Reliability and validity of the Turkish version of the Physical Activity Questionnaire for Older Children (PAQ-C)

Effects of aquatic exercise intervention on executive function and brain-derived neurotrophic factor of children with autism spectrum disorder

BACKGROUND

Limited knowledge exists regarding the effectiveness of aquatic exercise intervention for improving executive function (EF) in children with autism spectrum disorder (ASD). Additionally, the impact of aquatic exercise on brain-derived neurotrophic factor (BDNF) in children with ASD requires further investigation.

AIMS

This study aimed to explore the effects of a 12-week aquatic exercise intervention on core EF and BDNF levels in children with ASD.

METHODS AND PROCEDURES

Thirty children with ASD were assigned to an experimental or control group. The experimental group underwent a 12-week aquatic exercise intervention, while the control group engaged in supervised free activities. Pre- and post-intervention assessments measured EF and BDNF levels.

OUTCOMES AND RESULTS

The experimental group showed significant improvements (p < 0.05) in inhibition control, cognitive flexibility, and BDNF levels. However, working memory did not significantly improve. The control group exhibited no significant changes in EF or BDNF levels.

CONCLUSIONS AND IMPLICATIONS

Aquatic exercise appears to be a beneficial intervention for cognitive development in children with ASD, as it enhances inhibition control, cognitive flexibility, and BDNF levels in children with ASD. Furthermore, the observed improvements in EF following aquatic exercise intervention in children with ASD may be associated with increased BDNF levels.

Development and psychometric testing of a questionnaire for the Korea Youth risk behavior survey to assess physical activity behaviors

BACKGROUND

Physical activity is essential for physical, mental, and cognitive health. Providing evidence to develop better public health policies to encourage increased physical activity is crucial. Therefore, we developed an in-depth survey as part of the Korea Youth Risk Behavior Survey to assess the current status and determinants of physical activity among Korean adolescents.

METHODS

We developed an initial version of the questionnaire based on a review of validated questionnaires, recent trends and emerging issues related to adolescent physical activity, and the national public health agenda pertaining to health promotion. Content validity was confirmed by a panel of 10 experts. Face validity was confirmed through focus group interviews with 12 first-year middle school students. The test-retest reliability of the questionnaire was evaluated by administering it twice, approximately two weeks apart, to a sample of 360 middle and high school students. Additionally, the frequency or average number of responses was analyzed in a sample of 600 students who participated in the initial test-retest reliability evaluation of the questionnaire developed in this study.

RESULTS

Through item pool generation and content and face validity test, the final 15 questionnaire items were developed across five themes: levels of physical activity, school sports club activities, transportation-related physical activity, physical activity-promoting environments, and factors mediating physical activity. The test-retest reliability ranged from fair to substantial. Results from the newly developed survey reveal that only a minority of adolescents engage in sufficient physical activity, with only 17.2% and 21.5% participating in vigorous and moderate-intensity activities, respectively, for at least five days per week. Among school-based activities, 44.3% of students do not participate in school sports clubs due to reasons including absence of clubs and disinterest in exercise. The major motivators for physical activity are personal enjoyment and health benefits, whereas preferences for other leisure activities and academic pressures are the predominant barriers.

CONCLUSIONS

This study developed valid and reliable in-depth survey items to assess physical activity among Korean youths. It will hopefully enhance our understanding of adolescent physical activity, offering essential preliminary evidence to inform the development of public health strategies aimed at promoting adolescent health.

Peak expiratory flow, core performance and physical activity in normal-weight, overweight, and obese adolescents

