Validation of the Physical Activity Scale for Individuals With Physical Disabilities

doi:10.1016/j.apmr.2010.12.006

Archives of Physical Medicine and Rehabilitation

Volume 92, Issue 6, June 2011, Pages 923-928

https://doi.org/10.1016/j.apmr.2010.12.006 Get rights and content

Abstract

van den Berg-Emons RJ, L'Ortye AA, Buffart LM, Nieuwenhuijsen C, Nooijen CF, Bergen MP, Stam HJ, Bussmann JB. Validation of the Physical Activity Scale for Individuals With Physical Disabilities.

Objective

To determine the criterion validity of the Physical Activity Scale for Individuals With Physical Disabilities (PASIPD) by means of daily physical activity levels measured by using a validated accelerometry-based activity monitor in a large group of persons with a physical disability.

Design

Cross-sectional.

Setting

Participants' home environment.

Participants

Ambulatory and nonambulatory persons with cerebral palsy, meningomyelocele, or spinal cord injury (N=124).

Interventions

Not applicable.

Main Outcome Measures

Self-reported physical activity level measured by using the PASIPD, a 2-day recall questionnaire, was correlated to objectively measured physical activity level measured by using a validated accelerometry-based activity monitor.

Results

Significant Spearman correlation coefficients between the PASIPD and activity monitor outcome measures ranged from .22 to .37. The PASIPD overestimated the duration of physical activity measured by using the activity monitor (mean ± SD, 3.9±2.9 vs 1.5±0.9h/d; P<.01). Significant correlation (ρ=−.74; P<.01) was found between average number of hours of physical activity per day measured by using the 2 methods and difference in hours between methods. This indicates larger overestimation for persons with higher activity levels.

Conclusions

The PASIPD correlated poorly with objective measurements using an accelerometry-based activity monitor in people with a physical disability. However, similar low correlations between objective and subjective activity measurements have been found in the general population. Users of the PASIPD should be cautious about overestimating physical activity levels.

Section snippets

Participants

A total of 124 subjects participated in this study, including 51 (41%) wheelchair-dependent persons. Participants were aged 16 to 65 years and had a diagnosis of spastic bilateral CP (n=56), MMC (n=47), or SCI (n=21) (table 1). Participants were identified from 3 studies focusing on daily physical activity level and physical fitness conducted at the Department of Rehabilitation Medicine and Physical Therapy, Erasmus Medical Center, or Rijndam Rehabilitation Center (both located in Rotterdam,

Results

PASIPD intensity scores were 11.3±9.1 MET-hours per day for the total group, 11.8±9.1 MET-hours per day for subjects with CP, 10.8±7.6 MET-hours per day for subjects with MMC, 10.9±12.0 MET-hours per day for subjects with SCI, 11.3±8.6 MET-hours per day for ambulatory subjects, and 11.1±9.8 MET-hours per day for nonambulatory subjects.

Table 2 lists correlation coefficients for PASIPD outcome measures and activity monitor duration. Spearman correlations ranged from .10 to .37. The highest

Discussion

In this study, an extensively validated activity monitor was used to assess the criterion validity of the PASIPD for measuring daily physical activity levels. The study assessed subjects with various physical disabilities (CP, MMC, SCI), and varying ambulation and educational levels. Therefore, we believe our results contribute to understanding the validity of the PASIPD for quantification of daily physical activity in persons with a physical disability.

