Validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF): a systematic review.

Relation Between Self-Reported Physical Activity Level, Fitness, and Cardiometabolic Risk

BackgroundEstimation of physical activity contributes to early screening and prevention of decrease in body function. This study was conducted to examine the reliability and validity of the International Physical Activity Questionnaire (IPAQ) short form in elderly people.MethodsA total of 55 outpatients of 65 years old or older participated in this study. Physical activity over the last seven days was recorded on the IPAQ short form. Responses were converted to metabolic equivalent task minutes per week. The IPAQ short form was validated against accelerometer measurements as a gold standard. The test-retest method was performed over a two-week interval to examine the reliability of the IPAQ.ResultsThe more physically active by the IPAQ short form, the higher the measured value of the accelerometer (P < 0.001). Pearson's correlation coefficient was 0.43 for the correlation between the results of two measurements. Spearman Rho coefficients and Kappa values of test-retest reliability in five elements (vigorous days, vigorous minutes, moderate days, moderate minutes, and walk days) were 0.299-0.605 and 0.307-0.418, respectively.ConclusionThe validity of the IPAQ short form was proven, but the reliability was found to be low. Nevertheless, IPAQ short form seems worthwhile tool for the measurement of physical activity levels, concerning daily variation in physical activity of the elderly.

Aging, in conjunction with decreasing physical activity, is associated with a range of health problems. Simple, low-maintenance, population-based means of promoting activity to counteract the age-associated decline are required. We therefore assessed the effect of pedometry and buddy support to increase physical activity. We undertook a clustered randomized trial (HKCTR-346) of 24 community centers involving 399 older Chinese participants (≥ 60 yr). Centers were randomly allocated to 1) pedometry and buddy, 2) pedometry and no buddy, 3) no pedometry and buddy, and 4) no pedometry and no buddy with a 2 × 2 factorial design. The trial simultaneously tested the individual and combined effects of the interventions. The intervention groups also received monthly organized group activities to provide encouragement and support. Outcome measures were assessed at 6 and 12 months, including physical fitness and activity and cardiovascular disease risk factors (anthropometry and blood pressure). From the 24 centers, 356 volunteers (89.2%) completed the study. Those receiving the interventions had higher mean physical activity levels at 12 months of 1820 (95% confidence interval (CI) = 1360-2290) and 1260 (95% CI = 780-1740) MET·min·wk(-1), respectively relative to the decrease in the control groups. The buddy peer support intervention significantly improved mean aerobic fitness (12% [95% CI = 4%-21%]) and reduced both body fat (-0.6% [95% CI = -1.1% to 0.0%]) and time to complete the 2.5-m get-up-and-go test (-0.27 [95% CI = -0.53 to -0.01] s). No other improvements in the cardiovascular disease risk factors were observed. The combination of motivational tools was no better than the individual interventions. Both motivational interventions increased physical activity levels, and the buddy style improved fitness. These tools could be useful adjuncts in the prevention of obesity and age-related complications.

BackgroundThe International Physical Activity Questionnaire short-form (IPAQ-SF) is frequently used to assess physical activity (PA) level in the general adult population including pregnant women. However, the reliability and validity of the questionnaire in pregnancy is unknown. Therefore, the aims of the present study were to investigate test-retest reliability and concurrent validity of IPAQ-SF among pregnant women, and whether PA is reported differently among those who fulfill (active) vs. do not fulfill (inactive) recommendations of ≥150 min of weekly moderate intensity PA in pregnancy.MethodTest-retest reliability was examined by answering IPAQ-SF twice, two weeks apart (n = 88). To assess validity, IPAQ-SF was compared to the physical activity monitor SenseWear Armband® (SWA) (n = 64). The participants wore SWA for 8 consecutive days before answering IPAQ-SF. PA level was reported as time spent in moderate-, vigorous- and moderate-to-vigorous intensity PA (MPA, VPA and MVPA) corresponding to the cut-off points 3–6, >6 and >3 Metabolic Equivalents (METs), respectively.ResultsTest-retest intraclass-correlation of MPA, VPA and MVPA ranged from 0.81-0.84 (95% Confidence Intervals: 0.69,0.90). Comparing time spent performing PA at various intensities; the mean differences and limits of agreement (±1.96 Standard Deviation) from Bland-Altman plots were−84 ± 402 min/week for MPA,−85 ± 452 min/week for MVPA and 26 ± 78 min/week for VPA, illustrating that the total group under-reported MPA by 72% and MVPA by 52%, while VPA was over-reported by 1400%. For the inactive group corresponding numbers were 44 ± 327 min/week for MPA, 52 ± 355 min/week for MVPA and 16 ± 33 min/week for VPA, illustrating that the inactive group over-reported MPA by 13% and MVPA by 49%, while VPA was not detected by SWA, but participants reported 16 min of VPA/week. In contrast, corresponding numbers for the active group were−197 ± 326 min/week for MPA,−205 ± 396 min/week for MVPA and 35 ± 85 min/week for VPA, illustrating that the active group under-reported MPA by 81% and MVPA by 60%, while they over-reported VPA by 975%.ConclusionIPAQ-SF had good test-retest reliability, but low to fair concurrent validity for MPA, VPA and MVPA compared to an objective criterion measure among pregnant women. Further, women fulfilling PA guidelines in pregnancy under-reported, while inactive women over-reported PA level.