The objectives of this study were to (1) compare peak expiratory flow (PEF), physical activity (PA), and core performance among normal-weight, overweight, and obese adolescents and (2) explore the relationships between PEF, physical activity, core performance, and anthropometric measurements across these groups. Ninety adolescents aged 10-13 yr were categorized based on BMI: normal weight (n = 30, 5th to < 85th percentile, BMI-Z score -2 to < 1), overweight (n = 30, 85th to < 95th percentile, BMI-Z score 1 to < 2), and obese (n = 30, > 95th percentile, BMI-Z score > 2). PEF and percent-predicted values of PEF (PEF% pred) values were calculated. Waist and neck circumferences were measured. Physical activity levels were assessed using the Physical Activity Questionnaire for Older Children (PAQ-C), from which total and subscores were derived. Core performance was evaluated through modified push-up (MPU) and sit-up tests. The PEF% pred and PAQ-C scores showed no significant differences between groups (p > 0.05). However, MPU repetition rates were significantly lower in obese adolescents compared to overweight (p = 0.019) and normal-weight peers (p < 0.001). There was a significant correlation between PEF% pred and PAQ-C total scores (p = 0.014), as well as out-of-school subscores (p = 0.039) in overweight adolescents. Similarly, PEF% pred was linked to MPU repetitions in obese adolescents (p = 0.029). Obese adolescents exhibited decreased core performance relative to their overweight and normal-weight counterparts, which correlated with the PEF% pred. Physical activity was associated with PEF% pred exclusively in overweight adolescents.

Child and adolescent participation measurement tools and their translations: A systematic review

BACKGROUND

Numerous participation measurement tools targeting children and youth have been developed. Despite the translation of these tools into specific languages and cultures, the reliability and validity of the translated versions remain uncertain. To address this gap in knowledge, this study aims to identify tools for assessing the participation of children aged 5-18 years and to appraise the psychometric properties of their translated versions.

METHODS

Four electronic databases were searched for peer-reviewed studies published in English. Preferred Reporting Items for Systematic Reviews guidelines was followed. Study titles and abstracts were screened by four independent reviewers. Data were extracted for both original and translated versions of eligible tools. Instrument quality assessments were performed using the Outcome Measures Rating Form Guidelines. Any discrepancies were resolved by consensus.

RESULTS

Out of the 31 measurement tools examined, 18 tools had at least one translated version available, and among those original measurement tools, a total of 58 translated versions were identified. The most widely translated tool was the Physical Activity Questionnaire for Children (12 languages), and the most frequently translated language was Chinese (7 tools). Most translated versions verified internal consistency and content validity. Only three translated versions were verified inter-rater reliability, and seven translated versions were tested criterion validity with the gold standard tools assessing participation of children (e.g., accelerometer, Pediatric Evaluation of Disability Inventory and four 24-h recalls). None of the translated versions were tested for intra-rater reliability and responsiveness.

CONCLUSIONS

These findings can support the selection of psychometrically sound tools for children with disabilities, given their culture and language, and tool quality.

Assessment of quality of life and physical activity in patients with oligoarticular juvenile idiopathic arthritis in remission

The purpose of this study was to evaluate physical activity (PA) and health-related quality of life (HRQOL) in children with oligoarticular juvenile idiopathic arthritis (JIA) in remission in comparison with healthy peers and to determine the disease-related factors affecting PA levels. This study was conducted with 50 oligoarticular JIA patients in remission and 50 healthy peers between 9 and 14 years. Demographic and clinical characteristics, laboratory parameters, and treatments were noted from electronic medical records. HRQOL was assessed with the Pediatric Quality of Life Inventory (PedsQL). PA was evaluated with the Physical Activity Questionnaire for Children (PAQ-C). Oligoarticular JIA patients had significantly lower self-reported median PedsQL scores in the domains of school functioning and social functioning compared to the control group (67.5 (10) vs. 75 (25), p = 0.001 and 70 (15) vs. 85 (26.3), p < 0.001, respectively). The median PAQ-C score was 2.6 (1.1) in patients with JIA and 3 (0.9) in their healthy peers (p = 0.02). The PAQ-C score was 2.8 (1.2) in patients < 8 years at the disease onset and 2.3 (1) in those aged ≥ 8 years (p = 0.022). There was no significant difference in the number of affected joints, type of affected joint, MTX and biologic agent treatment, and remission with or without drugs with the total score of the PedsQL and PAQ-C. All PedsQL domains were positively correlated with the PAQ-C.  Conclusion: Oligoarticular JIA patients demonstrated lower PA and HRQOL scores compared to healthy controls despite favorable disease control. What is Known: • Oligoarticular JIA has fewer functional limitations and disabilities compared to other JIA subtypes. • As JIA can affect all aspects of a child's life, there is a need to improve the quality of life related to the disease. What is New: • It should be considered that patients with oligoarticular JIA may show lower PA and HRQOL scores compared to healthy controls despite favorable disease control. • Since there may be a relationship between PA and HRQOL, factors that may affect PA should be investigated to provide a holistic approach to JIA treatment.

