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The International Journal of Behavioral Nutrition and Physical Activity logoLink to The International Journal of Behavioral Nutrition and Physical Activity
. 2012 Aug 31;9:103. doi: 10.1186/1479-5868-9-103

A systematic review of reliability and objective criterion-related validity of physical activity questionnaires

Hendrik JF Helmerhorst 1,2, Søren Brage 1, Janet Warren 3,4, Herve Besson 1, Ulf Ekelund 1,5,
PMCID: PMC3492158  PMID: 22938557

Abstract

Physical inactivity is one of the four leading risk factors for global mortality. Accurate measurement of physical activity (PA) and in particular by physical activity questionnaires (PAQs) remains a challenge. The aim of this paper is to provide an updated systematic review of the reliability and validity characteristics of existing and more recently developed PAQs and to quantitatively compare the performance between existing and newly developed PAQs.

A literature search of electronic databases was performed for studies assessing reliability and validity data of PAQs using an objective criterion measurement of PA between January 1997 and December 2011. Articles meeting the inclusion criteria were screened and data were extracted to provide a systematic overview of measurement properties. Due to differences in reported outcomes and criterion methods a quantitative meta-analysis was not possible.

In total, 31 studies testing 34 newly developed PAQs, and 65 studies examining 96 existing PAQs were included. Very few PAQs showed good results on both reliability and validity. Median reliability correlation coefficients were 0.62–0.71 for existing, and 0.74–0.76 for new PAQs. Median validity coefficients ranged from 0.30–0.39 for existing, and from 0.25–0.41 for new PAQs.

Although the majority of PAQs appear to have acceptable reliability, the validity is moderate at best. Newly developed PAQs do not appear to perform substantially better than existing PAQs in terms of reliability and validity. Future PAQ studies should include measures of absolute validity and the error structure of the instrument.

Keywords: Systematic review, Physical activity, Self-report, Accelerometry, Validity, Reliability

Background

Physical inactivity is considered to be one of the four leading risk factors for global mortality [1]. The measurement of physical activity is a challenging and complex procedure. Valid and reliable measures of physical activity (PA) are required to: document the frequency, duration and distribution of PA in defined populations; evaluate the prevalence of individuals meeting health recommendations; examine the effect of various intensities of physical activity on specific health parameters; make cross-cultural comparisons and evaluate the effects of interventions [2].

Physical activity questionnaires (PAQs) are often the most feasible method when assessing PA in large-scale studies, likely because of their low cost and convenience but these instruments have limitations and should be selected and used judiciously. PAQs are prone to measurement error and bias due to misreporting, either deliberate (social desirability bias) or because of cognitive limitations related to recall or comprehension [3,4]. Cognitive immaturity or degeneration can make self-report of physical activity particularly difficult in the young and elderly [5,6]. Despite more frequent use of objective assessment methods to measure physical activity, PAQs still provide a practical method for PA assessment in surveillance systems, for risk stratification and when examining etiology of disease in large observational studies. Most PAQs are designed to be able to measure multiple dimensions of PA by reporting type, location, domain and context of the activity, provide estimates of time spent in activities of various levels of intensity, and may be able to rank individuals according to intensity levels of reported activity [7,8]. However, results from studies aimed at evaluating the validity of PAQs assessed in one population cannot be systematically extrapolated to other populations, ethnic groups, or other geographical regions. Consequently, a great variety of PAQs have been developed and tested for reliability and validity in recent years.

A comprehensive review of PAQs for use in adults was published in 1997 [9]. Since then, reviews summarizing the validity and reliability of PAQs have been carried out in children [10-12] and preschoolers [13]. Recently, specific reviews were published assessing the quality of PAQs available for children [11], adults [14] and the elderly [15]. The aim of the present study was to systematically review the literature on reliability of PAQs as well as their validity evaluated against objective criterion methods, for use in all age groups, published between January 1997 and December 2011 to quantitatively compare the performance between existing and newly developed PAQs.

Methods

Inclusion criteria

Studies meeting all of the following inclusion criteria were included: (i) published in the English language between January 1997 and December 2011; (ii) self- or interviewer-administered PAQs or parental proxy reports reporting both reliability and validity results; (iii) PAQs reporting validity results only, when the reliability data has been published previously; (iv) PAQs developed for a healthy general population and for observational surveillance studies; (v) PAQs tested in its original form or in an adapted version if results were reported for validity and reliability or validity only, when reliability results were published before; (vi) validity tested against an objective criterion measure of PA (i.e. accelerometry, heart rate, combined heart rate and accelerometry, doubly labeled water (DLW)); (vii) results on validity obtained by pedometer where the questionnaire was specifically developed to assess walking only.

