the EVIDENT project. A convenience sample of patients (n = 1,184; age 58.9±13.7 years; 60.5% female) completed the SBPAAT and the 7-day Physical Activity Recall (7DPAR) and, in addition, wore an accelerometer (ActiGraph GT3X) for seven consecutive days. Validity was evaluated by measuring agreement, Kappa correlation coefficients, sensitivity and specificity in achieving current PA recommendations with the 7DPAR. Pearson correlation coefficients with the number of daily minutes engaged in moderate and vigorous intensity PA according to the accelerometer were also assessed. Comparison with accelerometer counts, daily minutes engaged in sedentary, light, moderate, and vigorous intensity PA, total daily kilocalories, and total PA and leisure time expenditure (METs-hour-week) between the sufficiently and insufficiently active groups identified by SBPAAT were reported.ResultsThe SBPAAT identified 41.3% sufficiently active (n = 489) and 58.7% insufficiently active (n = 695) patients; it showed moderate validity (k = 0.454, 95% CI: 0.402-0.505) and a specificity and sensitivity of 74.3% and 74.6%, respectively. Validity was fair for identifying daily minutes engaged in moderate (r = 0.215, 95% CI:0.156 to 0.272) and vigorous PA (r = 0.282, 95% CI:0.165 to 0.391). Insufficiently active patients according to the SBPAAT significantly reported fewer counts/minute (-22%), fewer minutes/day of moderate (-11.38) and vigorous PA (-2.69), spent fewer total kilocalories/day (-753), and reported a lower energy cost (METs-hour-week) of physical activities globally (-26.82) and during leisure time (-19.62).ConclusionsThe SBPAAT is a valid tool to identify Spanish-speaking patients who are insufficiently active to achieve health benefits.

Project description:Feasible and cost-effective as well as population specific instruments for monitoring physical activity (PA) levels are needed for the management and prevention of non-communicable diseases. The WHO-endorsed Global Physical Activity Questionnaire (GPAQ) has been widely used in developing countries, but the evidence base for its validity, particularly for rural populations, is still limited. The aim of the study was to validate GPAQ among rural and urban residents in Bangladesh.A total of 162 healthy participants of both genders aged 18-60 years were recruited from Satia village (n = 97) and Dhaka City (n = 65). Participants were invited to take part in the study and were asked to wear an accelerometer (GT3X) for 7 days, after which they were invited to answer the GPAQ in a face to face interview.Valid accelerometer data (i.e., ≥10 h of wear times over ≥3 days) were received from 155 participants (rural = 94, urban = 61). The mean age was 35 (SD = ±9) years, 55% were females and 19% of the participants had no schooling, which was higher in the rural area (21% vs 17%). The mean ± SD steps/day was 9998 ± 3936 (8658 ± 2788 and 12,063 ± 4534 for rural and urban respectively, p = 0.0001) and the mean ± SD daily moderate-to-vigorous physical activity (MVPA) was 58 ± 30 min (51 ± 26 for rural and 69 ± 34 for the urban, p = 0.001) for accelerometer. In case of GPAQ, rural residents reported significantly higher moderate work related PA (MET-minutes/week: 600 vs. 360 p = 0.02). Spearman correlation coefficients between GPAQ total MVPA MET-min/day and accelerometer MVPA min/day, counts per minute (CPM) or steps counts/day were acceptable for urban residents (rho: 0.46, 0.55 and 0.63, respectively; p < 0.01) but poor for rural residents. The overall correlation between the GPAQ and accelerometer for sitting was low (rho: 0.23; p < 0.001). GPAQ-Accelerometer correlation for MVPA was higher for females (rho: 0.42), ≤35 age group (rho: 0.31) and those with higher education attainment (rho: 0.48). The Bland-Altman plots illustrated bias towards over estimation of GPAQ MVPA with increased activity levels for urban and rural residents.GPAQ is an acceptable measure for physical activity surveillance in Bangladesh particularly for urban residents, women and people with high education. Given waist worn accelerometers do not capture the typical PA in rural context, further study using a physical activity diary and a combination of multiple sensors (e.g., wrist, ankle and waist worn accelerometers) to capture all movement is warranted among rural population with purposive sampling of all education levels.

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Physical Activity Characteristics across GOLD Quadrants Depend on the Questionnaire Used.

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Physical Activity Characteristics across GOLD Quadrants Depend on the Questionnaire Used.

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