Validity and reproducibility of the Physical Activity Scale for the Elderly (PASE) questionnaire for the measurement of the physical activity level in patients after total knee arthroplasty

Sylvain Bolszak,Franco M Impellizzeri,Nicola A Maffiuletti,Nicola C Casartelli

doi:10.1186/1471-2474-15-46

Abstract

BackgroundThe need for valid and reproducible questionnaires to routinely assess the physical activity level of patients after total knee arthroplasty (TKA) is of particular concern in clinical settings. Aims of this study were to evaluate the validity and reproducibility of the physical activity scale for the elderly (PASE) questionnaire in TKA patients, with a particular view on gender differences.MethodsA total of 50 elderly patients (25 women and 25 men aged 70 ± 6 years) following primary unilateral TKA were recruited. The reproducibility was evaluated by administering the PASE questionnaire during two occasions separated by 7 days. The construct (criterion) validity was investigated by comparing the physical activity level reported by patients in the PASE questionnaire to that measured by accelerometry. Reproducibility was evaluated using intraclass correlation coefficients (ICC3,1) for reliability and standard error of measurement (SEM) and smallest detectable change (SDC) for agreement, while validity was investigated with Pearson correlation coefficients.ResultsReliability of the PASE total score was acceptable for men (ICC = 0.77) but not for women (ICC = 0.58). Its agreement was low for both men and women, as witnessed by high SEM (32% and 35%, respectively) and SDC (89% and 97%, respectively). Construct validity of the PASE total score was low in both men (r = 0.45) and women (r = 0.06).ConclusionsThe PASE questionnaire has several validity and reproducibility shortcomings, therefore its use is not recommended for the assessment of physical activity level in patients after TKA, particularly in women.

Highlights

The need for valid and reproducible questionnaires to routinely assess the physical activity level of patients after total knee arthroplasty (TKA) is of particular concern in clinical settings
* Correspondence: bolszaks@hotmail.com 1Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland 2Neuromuscular Research Laboratory, Schulthess Clinic, Zurich, Switzerland Full list of author information is available at the end of the article procedures performed in developed countries has increased by over 25% in the last decade, partly due to population aging [2,3], with about two thirds of all TKAs performed on women [5]
Women demonstrated a lower recreational activity physical activity scale for the elderly (PASE) sub-score at test session 2 compared to session 1 (P = 0.04)

Summary

Introduction

The need for valid and reproducible questionnaires to routinely assess the physical activity level of patients after total knee arthroplasty (TKA) is of particular concern in clinical settings. Aims of this study were to evaluate the validity and reproducibility of the physical activity scale for the elderly (PASE) questionnaire in TKA patients, with a particular view on gender differences. Accelerometric systems are able to provide the duration and the intensity of physical activities, as well as the associated energy expenditure. They are often used to validate physical activity questionnaires because they measure closely-related constructs [12]. Up to now, no questionnaire has proven to be valid and reproducible for the assessment of the PAL in patients after TKA [13]

Objectives

Methods

Results

Discussion

Conclusion