Exclusion criteria

We excluded studies that reported: (i) reliability and validity results in groups with specific clinical or medical conditions (except pregnancy); (ii) results from PAQs that were designed for specific intervention studies; (iii) results where the validity of the PAQ was tested against another self-report method (i.e. diaries, logs); (iv); results on validity using pedometers (except if walking only was tested) and indirect measures of physical activity (e.g. VO2max and body composition); (v) results on essential adaptations of original PAQs, without any published results on both reliability and validity.

Literature search

The PubMed, Medline and Web of Science databases were systematically searched using the following lists and terms:

List A: (physical activity AND health survey OR population survey OR question*)

List B: List B: measure* (i.e. measures, measurement), assess* (i.e. assessment, assessed), self-report, exercise, valid* (i.e. valid, validation, validity), reliab* (i.e. reliable, reliability), reproducible, accelerometer, heart rate, doubly labelled water, doubly labeled water. The search included titles, abstracts, key words and full texts.

Key search terms in List A were combined with each of the terms in List B.

The literature search was undertaken in two stages. The original literature search (1997–2008) was undertaken by two of the authors (JW, HB) independently and search results were compared and verified. The literature search was then updated to include studies up to December 2011 using exactly the same search criteria (HH). A second search strategy included screening references lists of publications that matched the inclusion criteria and any other publications of which the authors were aware but did not show up during the original literature search. Figure 1 displays an overview of the literature search.

Figure 1 .

Figure 1

Overview of the literature search.

Data collection and extraction

Data were extracted using a standardized pro-forma which included sample characteristics, questionnaire details, methods of validity and reliability testing, test results and authors’ conclusions. We retrieved full text of articles of all abstracts that met our inclusion criteria. Any queries about the inclusion of papers were resolved by one of the authors (UE).

Reliability

Reliability in all studies was tested through a test-retest procedure to measure consistency of the PAQs. Reliability results from included studies were reported as: intraclass correlation coefficients (ICC); Pearson and Spearman correlation coefficients; and agreement measures using Cohen’s weighted kappa (κ) and mean differences. Reliability was considered poor, moderate (acceptable), or strong when correlation coefficients or kappa statistics were <0.4, 0.4–0.8 or >0.8, respectively [16]. Similarly, an ICC > 0.70 or >0.90 was considered as acceptable and strong, respectively, in those studies reporting this measure [17].

Medians of reliability correlation coefficients across studies were calculated and included in the tables when possible.

Validity

Correlation coefficients were the most commonly used measures of validity, although the Bland-Altman technique [18] which determines absolute agreement between two measures expressed in the same units, was also frequently used. The Bland-Altman method estimates the mean bias and the 95 % limits of agreement (± 2SD of the difference) and is usually plotted as the difference between the methods against the mean of the methods for visual inspection of the error pattern throughout the measurement range; the dependence of error with the underlying level can be summarised in the error correlation coefficient but this was only seldom reported.

Medians of included validity correlation coefficients were calculated and included in the tables when possible. When calculating the medians, we excluded those studies reporting correlation coefficients for the associations of self-reported sedentary time. The medians for sedentary time are reported separately and associations of sedentary time with measures of total physical activity (i.e. total energy expenditure [TEE], physical activity level [PAL] and total activity from accelerometry [mean counts]) from the criterion method were excluded in these analyses as these measures are expected to be inversely related.

Classification

Questionnaires were classified as new or existing (i.e. previously published test results) PAQ. Existing questionnaires were subdivided into those which reported new reliability and validity results, and those which reported new results on validity only but had previously reported results on reliability. Questionnaires were classified as new, when the concerning study was the first to publish reliability and objective validity data on the PAQ. Hereafter, studies were further stratified for age group of the sample. Study populations with a mean age lower than 18 years were categorised as youth, 18 – 65 years were classified as adults, and elderly above 65 years.