Study results did not support the

Conclusions

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Cited by (63)

Transcultural adaptation and validation of a French version of the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD-Fr)
2021, Annals of Physical and Rehabilitation Medicine
Instruments Measuring Physical Activity in Individuals Who Use a Wheelchair: A Systematic Review of Measurement Properties
2020, Archives of Physical Medicine and Rehabilitation
Citation Excerpt :
Four studies investigated the content validity, construct validity, (structural validity and hypothesis testing), criterion validity, and internal consistency18-21 of the 11- or 13-item Physical Activity Scale for Individuals With Physical Disabilities (PASIPD). Double-labeled water was used as a criterion in 1 study,19 whereas an activity monitor was used as a criterion in another study.20 Two studies investigated properties of the 11-item PASIPD.20,21
To systematically review the evidence evaluating validity or reliability of self-reported and device-based instruments, to measure physical activity (PA) in individuals who use a wheelchair, and to make recommendations for the selection of PA outcomes tools.
PubMed, Embase, and CINAHL were systematically searched.
Studies reporting measurement properties of instruments to assess PA in individuals who use a wheelchair.
The Consensus-Based Standards for the Selection of Health Status Measurement Instruments checklist was used to assess the methodological quality of the included studies. The measurement properties of instruments assessing PA were examined.
The search yielded 5341 records, 61 were considered relevant, 21 articles were included. A best evidence synthesis was performed on 9 studies including 4 self-reported instruments and 13 studies including 8 device-based instruments. One study evaluated both self-reported and device-based instruments. The overall methodological quality of all studies ranged from poor to excellent. Variable levels of evidence were found for both the validity and reliability for self-reported instruments and for criterion validity for device-based instruments.
The Physical Activity Scale for Individuals with Disabilities (PASIPD) and The Physical Activity Recall Assessment for People with Spinal Cord Injury (PARA-SCI) seem the most promising self-reported instruments for measuring the intensity of PA. Device-based instruments that can be used for measuring both the intensity and type of PA are the GENEActiv, Actigraph GT3X+, Actiheart, or the Physical Activity Monitor System (PAMS), showing moderate evidence for a positive rating of criterion validity. For measuring the type of PA, the PAMS and VitaMove are suitable, showing both good evidence for a positive rating of criterion validity.
Focus on Risk Factors for Cardiometabolic Disease in Cerebral Palsy: Toward a Core Set of Outcome Measurement Instruments
2019, Archives of Physical Medicine and Rehabilitation
To identify existing outcome measurement instruments (OMIs) assessing risk factors for cardiometabolic disease in adolescents and adults with cerebral palsy (CP) reported on in the literature or used in the field.
The COnsensus-based Standards for the selection of health Measurement Instruments database of systematic reviews and 4 electronic databases (Embase, MEDLINE/Ovid, MEDLINE/Pubmed, PsychINFO) were searched up to June 19, 2017, that yielded 2594 articles. Experts in the field were consulted to identify any additional OMIs.
Two reviewers independently applied inclusion criteria to select eligible studies using or evaluating measurement properties of OMIs assessing 1 of 8 outcomes: cardiorespiratory endurance, body size, body composition, physical behavior, sleep, nutrition, blood pressure, and blood lipids and glucose. Studies with an experimental or observational design including ≥10 adolescents or adults with CP were included.
One reviewer extracted data that were summarized for study and sample characteristics, outcomes, OMIs used, and if applicable data on measurement properties. Two reviewers rated the methodological quality and the quality of the OMIs. Feasibility for clinical practice and research was rated by experts in the field.
Ninety OMIs were identified from 56 included articles and by the experts. Seventy OMIs pertained to cardiorespiratory endurance, body size, body composition, and physical behavior, whereas only 5 were identified for sleep and nutrition. Overall synthesis revealed that there is moderate to poor evidence for good quality of OMIs in this population. Based on feasibility for clinical practice, experts agreed on a single OMI per outcome (and 2 for cardiorespiratory endurance) to be included in a core set.
Despite the range of available OMIs to assess risk factors for cardiometabolic disease in adolescents and adults with CP, evidence of good quality is often lacking. Nonetheless, a preliminary core set of 9 OMIs was systematically developed.
Understanding the factors that impact the participation in physical activity and recreation in young adults with cerebral palsy (CP)
2019, Disability and Health Journal
Citation Excerpt :
Another limitation of this study is the use of a questionnaire to measure the amount of time and intensity of physical activity in young adults with CP. The young adults with CP in this study reported similar physical activity intensities to ambulatory adults with CP reported in the literature (11.849 -14.850 MET-hours per day); however, these results should be interpreted with caution, as it has been shown that recall questionnaires tend to overestimate the amount of time spent participating in physical activity.2,10 This may explain the differences in reported hours of physical activity in this study to that found in the literature using direct measurement of activity.51,52
Young adults with cerebral palsy (CP) are reported to be less active than their typically developing peers, have higher rates of sedentary behaviors, engage in slower tempo activities, and overall participate in a smaller variety of physical activities (PA). Functional motor level and environmental barriers have been purported to impact the ability of young adult with CP to participate in physical activity and recreational activities.
To examine the role functional motor level and environmental barriers have on participation in PA and recreation in young adults with CP.
A survey assessing functional motor level (Gross Motor Function Classification Scale), participation in physical activity (The Physical Activity Scale for Individuals with Physical Disabilities) and recreation (The Assessment of Life Habits), and environmental barriers (The Craig Hospital Inventory of Environmental Factors) was mailed to 442 young adults with CP, between the ages of 18–30 years.
97 surveys were returned. No differences in PA were found between GMFCS level; however, young adults in GMFCS levels I and II participated more in recreational activities than GMFCS levels III-V. Greater environmental barriers were experienced by young adults in GMFCS II-V.
This study showed that GMFCS level and physical/structural, policy and attitudinal barriers significantly impacted participation in recreational activities for young adults with CP. Strategies for addressing these barriers from both an individualized therapeutic and advocacy perspective are needed in order to facilitate engagement in physical activity and recreation for young adults with CP at all GMFCS levels.
Lifestyle and health changes in wheelchair users with a chronic disability after 12 weeks of using the WHEELS mHealth application
2024, Disability and Rehabilitation: Assistive Technology
Effects of the SmartDrive on mobility, activity, and shoulder pain among manual wheelchair users with spinal cord injury–a prospective long-term cohort pilot study
2024, Disability and Rehabilitation: Assistive Technology