Background&#13;\nAccording to the World Health Organization, sedentary lifestyle is a worldwide phenomenon nowadays and it is associated with many chronic diseases. Thus the promotion of active lifestyle is a public health priority. “The International Physical Activity Questionnaire Short Form” (IPAQ-SF) is recommended as an efficient and cost-effective tool for physical activity (PA) assessment. The validity of IPAQ-SF has been studied with inconsistent results within different age groups. This systematic review is aimed at analyzing and synthesizing validation tests of IPAQ-SF in adults.&#13;\n&#13;\nMethods&#13;\nPublished articles were searched with keywords of “International Physical Activity Questionnaire Short Form”, “IPAQ-SF”, “validation”, “validity”, and “adults” in bibliographic database “PubMed”, “Google scholar”, “Chinese National Knowledge Infrastructure” and “Wanfang Database”. Inclusion and exclusion criteria were applied and the results were extracted and summarized.&#13;\n&#13;\nResults&#13;\nTwelve studies published from January 2006 to January 2015 were included in this systematic review. Four studies were from North America (USA 2, Canada 1, Mexico 1), 1 study from South America (Brazil), 3 studies from Asia (Japan, Hong Kong, China), 2 studies from Europe (Norway and Greece), and 2 studies from Africa (Nigeria). Sample size ranged from 102 to 629 and subjects were aged from 23 to 51. The 12 papers included 14 validation analyses, using gold standards of objective movement assessments (6), objective fitness assessments (6), double labeled water (1) and physical activity log (1).&#13;\n&#13;\nFor the total PA score, the range of Spearman correlation r were -0.02 to 0.38 (mean 0.21) overall, 0.12 to 0.38 (mean 0.24) for studies using movement-assessment tools as the gold standard, and -0.02 to 0.36 (mean 0.19) for studies using fitness-assessing tools as the gold standard. None of the studies achieved the acceptable level of Spearman correlation r of 0.5.&#13;\n&#13;\nFor the specific PA score, higher Spearman correlation r was obtained for vigorous PA score (range -0.26 to 0.47, mean 0.24) than moderate PA score (range -0.09 to 0.5, mean 0.13), and walking PA score (range -0.05 to 0.17, mean 0.09).&#13;\n&#13;\nFor the accuracy of IPAQ-SF, only 5 papers reported the absolute difference of metabolic equivalent task (MET) between IPAQ-SF and gold standard. IPAQ-SF over-estimated MET in 4 studies, with “IPAQ- SF MET/ Criterion MET” ratio ranged from 1.11 to 6.41; IPAQ-SF under-estimated MET in 1 study, with an “IPAQ-SF MET/ Criterion MET” ratio of 0.52.&#13;\n&#13;\nConclusions&#13;\nThe validity of IPAQ-SF as measured by Spearman correlation r of 12 studies was low to moderate at best. Higher validity was obtained for vigorous PA than moderate PA and walking. IPAQ-SF also tended to overestimate MET. Given the difficulty of measuring PA objectively, IPAQ-SF is still useful in estimating physical activity, especially in large-scale studies. Future research should investigate the validity of IPAQ-SF in various subgroups (e.g. by age, sex, education level) to identify those with higher validity. Improved versions of IPAQ-SF and new scales could also be developed and examined.