Effects of Aquatic Exercise and Floor Curling on Balance Ability and Lower Limb Muscle Strength in Children with Intellectual Disabilities: A Pilot Study in China

Children with intellectual disabilities often face challenges in balance ability and lower limb muscle strength, which negatively impact their daily lives and motor function. Therefore, it is crucial to enhance the balance ability and lower limb muscle strength of children with intellectual disabilities. This study aimed to investigate the effects of a 12-week aquatic exercise and floor curling intervention on the balance ability and lower limb muscle strength of children with intellectual disabilities. Forty-two participants were randomly assigned to the aquatic exercise group, floor curling group, and control group. The aquatic exercise and floor curling groups received a 12-week intervention, while the control group engaged in supervised free activities. The participants' balance ability and lower limb muscle strength were assessed using the Berg Balance Scale and a muscle strength testing device before and after the intervention. The results showed significant improvements in balance ability and lower limb muscle strength for both the aquatic exercise group and the floor curling group after the intervention. The aquatic exercise group demonstrated an average improvement of 10.84% in balance ability and an overall average improvement of 16.28% in lower limb muscle strength. The floor curling group showed an average improvement of 9.04% in balance ability and an overall average improvement of 15.67% in lower limb muscle strength. These improvement results were statistically significant (p < 0.05) and ranged from medium to large effect sizes (d = 0.5~0.8). The findings of this study validate the positive effects of aquatic exercise and floor curling on the balance ability and lower limb muscle strength of children with intellectual disabilities. These interventions can be considered effective approaches for functional rehabilitation in children with intellectual disabilities.

An investigation of computer-game addiction, physical activity level, quality of life and sleep of children with a sibling with a chronic condition

BACKGROUND

It is known that chronic condition also affects siblings without chronic illness. Healthy siblings of children with a chronic condition and aged 9-14 years and healthy children with a sibling without chronic illness and their parents were included in the study.

AIM

The aim of our study was to examine the internet-game addiction, physical activity, quality of life and sleep in children with a sibling with chronic condition and compare them with their peers with a healthy sibling.

METHODS

Computer game addiction, physical activity, sleep quality and quality of life were evaluated respectively by Computer Game Addiction Scale for Children, Child Physical Activity Questionnaire, Children's Sleep Disorder Scale and Children's Quality of Life Scale.

RESULTS

While the mean age of 75 children with chronically ill siblings was 10.65 ± 1.59 years, the mean age of 75 healthy children with healthy siblings was 10.46 ± 2.09 years. It was observed that children with a sibling with a chronic condition were more tend to computer-game addiction, had lower sleep quality, lower quality of life in terms of school functionality and psychosocial health compared to children with a healthy sibling (p < 0.05).

CONCLUSIONS

It was revealed that in families with children with a chronic condition, siblings with no health problems should also be evaluated in psychosocial terms and supported by appropriate approaches, such as to increase the level of physical activity.

Cut-point values for classifying active children and validity and reliability of physical activity questionnaire for children in Morocco

BACKGROUND

The Physical Activity Questionnaire for Children (PAQ-C) is widely used to assess physical activity in populations; however, there is a lack of information about the psychometric properties (validity and reliability) and about the PAQ-C score meaning in populations from low-middle income countries.

AIMS

The aim of this study is to evaluate the reliability and validity of PAQ-C and to determine the cut-point values of PAQ-C using accelerometry as a reference in a group of Moroccan children.

METHODS

In a sample of 171 children and adolescents aged 8 to 14 years, physical activity was assessed with the GT3X + accelerometer and the PAQ-C. PAQ-C was administered for a second time (retest) after 1 week for a subsample (n = 73). Reliability was analyzed by intraclass correlation coefficient (ICC). The PAQ-C was compared against count per minute CPM and moderate to vigorous intensity PA (MVPA) obtained by accelerometry. Receiver operating curve analyses were performed to assess the performance of PAQ-C in identifying MVPA as measured by accelerometry (reference method).