PAQs included

PAQ abbreviations are listed in Table 1, with their respective timeframe. The details of these studies are shown in Tables 2 (new PAQs) and 5 (existing PAQs). A range of tests were used to assess reliability and validity with some studies reporting results for a total questionnaire summary score, and others assessing reliability and validity for various aspects, intensities, or domains of the questionnaire and/or by subgroups within the test population. The total score or index for the PAQ was reported, if available. In the absence of a total score, correlation coefficients by intensity category or group are reported. Where multiple results were reported, a decision was made about the data that constituted the main results based on the stated objectives for the study or questionnaire. Several studies compared results to another questionnaire concurrently but if this was a secondary aim of the specific study, the results were not included.

Table 1.

List of questionnaire abbreviations and the corresponding definitions

Acronym Definition Timeframe
1WPAR
One-week Physical Activity Recall
Last 7 days
7DPAR
7-Day Physical Activity Recall
Last 7 days
7DR
7-Day Recall
Last 7 days
7DR-O
7-Day Recall (occupational activity)
Last 7 days
AAFQ
Arizona Activity Frequency Questionnaire
Last 28 days
AAS
Active Australian Survey (modified version)
Last 7 days, usual week
Activitygram
Activitygram
Last 3 days
AQuAA
Activity Questionnaire for Adolescents and Adults
Last 7 days
AWAS
Australian Women's Activity Survey
Typical week last month
BAD
Bouchard Activity Diary
Last 3 days
BAQ
Baecke Activity Questionnaire
Usual activity
BAQ-mod
Baecke Activity Questionnaire (modified version)
Last year
BONES PAS
Beat Osteoporosis: Nourish and Exercise Skeletons Physical Activity Survey
Last 2 days
BRFSS PAQ
Behavioral Risk Factor Surveillance System Physical Activity Questionnaire (2001 version)
Typical week
CAPS-4WR
Cross-Cultural Activity Participation Study – 4 Weeks activity Recall
4 weeks
CAPS-TWR
Cross-Cultural Activity Participation Study – Typical Week activity Recall
Typical week
CAQ
College Alumnus Questionnaire
Last 7 days
CAQ-PAI
College Alumnus Questionnaire – Physical Activity Index
Last 7 days
CDPAQ
Computer Delivered Physical Activity Questionnaire
Previous day
CHAMPS
Community Healthy Activities Model Program for Seniors
Typical week last month
CHAMPS-MMSCV
Community Healthy Activities Model Program for Seniors (Modified Mailed Self-Complete Version)
Last 7 days
CHASE
Child Heart and Health Study in England questionnaire
Typical week
CLASS
Children's Leisure Activity Study Survey questionnaire
Typical week
CPAQ
Children's Physical Activity Questionnaire
Last 7 days
DQ-mod
Dallosso Questionnaire (modified version)
Typical day last week, typical week
EPAQ
EPIC Physical Activity Questionnaire
Last year
EPAQ-s
EPIC Physical Activity Questionnaire (short version)
Last year
EPAQ2
EPIC Physical Activity Questionnaire (second version)
Last year
FCPQ
Five City Project Questionnaire
Typical week
Fels PAQ
Fels Physical Activity Questionnaire for children
Last year
FPACQ
Flemish Physical Activity Computerized Questionnaire
Typical week
GAQ
GEMS (Girls Health Enrichment Multi-site Studies) Activity Questionnaire
Previous day, usual activity
GLTEQ
Godin Leisure-Time Exercise Questionnaire
Typical week
GPAQ
Global Physical Activity Questionnaire
Typical week
GSQ
Godin-Shephard Questionnaire
Typical week
HAQ
Harvard Alumni Questionnaire
Typical week
HBSC
Health Behaviour in School Children Questionnaire
