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FRI0224 A New Method to Assess Activity Limitations in Patients with Hip and Knee Osteoarthritis: the Animated Activity Questionnaire (AAQ): Part 1. Development, Validity and Reliability
  1. W.F. Peter1,2,
  2. M. Loos1,
  3. R.C. de Vet1,
  4. M. Boers1,
  5. J. Harlaar3,
  6. L.D. Roorda2,
  7. R.W. Poolman4,
  8. V.A. Scholtes4,
  9. J. Boogaard5,
  10. H. Buitelaar5,
  11. M. Steultjens6,
  12. E.M. Roos7,
  13. F. Guillemin8,
  14. M.G. Benedetti9,
  15. A. Escobar Martinez10,
  16. C.B. Terwee1
  1. 1Epidemiology and Biostatistics and the EMGO Institute for Health and Care research, VU University Medical Center
  2. 2Amsterdam Rehabilitation Research Center, Reade
  3. 3Rehabilitation Medicine and MOVE research institute, VU University Medical Center
  4. 4Orthopedics, joint research, Onze Lieve Vrouwe Gasthuis
  5. 5patient research partner, Amsterdam, Netherlands
  6. 6Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, United Kingdom
  7. 7Institute of Sports Science and Clinical Biomechanics, Odense, Denmark
  8. 8University of Lorrain, Nancy, France
  9. 9Istituto Ortopedico Rizzoli, Bologna, Italy
  10. 10Basurto University Hospital, Bizkaia, Spain


Background Self-report questionnaires and performance-based tests correlate moderately in measuring activity limitations, indicating that they measure different aspects. Self-reports measure mainly the patients' perception which may lead to cross-cultural differences. Performance-based tests measure an artificial situation, is resource-intensive and burdensome for patients. To overcome these drawbacks we developed and tested a pilot version of an animated activity questionnaire (AAQ), which demonstrated some promising features[1].

Objectives Development of the computerized Animated Activity Questionnaire (AAQ) to assess activity limitations in patients with hip/knee osteoarthritis (OA), and study validity and reliability.

Methods Based on the ICF core set for OA, focus groups of patients, and existing measurement instruments, the AAQ was developed. In 102 patients correlations were calculated between AAQ and self-reported Hip disability and Knee injury Osteoarthritis Outcome ADL Score (H/KOOS). In addition internal consistency was calculated. In a subgroup of 38/102 patients also correlations with performance based tests (Stair Climbing Test (TCT), Timed Up and Go test (TUG) and the 30 second Chair Stand Test (CST)) were calculated. Test-retest reliability was assessed by repeated scoring in a subgroup of 28/102 patients.

Results The AAQ includes animated videos of 17 basic daily activities with 4 levels of increasing difficulty (check the following link for two examples: Patients were asked to select the video that best matched their own performance. Cronbach's alpha was 0.95. In 102 patients correlation with H/KOOS ADL scores was high (0.83). In the subgroup of 38/102 patients the AAQ correlated highly with the TCT, TUG and CST (0.67, 0.61, and 0.71, respectively) and the H/KOOS (0.79). For test-retest reliability in 28/102 patients a Intraclass Correlation Coefficient of 0.97 (95% CI 0.93-0.99) was found.

Conclusions The AAQ has a high internal consistency and excellent test-retest reliability. The validity is supported by high correlations with performance-based tests, and the correlation with the self-reported H/KOOS was even higher than expected. Since the AAQ needs no reading ability or translation, it has potential for international use. Continuing research will focus on construct validity and cross-cultural validity.


  1. Terwee CB et al. Development and Validation of the Computer-Administered Animated Activity Questionnaire to Measure Physical Functioning of Patients With Hip or Knee Osteoarthritis. Phys Ther. 2013, Sep 12 [Epub ahead of print].

Acknowledgements Funded by EULAR Patient Reported Outcome research grant.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.3220

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