Validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF) as a measure of physical activity (PA) in young people with cerebral palsy: A cross-sectional study

Grace Lavelle,Marika Noorkoiv,Nicola Theis,Thomas Korff,Cherry Kilbride,Vasilios Baltzopoulos,Adam Shortland,Wendy Levin,Jennifer M Ryan

doi:10.1016/j.physio.2019.08.013

Abstract

ObjectivesThe aim of this study was to examine the validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF) as a measure of physical activity (PA) in young people with cerebral palsy (CP). DesignCross-sectional. SettingParticipants were recruited through 8 National Health Service (NHS) trusts, one school, one university and through organisations that provide services for people with disabilities in England. ParticipantsSixty-four, ambulatory young people aged 10–19 years with CP [Gross Motor Function Classification System (GMFCS) levels I–III] participated in this study. Main outcome measureThe IPAQ-SF was administered to participants. Participants were then asked to wear a wGT3X-BT triaxial accelerometer (ActiGraph, Pensacola, FL) for 7 days to objectively assess PA. Time spent in sedentary behaviour, in moderate to vigorous PA (MVPA) and in total PA (TPA) was compared between measures. ResultsYoung people with CP self-reported less time in sedentary behaviour and underestimated the time spent in TPA, when compared to accelerometer measurements. Bland–Altman plots demonstrated poor agreement between the measures for MVPA, with upper and lower 95% limits of agreement of −147 to 148.9minute. After adjusting for gender and GMFCS level, age was a predictor of the difference between measures for MVPA (P<0.001) and TPA (P<0.001). ConclusionsThese findings suggest that the IPAQ-SF is not a valid method of measuring TPA or sedentary behaviour in young people with CP and it is not appropriate for use when assessing an individual’s time in MVPA. Therefore, where feasible, an objective measure of PA should be used. Clinical trial registration numberISRCTN90378161.

Highlights

Cerebral Palsy (CP) is a non-progressive, neurodevelopmental condition defined as ‘a group of permanent disorders of the development of movement and posture, causing activity limitation that are attributed to non-progressive disturbances that occurred in the developing foetal or infant brain’ [1]
Mean time spent in moderate to vigorous PA (MVPA) and total PA (TPA), respectively, was lower when reported using the International Physical Activity Questionnaire Short Form (IPAQ-SF) in comparison to accelerometer data
While young people with cerebral palsy (CP) self-reported less time in sedentary behaviour, they underestimated the time spent in TPA when compared to objective physical activity (PA) data

Summary

Introduction

Cerebral Palsy (CP) is a non-progressive, neurodevelopmental condition defined as ‘a group of permanent disorders of the development of movement and posture, causing activity limitation that are attributed to non-progressive disturbances that occurred in the developing foetal or infant brain’ [1]. It is the most common form of childhood physical disability, with an incidence of 1.5–3.8 per 1000 births reported worldwide [2]. Despite the importance of promoting PA, as a potential modifiable risk factor for the prevention of NCDs and functional decline over time, there is a paucity of validated self-report measures of PA among young people with CP

Objectives

Methods

Results

Discussion

Conclusion