Typical week
HEPA99
Swiss Health Enhancing Physical Activity Survey 1999
Typical week
HUNT1
Nord-Trøndelag Health Study questionnaire (version 1)
Last 7 days
HUNT2
Nord-Trøndelag Health Study questionnaire (version 2)
Last year
IPAQ
International Physical Activity Questionnaire
Last 7 days, typical week
IPAQ-A
International Physical Activity Questionnaire (modified for Adolescents)
Last 7 days
IPAQ-E
International Physical Activity Questionnaire (short version modified for Elderly)
Last 7 days
IPAQ-LC
International Physical Activity Questionnaire (Long version in Chinese)
Last 7 days
IPAQ-s
International Physical Activity Questionnaire (short version)
Last 7 days
IPAQ-SALVCF
International Physical Activity Questionnaire (Self-Administered Long Version in Canadian French)
Last 7 days
JPAC
Jackson heart Physical Activity Cohort (i.e. modified KPAS)
Last year
KPAS
Kaiser Physical Activity Survey
Last year
KPAS-mod
Kaiser Physical Activity Survey (modified version)
Current trimester
LRC
Lipid Research Clinics questionnaire
Usual activity
MAQ
Modifiable Activity Questionnaire
Last year
MARCA
Multimedia Activity Recall for Children and Adolescents
Previous day
MLTPAQ
Minnesota Leisure Time Physical Activity Questionnaire
Last year
MRPARQ
Many Rivers Physical Activity Recall Questionnaire
Typical week
NHS-PAQ
Nurses' Health Study II – Physical Activity Questionnaire
Last 7 days
OIMQ
Office In Motion Questionnaire
Last 7 days
OPAQ
Occupational Physical Activity Questionnaire
Typical week
PAAT
Physical Activity Assessment Tool
Last 7 days
PAQ-A
Physical Activity Questionnaire for Adolescents
Last 7 days
PAQ-C
Physical Activity Questionnaire for older Children
Last 7 days
PAQ-EJ
Physical Activity Questionnaire for Elderly Japanese
Typical week last month
PASE
Physical Activity Scale for the Elderly
Last 7 days
PDPAR
Previous Day Physical Activity Recall
Previous day
PMMAQ
Past Month – Modifiable Activity Questionnaire
Last month
PPAQ
Pregnancy Physical Activity Questionnaire
Current trimester
Pre-PAQ
Preschool-age Children's Physical Activity Questionnaire
Last 3 days (1 week, 2 weekend days)
PWMAQ
Past Week – Modifiable Activity Questionnaire
Last 7 days
PYTPAQ
Past Year Total Physical Activity Questionnaire
Last year
QAPSE
Questionnaire d'Activité Physique Saint-Etienne
Typical week last year
RPAQ
Recent Physical Activity Questionnaire (i.e. EPAQ2 redesigned)
Last month
RPAR
Recess Physical Activity Recall
Last recess
S7DR
Stanford 7-Day Recall
Last 7 days
SAPAC
Self-Administered Physical Activity Checklist (modified version)
Last 3 days
SBQ
Sedentary Behavior Questionnaire
Typical week
SHAPES
School Health Action, Planning Evaluation System
Last 7 days
SHS97
Swiss Health Survey 1997
Typical week
SP2PAQ
Singapore Prospective Study Program Physical Activity Questionnaire
Last 3 months
SPAQ
Scottish Physical Activity Questionnaire
Last 7 days
SSAAQ
Sub-Saharan Africa Activity Questionnaire
Last year
SUA
Stanford Usual Activity
Usual activity, last 3 months
SWAPAQ
Swedish Adolescent Physical Activity Questionnaire
Last 7 days
TCQ
Tecumseh Community Questionnaire
Last year
TOQ
Tecumseh Occupational Questionnaire
Last 7 days
WAC
Weekly Activity Checklist
Last 7 days
WHI-PAQ
Women's Health Initiative – Physical Activity Questionnaire
Last 7 days
YMCLS
Youth Media Campaign Longitudinal Survey
Last 7 days
YPAQ
Youth Physical Activity Questionnaire
Last 7 days, previous day
YPAS
Yale Physical Activity Scale
Typical week last month
YRBS
Youth Risk Behavior Survey
Last 7 days
PAEE
Physical Activity Energy Expenditure
 
