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Vergauwen K.1,2,3, Huijnen I.P.J.4,5,6, Depuydt A.7, Van Regenmortel J.7, Meeus M.8,9,10
1Artesis Plantijn University College, Health and Social Care, Antwerp, Belgium, 2Ghent University, Occupational Therapy, Ghent, Belgium, 3Catholic University Leuven, Occupational Therapy, Leuven, Belgium, 4Research School CAPHRI Maastricht University, Rehabilitation Medicine, Maastricht, Netherlands, 5Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, Netherlands, 6Academic Hospital Maastricht, Rehabilitation Medicine, Maastricht, Belgium, 7Self-employed, Antwerp, Belgium, 8Ghent University, Rehabilitation Sciences and Physiotherapy, Ghent, Belgium, 9University of Antwerp, Rehabilitation Sciences and Physiotherapy, Antwerp, Belgium, 10Pain in Motion Research Group, Antwerp, Belgium
Background: A lower activity level and imbalanced activity pattern are frequently observed in persons with chronic fatigue syndrome (CFS) due to debilitating fatigue and post-exertional malaise (PEM), resulting in limitations in important areas of life. Rehabilitation treatments should focus on enabling patients to perform their daily life activities, thus insight in a patient's physical activity level and pattern is necessary. Identification of measurement instruments to evaluate the physical activity level and pattern is therefore important.
Purpose: To identify measurement instruments suited to evaluate the physical activity level and/or pattern in patients with CFS and review their psychometric properties.
Methods: A systematic literature search was performed in the electronic databases PubMed and Web of Science until 28 February 2014. Articles including relevant measurement instruments were identified and included for further analysis. The psychometric properties of relevant measurement instruments were extracted from the included articles and rated based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist.
Results: The review was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A total of 108 articles and 15 unique measurement instruments were found, but solely three instruments were evaluated in patients with CFS. The Chronic Fatigue Syndrome-Activity Questionnaire (CFS-AQ), Activity Pattern Interview (API) and International Physical Activity Questionnaire-Short Form (IPAQ-SF) are three self-report instruments measuring the physical activity level. No studies about the psychometric properties of motion sensors in patients with CFS were found, although they are often used as the gold standard to measure the physical activity pattern.
Conclusion(s): Although none of the three measurement instruments are optimal to use, the IPAQ-SF is equally capable of evaluating the physical activity level like the CFS-AQ and API and has the highest sensitivity of the three instruments. More research is needed to evaluate the psychometric properties of existing instruments, including the use of motion sensors, and new self-report measurement instruments capable of measuring the physical activity pattern should be developed.
Implications: There are many measurement instruments available to measure the physical activity level and pattern, but the psychometric properties of most measurement instruments in patients with CFS are unknown. Their results should therefore be interpreted with caution when used in scientific research or clinical practice with patients with CFS. Based on the evaluation of all measurement instruments, their psychometric properties and further remarks, the IPAQ-SF seems currently the best measurement instrument to evaluate the activity level in a population with CFS. Although the IPAQ-SF is a self-report measurement, it provides insight of a patients own view on his activity level and allows assessment over a longer time span and long distance.
Funding acknowledgements: None
Topic: Research methodology & knowledge translation
Ethics approval: None
All authors, affiliations and abstracts have been published as submitted.
