The validity of the International Physical Activity Questionnaire (IPAQ) for adults with progressive muscle diseases

An exploration into self-reported inactivity behaviours of adults with an intellectual disability using physical activity questionnaires

BACKGROUND

Inactivity is a correlate of adverse health. Adults with an intellectual disability (ID) are more inactive than the general population and often present with more complex health issues. Self-reported activity questionnaires such as the International Physical Activity Questionnaire - Short Form (IPAQ-SF) and Rapid Assessment of Physical Activity (RAPA) questionnaire are the predominant source of activity information because of their low cost, non-invasive nature, ease of administration and interpretation of results.

METHODS

Correlates of inactivity among the general and ID populations were identified through a literature scoping review. Inactivity was measured using the RAPA and the IPAQ-SF. A multiple-imputation chained equation was used to impute missing data. Using Pearson chi-squared analyses, relationships between these correlates as well as covariates of age, sex, level of ID, body mass index (BMI) and aetiology, and RAPA and IPAQ-SF categories were explored. Logistic regression provided more detailed analyses. Results were summarised using the Systems of Sedentary Behaviour framework. Spearman correlations examined the IPAQ-SF and RAPA relationships.

RESULTS

Three correlates for inactivity emerged from the IPAQ-SF and RAPA questionnaire. Up after 07:00 h was a correlate for both. Difficulty walking 100 yards and epilepsy were additional correlates of inactivity. Weak but significant correlations were seen between IPAQ-SF and RAPA scores.

CONCLUSIONS

High inactivity levels are present in adults with an ID. The IPAQ-SF and RAPA questionnaires are weakly correlated.

Sarcopenia risk, sarcopenia-related quality of life, and associated factors in people living with human immunodeficiency virus (HIV): A web-based survey

OBJECTIVES

We aimed to screen for the risk of sarcopenia and sarcopenia-related quality of life and associated factors of people living with HIV (PLWH).

RESEARCH METHODS AND PROCEDURES

This nonprobabilistic web-based survey evaluated PLWH. The participants were invited directly from a university-based inpatient clinic and responded to a web questionnaire that included the SARC-F and SarQoL to screen people at risk of sarcopenia and their quality of life. People at risk of sarcopenia were defined by the proposed cutoff points for SARC-F (≥ 4 points), and SarQoL overall score was categorized according to the median. Moreover, we performed a logistic regression to investigate associations between HIV-, lifestyle-, and health-associated factors (i.e., physical activity, dietary pattern, sleep quality, gastrointestinal symptoms, HIV diagnosis, type, combinations, and duration of ART, smoking, drinking, BMI, and weight loss), and outcomes (SARC-F and SarQoL).

RESULTS

The sample comprised 202 PLWH, mainly middle-aged (50.6-60.5 y; n = 101). Only 5.9% (n = 12) are at risk of sarcopenia according to SARC-F, and only 17.3% (n = 35) exhibited lower sarcopenia-related quality of life according to SarQoL. In the multiple models, only the gastrointestinal symptoms increased the odds of sarcopenia risk (OR: 1.058; P = 0.01) and poor sarcopenia-associated quality of life (OR: 1.041; P = 0.013).

CONCLUSIONS

We verified that only 5.9% and 17.3% of PLWH are at risk of sarcopenia and presented lower sarcopenia-related quality of life, respectively. Only the gastrointestinal symptoms were associated with a risk of sarcopenia and lower sarcopenia-related quality of life, without significant differences between age groups.

Reliability and Validity of the International Physical Activity Questionnaire Adapted to Include Adults With Physical Disability

BACKGROUND

People with physical disabilities (PWD) participate in less physical activity than people without physical disabilities (PWoD), which increases the risk for several negative health consequences. Comparing physical activity between PWD and PWoD remains a challenge since no reliable and valid survey exists to measure physical activity in both populations. The International Physical Activity Questionnaire (IPAQ) was adapted to be inclusive of PWD using a recently developed survey adaption framework; however, the adapted IPAQ has not been assessed for reliability and validity. The objective of this study was to assess the reliability and validity of the adapted IPAQ.