RESULTS

Test-retest reliability was poor with an ICC = (0.48 [0.27; 0.63] for the whole sample, while for the ≥11 year group, the intra-class correlation coefficient was moderate (0.71 [0.42; 0.86]. PAQ-C scores were significantly related to accelerometry-derived metrics of physical activity, CPM (R = 0.29, P < 0.001) and MVPA (R = 0.26, P < 0.001). For the age group ≥11 years, the associations between PAQ-C Scores and CPM and MVPA were stronger, respectively, R = 0.37 (P < 0.001), R = 0.38 (P < 0.0001). We identified that a PAQ-C Score cut-point of 2.33 (95%CI [0.43-0.68]) discriminated adequately between those who met physical activity guidelines and those that did not in the overall sample.

CONCLUSIONS

The PAQ-C is valid and useful to assess population level physical activity in those ≥11 years in Morocco and so might be helpful in population surveillance of physical activity in Moroccan adolescents.

Examination of Physical Activity Patterns of Children, Reliability and Structural Validity Testing of the Hungarian Version of the PAQ-C Questionnaire

INTRODUCTION

Several studies report on the importance of physical activity (PA) in childhood, which influences attitudes towards health in adulthood. For monitoring PA, trustworthy measurement tools are needed. The study aimed to adapt the Physical Activity Questionnaire for Children (PAQ-C) to the Hungarian language and assess its validity, reliability, and factor structure.

METHODS

A total of 620 children (the average age was 10.62 (SD 2.36)) participated in the cross-sectional study. To assess physical activity, the PAQ-C questionnaire was used. The collected data were analysed using IBM SPSS version 28.0 and IBM SPSS AMOS 29.0 software.

RESULTS

The internal consistency was acceptable (alpha = 0.729) and the test-retest reliability showed acceptable agreement (ICC = 0.772). The confirmatory factor favoured a one-factor structure of the questionnaire. The average PAQ-C score for girls was 2.87 (SD 1.07), and for boys it was 3.00 (SD 1.05), which showed a significant difference (p = 0.005).

DISCUSSION

Based on our findings, our study tested the validity and reliability of the one-factor PAQ-C questionnaire, a valid and reliable measurement tool to test the physical activity patterns of primary school children in a Hungarian sample. Further research is needed to develop physical activity monitoring of Hungarian children.

Cystic fibrosis related bone disease in children: Can it be predicted?

BACKGROUND&AIMS

Cystic fibrosis (CF) -related bone disease (CFBD) is an important complication of CF, and low BMD in childhood is a precursor of CFBD. Here, we aimed to investigate bone turnover biomarkers, including osteocalcin (OC), receptor activator of nuclear factor kappa B ligand (RANKL) and osteoprotegerin (OPG) in relation to low BMD in children with CF (cwCF). We also evaluated factors which could affect bone turnover with particular emphasis on fat-free mass (FFM), forced expiratory volume in 1 s (FEV1), hand grip strength (HGS), and functional capacity and physical activity.

METHODS

Sixteen cwCF aged 8-18 years with moderate low BMD (group1) and 64 cwCF with normal BMD (group2) were enrolled. Serum RANKL, OC, and OPG were determined by immunoenzymatic assays. Multiple parameters including pancreatic status, lung functions, body mass index (BMI), FFM measured by bioelectric impedance analysis (BIA), 6-minute walk test, vitamin D, nutritional intake, HGS, functional capacity and physical activity, serum and urine biomarkers were compared between the two groups.

RESULTS

We found similar serum levels of RANKL (p = 0.501), OC (p = 0.445), OPG (p = 0.380), and RANKL/OPG ratio (p = 0.449) between group1 and group2 in cwCF. BMI z-score (p < 0.001), FFMI z-score (p < 0.001), FEV1 z-score (p = 0.007), and right-HGS (%pred) (p = 0.009) significantly differed between the two groups. Multivariate linear regression revealed that the only factors that predicted BMD were FFMI z-score and HGS %pred.

CONCLUSION

Serum OC, OPG, RANKL and RANKL/OPG ratio did not predict BMD in cwCF. FFMI z-score and HGS %pred measured by non-invasive and practical methods were the best predictors of BMD.

