Background Physical activity (PA) is recommended as a core treatment for osteoarthritis (OA). Previous research evaluating the measurement properties of PA instruments in OA populations has focused solely on knee and hip OA (Terwee et al. 2011). To date there is still no consensus on which instrument is the most suitable for OA and joint pain research.
Objectives To identify the most suitable self-report PA instruments for OA and joint pain research.
Methods Systematic searches were conducted to identify PA instruments in OA and joint pain research. Appraisal of measurement properties (reliability, measurement error, validity, responsiveness and interpretability) in populations with OA or joint pain or older adults (aged 45 years and over) was then conducted. Searches were made in Embase, Medline and Web of Science databases. Data on each instrument’s measurement properties were extracted using the QAPAQ (Qualitative Attributes and Measurement Properties of Physical Activity Questionnaires) checklist. Study methodology was then assessed for quality using a modified COSMIN (COnsensus-based Standards for the selection of health Measurement Instruments) checklist. At least two reviewers independently reviewed selection criteria, completed data extraction and methodology quality assessments.
Results Twenty different validated PA instruments were obtained from 51 studies. Twenty-five (49%) studies using non-validated instruments were excluded. Measurement properties were identified 37 studies; with 6 (16%) studies in a population with OA or joint pain and 31 (84%) additional studies in older adults. In older adults the International Physical Activity Questionnaire (IPAQ), Physical Activity Scales for the Elderly (PASE), Active Australia Survey (AAS) and Short Telephone Activity Rating (STAR) questionnaire were shown to be reliable (ICC=>0.7). Criterion validity was evaluated in the PASE (r=0.68) and modified Baecke (r=0.54). Correlations with objective measures of PA and measures of physical function were found in the IPAQ, PASE and STAR (r=0.3-0.5). In OA and joint pain populations the IPAQ, PASE, University California in Los Angeles (UCLA) scale, Tegner and Activity Rating Scale (ARS) were shown to be reliable (ICC=>0.7). The PASE was also found to correlate with objective measures (r=0.3). The UCLA, Tegner and ARS scales all showed correlations with physical function (r=0.26-0.5).
Conclusions A large number of validated instruments are available to assess PA levels in adults with OA and joint pain. The IPAQ and PASE appear to be most suitable for measuring self-reported PA in OA and joint pain research; however 23% of studies evaluating the IPAQ and PASE had small sample sizes (n=<50). There is a need for well conducted validation studies on the IPAQ and PASE in joint pain and OA populations.
References Terwee, C.B., Bouwmeester, W., van Elsland, S.L., de Vet, H.C. & Dekker, J. 2011, “Instruments to assess physical activity in patients with osteoarthritis of the hip or knee: a systematic review of measurement properties”, Osteoarthritis and cartilage / OARS, Osteoarthritis Research Society, vol. 19, no. 6, pp. 620-633.
Disclosure of Interest None Declared