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Silva F.G.1, Oliveira C.B.1, Hisamatsu T.M.1, Franco M.R.1, Morelhão P.K.1, Pinto R.Z.1
1São Paulo State University (UNESP), Physiotherapy Department, Presidente Prudente, Brazil
Background: Physical inactivity is recognized as a major contributing risk factor for disability-adjusted life years and premature death. In Brazil, about 60% of the population are not engaged in any kind of physical activity. Currently there are many different methods for assessing physical activity levels. Choosing the ideal method depends on several factors, such as the physical activity domains of interest, sample size, population being studied and the applicability of the instrument. Self-report instruments are widely used and the number of questionnaires has increased considerably. Thus, the choice of which questionnaire to use becomes a challenge since they require a strict process of cross-cultural adaptation and assessment of the measurement properties.
Purpose: To identify and evaluate the quality of the translation and the cross-cultural adaptation procedures as well as the measurement properties of questionnaires available in Portuguese that assess physical activity levels.
Methods: Systematic literature searches were conducted on MEDLINE, EMBASE, CINAHL, SCIELO and LILACS. The search strategy combined terms related to physical activity, questionnaires and portuguese. To be included, studies should investigate questionnaires designed to evaluate physical activity levels for the general or clinical population and/or used in observational studies. Data related to translation, cultural adaptation and psychometric properties of each study were extracted. Methodological quality of the studies was assessed using a modified version of the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN).
Results: Forty-four studies were included in this review. The most frequent questionnaires assessed were IPAQ - International Physical Activity Questionnaire (short version, n=4; and long version, n=7), Baecke - Habitual Physical Activity Questionnaire (n=6) and PACI - Physical Activity Checklist Interview (n=3). Translation and cross-cultural adaptation (n=10), reliability (n=25) and construct validity (n=19) were the most measurement properties investigated. The methodological quality of the included studies revealed that many of them were considered as ´´poor ´´ according to the COSMIN criteria for reliability (n=25), construct validity (n=19), internal consistency (n=5) and cross-cultural validity (n=12). Reliability of the questionnaires ranged from moderate to excellent and construct validity revealed a correlation between the questionnaires and objective measures ranging from none to moderate. No study was identified investigating the responsiveness.
Conclusion(s): These findings showed that most studies investigating measurement properties of physical activity questionnaires available in Portuguese are assigned to the IPAQ and the Baecke questionnaires. Importantly, the measurement properties of most questionnaires have not been fully tested. Furthermore, there is a lack of studies investigating the responsiveness of self-report questionnaires.
Implications: Our findings revealed that information derived from current questionnaires available in Portuguese need to be interpreted with caution due to low methodological quality and the lack of studies investigating all measurement properties. Future studies should investigate the responsiveness of physical activity questionnaires to verify their ability to detect changes over time. In addition, we advocate for the use of COSMIN methodology in future studies in this area.
Funding acknowledgements: Supported by the São Paulo Research Foundation (grant nos. 2016/03826-5, 2015/17093-7, 2015/07704-9, 2015/02744-2, and 2014/14077-8).
Topic: Health promotion & wellbeing/healthy ageing
Ethics approval: Ethics approval was not required
All authors, affiliations and abstracts have been published as submitted.