TEE
Total Energy Expenditure
 
MPA
Moderate intensity Physical Activity
 
VPA
Vigorous intensity Physical Activity
 
MVPA
Moderate and Vigorous intensity Physical Activity
 
PAL
Physical Activity Level
 
MET
Metabolic Equivalent of Task
 
Acc
Accelerometry
 
HR
Heart Rate monitoring
 
DLW
Doubly Labeled Water
 
Ped
Pedometer
 
ML Mini-Logger  

Frequently used acronyms also included at the bottom of the table.

Table 2.

Descriptive characteristics of new PAQs

Age group
Reference
Name questionnaire
Country
Domains of activity
Population
Primary outcome
          Size Age (years) Sex Ethnicity  
Youth
Dwyer (2011)[19]
Pre-PAQ
Australia
Habitual and sedentary activities in home environment
103 reliability, 67 validity
3 - 5.9
M/F
Mainly Caucasian
Min/day
Youth
Economos (2010)[20]
BONES PAS
United States
Common activities for children
41 reliability, 40 validity
6 - 9
M/F

METs, WBF score
Youth
Martinez-Gomez (2010)[21]
RPAR
Spain
Sedentary, leisure, transportation, sports/exercise
125
12 - 14
M/F

MET-min, minutes
Youth
Philippaerts (2006)[22]
FPACQ
Belgium
Sedentary, leisure, occupation, transportation
33
12 - 18
M/F
Mainly Caucasian
Total hr/week, METs
Youth
Ridley (2001)[23]
CDPAQ
Australia
Type, duration, intensity, organization of activities before, during and after school
30
11.96 ± 0.53
M/F

METs, minutes
Youth
Ridley (2006)[24]
MARCA
Australia
Sedentary, leisure, household, occupation, transportation, sports/exercise during a school day or another day
32 reliability, 66 validity
9 - 15
M/F

PAL, EE, total time in any activity
Youth
Telford (2004)[25]
CLASS
Australia
30 physical activities over weekdays and weekends
280
5 - 6, 10 - 12
M/F
Mainly Australian born
Total min/week
Youth
Treuth (2003)[26]
GAQ, Activitygram
United States
GAQ: 28 physical, 7 sedentary usual activities. Activitygram: log of all activities in light, moderate, vigorous intensity
68
8 - 9
F
African-American
GAQ score, Activitygram score
Youth
Treuth (2005)[27]
Fels PAQ
United States
Leisure, occupation, sports/exercise
229
7 - 19
M/F

Fels PAQ scores
Youth
Welk (2007)[28]
YMCLS
United States
Free time activity, organized activity, any outside school activity
192
9 - 13
M/F
Mixed
Frequency/week, min/day
Youth
Wong (2006)[29]
SHAPES
Canada
Moderate and vigorous activity and participation in physical, sedentary activities
1636 reliability, 67 validity
Grades 6 - 12
M/F
Mixed
Min/day, EE
Adults
Ainsworth (2000)[30]
KPAS
United States
Household, occupation, sports/exercise, active living habits
50
20 - 60
F
Mainly white
KPAS activity indexes
Adults
Besson (2010)[31]
RPAQ
United Kingdom
Sedentary, leisure, household, occupation, transportation
131 reliability, 50 validity
21 - 55
M/F

MET-hr/day, PAEE (kJ/day), TEE (kJ/day)
Adults
Chasan-Taber (2004)[32]
PPAQ
United States
Sedentary, household, occupation, transportation, sports/exercise
63
16 - 40
F
Mixed
MET-hr/week
Adults
Chinapaw (2009)[33]
AQuAA
Netherlands
Sedentary, leisure, household, occupation, transportation, sports/exercise
111 reliability, 89 validity
12 - 38
M/F

MET-min/week, AQuAA score
Adults
Craig (2003)[34]
IPAQ
12 countries
Short form: sitting, walking, moderate and vigorous intensity. Long form: sedentary, leisure, household, occupation, transportation
Long form: 1880 reliability, 744 validityShort form: 1974 reliability, 781 validity.
18 - 65
M/F
Mixed
Weighted MET-min/week
Adults
Fjeldsoe (2009)[35]
AWAS
Australia
Sedentary, household, occupation, transportation, planned activities
40 reliability, 75 validity
32 ± 5
F

Total min/week for each intensity level
Adults
Friedenreich (2006)[36]
PYTPAQ
Canada
Leisure, household, occupation
154
35 - 65
M/F

MET-hr/week, total hours/week
Adults
Kurtze (2007)[37]
HUNT2
Norway
Leisure, occupation in light and hard intensity
108
20 - 39
M

Light, hard PA summary score
Adults
Kurtze (2008)[38]
HUNT1
Norway
Leisure
108
20 - 39
M

Summary index of weekly PA
Adults
Lowther (1999)[39]
SPAQ
Scotland
Leisure, occupation in moderate, hard, very hard intensity
34 reliability, 30 validity
33 ± 12, 33 ± 11 (reliability); 37 ± 11, 35 ± 14 (validity)
M/F