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: Supported by Kinder Fonds Adriaanstichting (grant no. 2003/0047-063), Johanna Kinder Fonds (grant nos. 2003/0047-063, 20000005/20000158, 2002/0067), and ZONmw Rehabilitation program (grant no. 1435.0003).

: No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

: Reprints are not available from the author.

: Published online April 19, 2011 at www.archives-pmr.org.

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Original articleValidation of the Physical Activity Scale for Individuals With Physical Disabilities

Abstract

Objective

Design

Setting

Participants

Interventions

Main Outcome Measures

Results

Conclusions

Section snippets

Participants

Results

Discussion

Conclusions

J Pediatr

Arch Phys Med Rehabil

Arch Phys Med Rehabil

Pain

Arch Phys Med Rehabil

J Clin Epidemiol

J Clin Epidemiol

J Clin Epidemiol

Sleep Med

Ann Epidemiol

J Sci Med Sport Sports Med Australia

Healthy people 2010: understanding and improving health

Body fat, fitness and level of everyday physical activity in adolescents and young adults with meningomyelocele

J Rehabil Med

Inactive lifestyle in adults with bilateral spastic cerebral palsy

J Rehabil Med

Level of activities associated with mobility during everyday life in patients with chronic congestive heart failure as measured with an “activity monitor”

Phys Ther

Triad of physical activity, aerobic fitness and obesity in adolescents and young adults with myelomeningocele

J Rehabil Med

Validity of the detection of wheelchair propulsion as measured with an activity monitor in patients with spinal cord injury

Spinal Cord

Measuring daily behavior using ambulatory accelerometry: the activity monitor

Behav Res Methods Instrum Comput

Validity of ambulatory accelerometry to quantify physical activity in heart failure

Scand J Rehabil Med

Original article
Validation of the Physical Activity Scale for Individuals With Physical Disabilities