Exploring obesity, physical activity, and digital game addiction levels among adolescents: A study on machine learning-based prediction of digital game addiction

Primary study aim was defining prevalence of obesity, physical activity levels, digital game addiction level in adolescents, to investigate gender differences, relationships between outcomes. Second aim was predicting game addiction based on anthropometric measurements, physical activity levels. Cross-sectional study design was implemented. Participants aged 9-14 living in Kirikkale were part of the study. The sample of the study consists of 405 adolescents, 231 girls (57%) and 174 boys (43%). Self-reported data were collected by questionnaire method from a random sample of 405 adolescent participants. To determine the physical activity levels of children, the Physical Activity Questionnaire for Older Children (PAQ-C). Digital Game addiction was evaluated with the digital game addiction (DGA) scale. Additionally, body mass index (BMI) status was calculated by measuring the height and body mass of the participants. Data analysis were performed using Python 3.9 software and SPSS 28.0 (IBM Corp., Armonk, NY, United States) package program. According to our findings, it was determined that digital game addiction has a negative relationship with physical activity level. It was determined that physical activity level had a negative relationship with BMI. In addition, increased physical activity level was found to reduce obesity and DGA. Game addiction levels of girl participants were significantly higher than boy participants, and game addiction was higher in those with obesity. With the prediction model obtained, it was determined that age, being girls, BMI and total physical activity (TPA) scores were predictors of game addiction. The results revealed that the increase in age and BMI increased the risk of DGA, and we found that women had a 2.59 times greater risk of DGA compared to men. More importantly, the findings of this study showed that physical activity was an important factor reducing DGA 1.51-fold. Our prediction model Logit (P) = 1/(1 + exp(-(-3.384 + Age*0.124 + Gender-boys*(-0.953) + BMI*0.145 + TPA*(-0.410)))). Regular physical activity should be encouraged, digital gaming hours can be limited to maintain ideal weight. Furthermore, adolescents should be encouraged to engage in physical activity to reduce digital game addiction level. As a contribution to the field, the findings of this study presented important results that may help in the prevention of adolescent game addiction.

The evaluation of static and dynamic postural balance in children with thoracic hyperkyphosis

BACKGROUND

To investigate how postural balance is affected by thoracic hyperkyphosis compared to healthy children and elucidate the relationship between balance and strength and tightness.

METHODS

A cross-sectional analysis using standardized measures to identify balance function in children with thoracic hyperkyphosis (n = 31) and compare age-matched healthy children (n = 31). Primary outcome measurements were performed for the static and dynamic balance with the biodex balance system and limits of stability with the functional reach test. Secondary outcome measurements were strength with a hand-held dynamometry, tightness with the length test of pectoralis minor and hip flexors, and the sit-reach test for hamstrings. Mann-Whitney U test was used to compare the difference between the groups. Spearman's correlation was used to analyze the possible correlations between balance and strength and tightness.

RESULTS

A significant difference was found between the groups for static balance with eyes closed (except double-leg stance anteroposterior stability index) and for the forward reach distance (p < 0.05). Strength and tightness were significantly different in children with thoracic hyperkyphosis than in healthy children (p < 0.05). Also, it was found that muscle strength of trunk extension and hip abduction and tightness of hip flexors and hamstring were factors associated with static balance with eyes closed (r > 0.10, p < 0.05).

CONCLUSIONS

Static balance in children with thoracic hyperkyphosis is affected when visual input is particularly removed, and static balance with eyes closed is correlated with changed strength and tightness in some of the trunk and lower extremity muscles.

Investigation of obesity, eating behaviors and physical activity levels living in rural and urban areas during the covid-19 pandemic era: a study of Turkish adolescent

Background

The purpose of this study was to determine the eating behaviors, obesity and physical activity status of children of similar ages living in rural and urban areas and to examine these relationships during the coronavirus disease (COVID-19) pandemic process.

Method

The research was conducted using the scanning model. The research group consists of children living in rural and urban areas in Turkey. The sample of the study consists of a total of 733 adolescent participants, 351 females (47.9%) and 382 males (52.1%). After anthropometric measurements were made, the Physical Activity Questionnaire for older children and the Yale Food Addiction Scale for children 2.0 were used to determine the food addiction and physical activity status of children during the COVID19 pandemic process. Since the groups were homogeneously distributed, independent samples t-test and Pearson correlation test were used.