METHODS

To assess test-retest reliability, the adapted IPAQ was completed twice within a 72-hour period by 172 individuals (PWD: n = 102, PWoD: n = 70) and compared using intraclass correlation coefficients. Using Spearman rho, convergent validity and construct validity were assessed in 62 individuals by comparing the adapted IPAQ against the original instrument and activity monitor measured step count, respectively.

RESULTS

The adapted IPAQ demonstrated moderate test-retest reliability, with intraclass correlation coefficients of total scores for the total sample of .690 (95% confidence interval [CI] .581-.770) and among subgroup analysis (PWD, .640, 95% CI, .457-.761; PWoD, .758, 95% CI, .610-.850). Correlation coefficients were also good for the assessment of convergent validity of total score (.727; 95% CI, .579-.829; P < .001). Construct validity assessment yielded moderate coefficient (.406; 95% CI, .166-.596; P = .001).

CONCLUSIONS

The adapted IPAQ demonstrated acceptable reliability and validity and is appropriate for use in PWD and PWoD.

Influence of physical activity on endothelial function in people living with HIV

INTRODUCTION

Decreased physical activity is a major cardiovascular risk factor that is particularly pronounced in people living with HIV (PLHIV), who are more susceptible to endothelial dysfunction and accelerated atherosclerosis than the general population due to multiple mechanisms. The aim of the present study was to analyse whether regular physical activity is capable of improving endothelial function measured by flow-mediated dilatation (FMD) in PLHIV.

METHODS

We performed FMD measurement in 38 PLHIV, along with the assessment of their regular physical activity level using the International Physical Activity Questionnaire (IPAQ).

RESULTS

Flow-mediated dilatation results in PLHIV were 0.31 ± 0.06 mm and 7.34% ± 1.41% for absolute and relative FMD, respectively. IPAQ results showed that the average weekly level of physical activity was 3631.1 ± 1526.7 MET-min/week, whereas the average daily sitting time was 287.3 ± 102.7 min/day. Predictors jointly accounted for 48% (adjusted value 42%) of FMD variance. Bootstrapped confidence levels revealed that physical activity had a statistically significant effect on the outcome [beta = 0.517, 2.5% confidence interval (CI) = 0.205, 97.5% CI = 0.752].

CONCLUSION

Physical activity represents a widely available and uncostly tool that is capable of improving endothelial function and overall cardiovascular health in PLHIV.

The cross-sectional associations of chronic conditions and disability with self-reported physical activity among adults in England

OBJECTIVE

Using cross-sectional data from the 2018 Health Survey for England, this study describes the types of impairment reported by people with chronic conditions and the association of chronic conditions and impairments with physical activity(PA).

METHODS

Participants self-reported the presence of seven chronic health conditions (diabetes; stroke/ischemic heart disease; hypertension; chronic obstructive pulmonary disease (COPD); asthma; arthritis/rheumatism/fibrositis; back problems), 11 types of impairment (vision, hearing, mobility, dexterity; learning; memory; mental health; stamina; social or behavioural; other; none); and their PA using the International Physical Activity Questionnaire. Multivariable Poisson regression was used to estimate the association of a)impairment type, b)number of impairments, and c)impairment type and chronic condition (mutually adjusted) with PA.

RESULTS

In total, 2243 adults (55% female, 44% age > 55 yrs) reported having a chronic condition. PA volume (MET minutes per week: median (IQR)) was highest in participants with asthma (2093 (693-4479)), and lowest in those with COPD (454 (0-2079)). There was a negative association between number of impairments and levels of PA. After adjustment for age, sex, ethnicity and education, and mutually adjusting for all other conditions and impairments, diabetes (Incident rate ratio (95% confidence interval): 0.83 (0.73-0.94)), COPD (0.76 (0.59-0.99)), a mobility impairment (0.63 (0.56-0.72)), a dexterity impairment (0.86 (0.75-0.98)), or a memory impairment (0.84 (0.72-0.99)) was negatively associated with PA.

CONCLUSION

Future PA research requires consideration of the number and types of impairments that individuals experience, as well as assessing chronic conditions. This will improve understanding of the barriers to PA participation and inform interventions.