BackgroundDue to the large mortality from inactivity-related non-communicable diseases in low- and middle- income countries, accurate assessment of physical activity is important for surveillance, monitoring and understanding of physical (in)activity epidemiology in many of these countries. Research on relative performance of self-report physical activity instruments commonly used for epidemiological research in Africa have rarely been reported. The present study compared estimates of physical activity measured with the International Physical Activity Questionnaire – Short Form (IPAQ-SF) and the Baecke Physical Activity Questionnaire (BPAQ) among urban and rural black South African adults.MethodsSelf-reported physical activity data using the IPAQ-SF and BPAQ were collected from a representative sample of 910 urban and rural black South African adults (age = 59.2 ± 9.5 years, 69.7 % women) participating in the 2015 wave of the Prospective Urban and Rural Epidemiological (PURE) study in the North West Province of South Africa. Between-method relationships (pearson correlations [r] and intraclass correlation coefficients [ICCs]) and agreements (Bland-Altman mean difference with 95 % limits of agreement and Kappa coefficient [k]) of IPAQ-SF and BPAQ variables were estimated. Sensitivity and specificity of the BPAQ relative to the IPAQ-SF to classify individuals according to the international guidelines for sufficient physical activity were calculated using chi-square statistics.ResultsCorrelations between IPAQ-SF scores and BPAQ indices were small (r = 0.08–0.18; ICCs = 0.09–0.18) for BPAQ leisure and sport indices, moderate-to-large for work index (r = 0.42–0.59; ICCs = 0.40–0.62) and total physical activity index (r = 0.52–0.60; ICCs = 0.36–0.51). Between methods mean difference for total physical activity was large (1.85 unit), and agreement in physical activity classifications was poor to moderate (k = 0.16–0.44). The sensitivity of the BPAQ to identify sufficiently active people from the IPAQ-SF was very good (98 %), but its specificity to correctly classify insufficiently active people was weak (23 %).ConclusionNotable disparities in physical activity estimates between methods suggest that utilization of IPAQ-SF and BPAQ for surveillance and epidemiology studies in Africa should depend on research questions and population to be studied. Future studies with objective measures are needed to confirm the relative validity between the two instruments.

Criterion validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF) for use in patients with rheumatoid arthritis: comparison with the SenseWear Armband

To examine self-reported physical activity levels from the International Physical Activity Questionnaire (IPAQ) as an independent predictor of dual-energy x-ray absorptiometry (DXA)-measured percent body fat (%BF) from body mass index (BMI), gender, and race. Two hundred and seventy-eight students, aged 18-24 yr, volunteered to participate. There were 133 males (85 white and 48 black) and 145 females (77 white and 68 black). Total activity levels were quantified in MET hours per week (MET h wk(-1)) using the IPAQ short form. Height and weight were measured, and BMI values were calculated (kg m(-2)). %BF was assessed using DXA. Linear regression analysis was used to develop and compare a body fat prediction equation with (full) and without (reduced) the variable MET-h.wk. Both models included BMI, gender, and race as predictor variables. The prediction sum of squares (PRESS) statistic was used to cross-validate both models, and the individual predictive accuracy was compared using modified Bland-Altman plots. Mean +/- SD values were as follows: BMI = 24.4 +/- 4.1 kg m(-2), %BF = 24.5 +/- 9.3%, and MET h wk(-1) = 37.4 +/- 21.9. Gender, BMI, and race explained 81% of the variance in %BF, with a root mean square error (RMSE) of 4.07. The full model with MET-h.wk improved the prediction of %BF by 2% (R2 = 0.83, RMSE = 3.87). When cross-validated, the corresponding PRESS statistics for the reduced and full model were 4.10 and 3.90, respectively. Bland-Altman limits of agreement were greater for the reduced model compared with the full model (-8.09, 8.10 vs -7.67, 7.68). These results suggest that %BF can be predicted with greater precision and accuracy in a young adult population when MET-h.wk are included in addition to BMI, gender, and race.

Participation in an employee fitness program: Determinants of high adherence, low adherence, and dropout : L. Lechner, H. De Vries. JOEM, 37(4), April 1995

The International Physical Activity Questionnaire – Short Form (IPAQ-SF) is a globally-used self-report measure of physical activity (PA). Validity evidence exists; none has evaluated the IPAQ-SF with reduced recall time. This study evaluates absolute and relative agreement for PA at all intensities, and relative to recommended guideline classification through: (1) a daily, online-delivered adapted IPAQ-SF and (2) accelerometer (a) with a 10-minute bout minimum (TMBM) and (b) without (NBM). Fifty-five participants (mean 28.3 years, 61.8% females) wore an accelerometer and completed the IPAQ-SF for 7 consecutive days. IPAQ-SF and NBM correlations were acceptable (total PA 0.45, moderate-to-vigorous PA 0.38). IPAQ-SF underestimated NBM values. IPAQ-SF sensitivity compared to NBM guideline classification was 70%; specificity was 100%. Correlations with TMBM were weaker for all intensities. IPAQ-SF overestimated TMBM values. IPAQ-SF sensitivity compared to TMBM guideline classification was 77%; specificity was 55%. The adapted IPAQ-SF showed acceptable validity evidence for relative PA measurement.