Result

In terms of food addiction and physical activity levels, children living in the urban have higher scores than children living in rural areas. In addition, children living in the urban were taller and have higher body mass values than those in rural areas. In terms of physical activity level and food addiction levels, while girls living in the urban had higher activity levels than those living in rural areas, no statistically significant difference was found between the physical activity levels of boys. When evaluated in terms of general and gender, it was determined that children living in rural areas were overweight and obese at a higher rate. Obese children had higher levels of food addiction and lower physical activity levels than non-obese children.

Conclusion

In order to prevent childhood obesity, the level of food addiction should be reduced as well as increasing the level of physical activity. This study is limited in terms of cross-sectional evaluation. Future research can experimentally reveal how much obesity is reduced by methods such as exercise and diet interventions.

Physical activity questionnaire for older children (PAQ-C): Arabic translation, cross-cultural adaptation, and psychometric validation in school-aged children in Saudi Arabia

The validity of the Physical Activity Questionnaire for Older Children (PAQ-C) has been mostly studied in North America and Europe. We investigated the psychometric validation of the Arabic version of the PAQ-C in students in Saudi Arabia. The students (n = 327, age = 8-14 years) of six primary schools in the Majmaah region participated in the study. Participants completed the PAQ-C, and their demographics were recorded. The PAQ-C scores satisfied the following factor analysis assumptions: diagonal elements of the anti-image correlation matrix (>0.5), Bartlett's test of sphericity (p < 0.001), determinant (>0.00001), Kaiser-Meyer-Olkin test of sampling adequacy (>0.8), and communality (all values > 0.2). Exploratory factor analysis results were inconclusive, with two measures favoring a 2-factor solution (Kaiser's criteria (Eigenvalue ≥ 1), and cumulative variance rule (>40%)); whereas, the scree test and the Monte Carlo parallel analysis favored a 1-factor structure. The confirmatory factor analysis favored a 1-factor solution: highest CFI, lowest RMSEA, non-significant χ² statistics, and lowest χ²/df. The values of item-total correlation, corrected item-total correlation, and Cronbach's alpha if an item was deleted, ranged from 0.20-0.57, 0.42-0.64, and 0.70-0.75, respectively. The PAQ-C showed a Cronbach's alpha of 0.74. A 1-factor structure of the Arabic version of the PAQ-C had adequate psychometric validity in schoolchildren in Saudi Arabia.

The Effect of an Obesity Prevention Program on Children's Eating Behaviors, Food Addiction, Physical Activity, and Obesity Status

PURPOSE

This study was carried out to determine the effect of an obesity prevention program on children's eating behaviors, food addiction, physical activity, and obesity prevalence.

DESIGN AND METHODS

A pretest-posttest quasi-experimental design was used in the study. The study was conducted with a total of 128 students, including 55 in the intervention and 73 in the control groups. The obesity prevention program was implemented in the intervention group, and a routine curriculum training program was followed in the control group. The study data were collected before the intervention and in the third, sixth, and fifteenth months after the completion of the intervention. The data were evaluated using the chi-square test, McNeamer test, Cochrane Q test, multivariate analysis of variance in repeated measures, the Bonferroni adjusted paired t-test, power analysis, effect size, and regression analysis.

RESULTS

At the end of the study, it was determined that the body mass index values and food addiction rates of the students in the intervention group were lower than those of the students in the control group (p < .05). There was a significant difference between the mean scores of the students in the intervention and control groups obtained from the eating behavior questionnaire and the physical activity questionnaire in terms of time, group, and group * time interaction (p < .05). Also, the intervention program was found to have a large effect size (0.39) and a strong effect (0.85) on body mass index.

CONCLUSION

The obesity prevention intervention program was found to be effective in increasing children's positive eating behaviors and mean physical activity score and decreasing food addiction rates and body mass index values.

PRACTICE IMPLICATIONS

We recommend that the intervention program implemented in this study should be used widely in the curriculum of the Ministry of Education. This program shows that the school nurse is effective in preventing obesity in children. For this reason, there should be a school nurse in schools for implementing health-promoting education programs.