Poor cardiorespiratory fitness may be an indicator of more severe liver inflammation in non-alcoholic fatty liver disease patients

INTRODUCTION

Non-alcoholic fatty liver disease (NAFLD) is related to cardiovascular disease. Cardiorespiratory fitness (CRF) is an important indicator of cardiovascular health. Therefore, we aimed to evaluate the CRF of NAFLD patients.

METHODS

Cross-sectional study, including 32 patients with biopsy-proved NAFLD. The patients underwent ergometric test (ET) and six-minute walk test (6MWT) to determine CRF. The test results were compared to disease parameters and with each other.

RESULTS

Considering the ET, 20 (62.5%) patients had very poor or poor CRF, and in 12 (37.5%), it was regular or good. In the 6MWT, 13 (40.6%) individuals had poor CRF, in 12 (37.5%), it was very poor, and in seven (21.9%), regular. NAFLD activity score (NAS) ≥5 was observed in 12 (37.5%) individuals. Twelve (37.5%) patients were sedentary, 11 (34.4%), insufficiently active, and nine (28.1%), active. Obesity and liver inflammation on biopsy were associated with very poor/poor CRF. NAS ≥5 and sedentary lifestyle were independently associated with very poor/poor CRF by ET. Although mean VO2max values determined by both tests were similar, no correlation of VO2max determined by ET and 6MWT was observed, as occurred for the distance walked in 6MWT and values of metabolic equivalent (MET) determined by ET. There was no reproducibility between CRF determined by ET and 6MWT.

CONCLUSION

Most NAFLD patients had very poor or poor CRF. Severe liver injury (NAS ≥5) and sedentary lifestyle were independently associated with very poor/poor fitness, according to ET. No reproducibility was observed between the CRF defined by ET and 6MWT.

Orthorexia Nervosa and Disordered Eating Attitudes, Self-Esteem and Physical Activity among Young Adults

A relation between Orthorexia Nervosa (ON) and increased frequency of physical activity has been put in evidence by recent studies. It is well known that intense physical exercises are typically related to eating disorders, but its relationship with ON is still a subject of debate. Other transdiagnostic features could be necessary to conceptualize and understand ON; in this way, low self-esteem is related to eating behavior but is not still extensively investigated in ON, and, to date, data are so heterogeneous that they do not allow us to understand if this is a psychological feature somehow associated with ON. The current study aimed to assess whether disordered eating attitudes, self-esteem, and physical activity are associated with ON in young adults from Poland and Italy. Moreover, we investigated the differences by comparing lower and higher ON levels related to disordered eating attitudes, self-esteem, and physical activity. Our results indicated that a great concern about dieting significantly predicted problems associated with healthy eating, knowledge about healthy eating, and feeling positive about healthy eating. In addition, young adults with a high level of ON demonstrated higher levels of disordered eating attitudes and vigorous-intensity physical activity than young adults with a low level of ON. Future studies are needed to assess the direct effect of physical activity and self-esteem on ON.

Relationship between Objectively and Subjectively Measured Physical Activity in Adolescents during and after COVID-19 Restrictions

Background: Studying the relationship between subjectively and objectively measured physical activity (PA) can provide viable information on youths’ behaviors. However, the restrictions due to COVID-19 pandemic, which reduced children’s possibilities to be active, may negatively affect it. The aim of this study was to assess the relationship between subjectively and objectively measured PA levels (light, moderate, vigorous, and moderate-to-vigorous) during COVID-19-based restrictions and after they were lifted, and to determine whether such relationships changed in these two periods. Methods: A total of 26 adolescents (58% girls; mean age = 12.4 ± 0.5) wore accelerometers during public restrictions and after they were removed. Participants also completed the International Physical Activity Questionnaire during the same periods. Results: High significant correlations were found at all levels of PA (r = 0.767–0.968) in both time periods, except for moderate PA during restrictions. Comparing the two periods, significantly higher correlations were found for moderate PA (p < 0.001) and moderate-to-vigorous PA (p = 0.003) after restrictions were lifted. Conclusions: In this highly active cohort of adolescents, results emphasize the potential threat of lockdown conditions for youths’ ability to accurately perceive their behaviors, with possible detrimental consequences on the short- and long-term health.