Self-reported physical activity questionnaires (e.g., International Physical Activity Questionnaire, IPAQ) are a cost-effective, time-saving, and accessible method to assess sedentary behaviour and physical activity. There are conflicting findings regarding the validity of self-reported questionnaires in comparison to accelerometer-measured data in a free-living environment. This study aimed to investigate the concurrent validity between self-reported Arabic–English IPAQ short form (IPAQ-SF) and Fibion (Fibion Inc., Jyväskylä, Finland) accelerometer-measured sedentary and physical activity time among young adults. One hundred and one young healthy adults (mean age 20.8 ± 2.4 years) filled in the IPAQ short form (IPAQ-SF) and wore the Fibion device on the anterior thigh for ≥ 600 min per day for 4–7 days. Concurrent validity between the IPAQ-SF and Fibion accelerometer for sitting, walking, moderate activity, and vigorous activity time was assessed using the Spearman correlation coefficient (ρ\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\rho$$\\end{document}) and Bland–Altman plots. Significant weak associations between IPAQ-SF and Fibion measurements were found for total activity time (ρ\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\rho$$\\end{document} = 0.4; P < 0.001) and for the duration of walking (ρ\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\rho$$\\end{document} = 0.3; P = 0.01), moderate (ρ\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\rho$$\\end{document} = 0.2; P = 0.02), and vigorous-intensity activities (ρ\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\rho$$\\end{document} = 0.4; P < 0.001). However, ρ\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\rho$$\\end{document} was not significant (ρ\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\rho$$\\end{document} = − 0.2; P = 0.09) for sitting time. In addition, all the plots of the measured variables showed a proportional bias. A low association and agreement were found between self-reported IPAQ-SF scores and Fibion accelerometer measurements among young adults in the UAE. Adult sedentary and physical activity measurements should be obtained objectively with accelerometers rather than being limited to self-reported measures.

Physical activity plays an important role in the prevention of chronic lifestyle-related diseases. The development of valid instruments for the assessment of physical activity remains a challenge in field studies. The purpose of the present study was therefore to determine the level of agreement between physical activity objectively measured by the ActiHeart® (Cambridge Neurotechnology Ltd, Cambridge, UK) device and subjectively reported physical activity by means of the International Physical Activity Questionnaire Short Form (IPAQ-SF) among adolescents attending schools in the Tlokwe Local Municipality, South Africa. A cross-sectional study design was used with a total of 63 boys and 45 girls aged 15 years who took part in the Physical Activity and Health Longitudinal Study (PHALS). Stature and weight were measured according to standard International Society for the Advancement of Kinanthropometry (ISAK) protocols. Objective physical activity (PA) was measured by a combined heart rate and accelerometer device (ActiHeart®) for seven consecutive days. Time spent in moderate-to-vigorous intensity physical activity (MVPA) was assessed. Subjective physical activity was assessed with the self-reported IPAQ-SF. Objective PA indicated that 93% of the participants were inactive and only 6% were highly active. The IPAQ-SF showed that 24% were inactive, with 57% active. A non-significant correlation (r = 0.11; p = 0.29) between the ActiHeart® measure of activity energy expenditure (AEE) and total physical activity (IPAQ-SF) was observed. The Bland–Altman plot showed no agreement between the two measurement instruments and also a variation in the level of equivalence. When Cohen’s kappa (κ) was run to determine the agreement between the two measurement instruments for estimated physical activity, a poor agreement (κ = 0.011, p < 0.005) between the two was found. The poor level of agreement between the objective measure of physical activity (ActiHeart®) and the IPAQ-SF questionnaire should be interpreted cautiously. Future physical activity research using a combination of subjective and objective assessment methods in a large-scale cohort in adolescents is recommended.