The impact of COVID-19 on Physical Activity of Czech children

INTRODUCTION

The pandemic of coronavirus disease (COVID-19) and related restrictions (closed schools and sports centers, social isolation, masks) may have a negative impact on children's health. The purpose of this study was to evaluate the level of physical activity (PA) of Czech children during COVID-19 in autumn 2020.

METHODS

Ninety-eight Czech children (mean age = 10.1 ± 1.47 years) completed the standardized Physical Activity Questionnaire for Older Czech Children (PAQ-C/cz) during COVID lockdown. Data were compared with previously published norms. Thirty-five children also reported daily number of steps measured by accelerometers.

RESULTS

Total PAQ-C score was 0.38 lower during COVID compared to Pre-COVID [t(302) = 5.118., p < .001]. The male PAQ-C total score was 0.37 lower [t(146) = 3.21., p = .002)] and the female total score was 0.39 lower [t(154) = 3.97., p < .001] during COVID compared to Pre-COVID. Specifically, responses of PA during spare time, before-school, physical education (PE), and recess were significantly lower during COVID. The average number of steps was 7.767 steps/day (boys = 9.255; girls = 6.982).

CONCLUSION

COVID lockdown resulted in significant reduction of PA in Czech children. Strategies to promote adequate PA of children during the pandemic need to be determined.

Adaptation and validation of the Physical Activity Questionnaire for Older Children (PAQ-C) among Czech children

The study aimed to adapt the standardized Physical Activity Questionnaire for Older Children (PAQ-C) into the Czech language and assess its psychometric properties. A forwards-and-backwards translation method was carried out to prepare the Czech PAQ-C version (PAQ-C/CZ), followed by adjustments based on socio-cultural aspects. In the next phase, participants (n = 169) wore accelerometers for seven days. On the 8th day, participants completed the PAQ-C/CZ in school so that it was possible to determine the concurrent validity (correlation between the accelerometer and PAQ-C/CZ data, Spearman’s r), internal consistency (Cronbach’s alpha), item/scale properties (corrected item-total correlations, CITCs), and factor structure (exploratory factor analysis, EFA) for PAQ-C/CZ. In the last phase, participants (n = 63) completed the PAQ-C/CZ twice on two consecutive school days in the morning to determine the test-retest reliability (intraclass correlation coefficient, ICC; independent sample T-test). The PAQ-C/CZ indicated moderate internal consistency (alpha = 0.77), acceptable item/scale properties (CITCs = 0.29–0.61), and good test-retest reliability (ICC = 0.73–0.94). The EFA findings suggested a single factor model (factor load = 0.32–0.73) for PAQ-C/CZ, with items 2, 3, and 4 contributing low to the total score. Results on concurrent validity showed low but significant association (r = 0.28, p < 0.05) between accelerometer and PAQ-C/CZ data. Considering the study results, the PAQ-C/CZ can be recommended as a tool for moderate-to-vigorous physical activity assessment in large-sample research studies only, but with an emphasis on the interpretation of the correct results.

Towards a Functional Approach to the Assessment of Daily Life Physical Activity in Children: Are the PAQ-C and Fitbit Flex-2 Technically Adequate?

Considering the need for functional physical activity (PA) measures in PA settings, this study sought to determine the technical adequacy of the Physical Activity Questionnaire for Older Children (PAQ-C) and the Fitbit Flex-2, two instruments with promising features for wide use, using the Actigraph GT3X+ accelerometer as the criterion reference. A total of 218 Greek children (94 boys, 124 girls; mean age = 10.99 ± 1.52 years) volunteered to join in. Participants wore the PA trackers for seven days and completed the PAQ-C. Moreover, a sub-group (n = 60) recompleted the PAQ-C after a week. Results revealed acceptable internal consistency and excellent test-retest reliability for the PAQ-C. Regarding concurrent validity, weak to moderate correlations with PA parameters recorded by the GT3X+ were revealed for the total PAQ-C and were excellent for the Flex-2, while a Bland-Altman plot indicated good agreement. Finally, in alignment with relevant literature, significant gender, but no age, differences were found in participants' PA records in all the tools applied. The above results support the use of the PAQ-C and the Fitbit Flex-2 in children. Considering that they shed light into different parameters of children's habitual PA, their combined utilisation, providing comprehensive information, is strongly recommended.