To examine the validity of the International Physical Activity Questionnaire short form (IPAQ-SF) against an objective method for assessing physical activity (PA) in Japanese adults with type 1 diabetes (T1D). This cross-sectional study included 126 adults with T1D (aged 20-74years). The participants wore a triaxial accelerometer for 7 consecutive days and completed the IPAQ-SF (a recall survey for the last 7days) on the day following the 7-day accelerometer period. This ensured alignment between the periods assessed by both the methods. A total of 112 participants were analyzed. The IPAQ-SF group had lower daily time in sedentary behavior (SB), total moderate-intensity PA (MPA) (including walking), vigorous-intensity PA (VPA), total PA (including walking), and daily metabolic equivalent (MET)-min in total PA than those in the accelerometer group. Significant correlations were observed between the methods for all variables: daily time in SB, total MPA, VPA, total PA, and daily MET-min in total PA (ρ = 0.203-0.527). In addition, walking time reported in the IPAQ-SF correlated with the step counts recorded by the accelerometer (ρ = 0.444). However, among these parameters, only daily time in VPA was able to provide acceptable levels of validity (≥ 0.50) and predict values recorded by the accelerometer. These results indicate that the IPAQ-SF scores have a weak correlation with each type of accelerometer-measured PA, while the IPAQ-SF may underestimate each type of PA compared to an accelerometer in Japanese adults with T1D. The online version contains supplementary material available at 10.1007/s13340-024-00759-w.

Background The association between the International Physical Activity Questionnaire Short Form (IPAQ-SF) and objective measures of physical activity has never been evaluated in participants with newly diagnosed bipolar disorder (BD). Our aim was to compare IPAQ-SF to objective measures in participants with newly diagnosed BD, their unaffected first-degree relatives (UR), and healthy control individuals (HC) in groups combined and stratified by group. Materials and methods Physical activity measurements were collected on 20 participants with newly diagnosed BD, 20 of their UR, and 20 HC using individually calibrated combined acceleration and heart rate sensing (Actiheart) for seven days. IPAQ-SF was self-completed at baseline. Correlation between measurements from the two methods was examined with Spearman rank correlation coefficient and agreement levels examined with modified Bland–Altman plots. Results Physical activity energy expenditure (PAEE) from IPAQ-SF was weakly but significantly positively correlated with physical activity estimates measured using acceleration and heart rate in groups combined (Actiheart PAEE) (ρ= 0.301, p = 0.02). Correlations for each group were positive, but only in UR were it statistically significant (BD: p = 0.18, UR: p = 0.007, HC: p = 0.84). Self-reported PAEE and moderate-intensity were markedly underestimated [PAEE in all participants combined: 62.7 (Actiheart) vs. 24.3 kJ/day/kg (IPAQ-SF), p < 0.001], while vigorous-intensity was overestimated. Bland–Altman plots indicated proportional bias. Conclusion These results suggest that the use of the IPAQ-SF to monitor levels of physical activity in participants with newly diagnosed BD, in a psychiatric clinical setting, should be used with caution and consideration.

Physical activity (PA) is an important target for improving clinical outcomes in heart failure (HF) patients. Nonetheless, assessing the daily PA profile in this population is a challenging task, traditionally performed using self-report questionnaires such as the International PA Questionnaire Short Form (IPAQ-SF). This study aimed to evaluate the concurrent validity of the IPAQ-SF and accelerometer-assessed PA using six published cut-points in patients with HF and reduced or mildly reduced ejection fraction. The concordance between the IPAQ-SF and a hip-worn accelerometer regarding daily time spent performing moderate to vigorous PA in bouts of at least 10min was assessed in 53 participants for seven consecutive days using six different cut-points (Barnett, Dibben, Mark, Sanders, Troiano, and Vaha-Ypya). Spearman's correlation and Bland-Altman plots were used to evaluate concurrent validity between methods. Regressions were used to study the association between patient variables, wear protocol (waking hour or 24h), and absolute bias. The kappa index was used to evaluate the concordance between IPAQ-SF and accelerometry for classifying patients as active or non-active. All analyses were re-run using non-bouted metrics to investigate the effect of bouted versus non-bouted analysis. The IPAQ-SF and accelerometry showed low to negligible correlation (ρ=0.12 to 0.37), depending on the cut-point used. The regression analysis showed that the absolute bias was higher in participants following the waking-hour protocol at all cut-points except Dibben's (P≤0.007). The concordance between the two methods to classify patients as active and non-active was low when using Mark (κ=0.23) and Barnett (κ=0.34) cut-points and poor for the remaining cut-points (κ=0.03 to 0.18). The results of the sensitivity analysis showed negligible to low correlation using non-bouted metrics (ρ=0.27 to 0.33). Moderate to vigorous PA measures using IPAQ-SF and accelerometers are not equivalent, and we do not encourage researchers to use IPAQ-SF alone when assessing PA in HF patients. Moreover, applying personalized collection and processing criteria is important when assessing PA in HF patients. We recommend following the 24h protocol and selecting cut-points calibrated in patients with cardiovascular diseases. Finally, it is necessary to develop a new tailored questionnaire that considers walking intensity and is adjusted to the current World Health Organisation recommendations, which use non-bouted metrics.