Total min/week
Adults
Mäder (2006)[40]
SHS97, HEPA99, IPAQ, OIMQ
Switzerland
Sedentary, leisure, household, occupation, transportation
178 reliability, 35 validity
15 - 75
M/F
Mainly Caucasian
MET-min/week, days/week, combined variable
Adults
Meriwether (2006)[41]
PAAT
United States
Leisure, household, occupation, transportation
68 reliability, 63 validity
20 - 61
M/F
Mainly white
Total min/week
Adults
Reis (2005)[42]
OPAQ
United States
Occupational sitting/standing, walking, heavy labour
41
20 - 63
M/F

MET-min/week
Adults
Rosenberg (2010)[43]
SBQ
United States
9 sedentary activities
49 reliability, 842 validity
20.4 ± 1.3 (reliability); ♀41.2 ± 8.7, ♂43.9 ± 8.0 (validity)
M/F
Mainly white
Total hr/week
Adults
Sobngwi (2001)[44]
SSAAQ
Cameroon
Leisure, occupation, walking/cycling
89 reliability, 54 acc, 89 HR
19 - 68
M/F
African
Total hr/day, MET-hr/day
Adults
Timperio (2003)[45]
1WPAR
Australia
All activities in walking, moderate, vigorous intensity
118 reliability, 122 validity
25 - 47
M/F

MET-min/day
Adults
Wareham (2002)[46]
EPAQ2
United Kingdom
Sedentary, leisure, household, occupation, transportation
399 reliability, 173 validity
40 - 74
M/F
Mixed
MET-hr/week
Adults
Wareham (2003)[47]
EPAQ-s
United Kingdom
Leisure, household, occupation, transportation
2271 reliability, 173 validity
40 - 74
M/F
Mixed
PA index, mean day PAR
Adults
Yore (2007)[48]
BRFSS PAQ (2001 version)
United States
Leisure, household, occupation, transportation
60
44.5 ± 15.7
M/F
Mixed
MPA and VPA min/week
Elderly Yasunaga (2007)[49] PAQ-EJ Japan Household, occupation, transportation, sports/exercise 147 65 - 85 M/F Japanese PAQ-EJ score (MET-hr/week)

Domains named in paper were reclassified, unless the activities were very different from categories used, according to the following system: Occupation: work, school, labour. Transportation: travel, commuting, employment. Household: home/life, housework, caregiving, domestic life, child/elder/self care, cooking, chores, gardening, stair climbing. Leisure: leisure, recreation time. Sports/exercise: play, sports, exercise, workout. Sedentary: sedentary behaviours, e.g. sitting, TV viewing activities, eating, sleeping, bathing, inactivity. "– = not stated, M = Male, F = Female.

Results were reported for both total score and other aspects (e.g. domain, intensity) when this substantially added to the information for the specific study, for example when total PA was tested against a different validation method than PA intensities [31]. Some questionnaires assessed sedentary behaviour and these results are specifically reported in the tables or text. Sedentary behaviour has recently been suggested to be considered distinctively from physical activity in associations with health outcomes [50].

Results

The search string (JW and HH) resulted in a total of 11098 hits. The first literature search resulted in 125 papers being retrieved for data extraction. The update of the literature review to December 2011 resulted in a further 75 papers being retrieved for data extraction (Figure 1). More than half of the papers retrieved were excluded (n = 104). The main reasons for exclusion were inappropriate criterion measures, generally a measure of aerobic fitness (n = 48), and lack of information on reliability (n = 26) or validity (n = 17) (Figure 1).

New PAQs

The description of newly developed PAQs is summarized in Table 2. The literature search found 31 articles, reporting results from 34 newly developed PAQs of which 10 were from the United States, 10 from Europe, six from Australia, two from Canada, and one study from Japan and Sub-Saharan Africa, respectively. Of note was a 12–country international study testing the International Physical Activity Questionnaire (IPAQ) [34]. This questionnaire is available in a short form for surveillance and in a longer form when more detailed physical activity information is collected. Both forms are available in a number of languages. IPAQ has been rigorously tested for reliability and validity and this has been replicated in a number of countries.

Nineteen studies tested the reliability and validity in adults, an additional 11 studies focused on youth [19-29] and one study was performed in Japanese elderly (n = 1) [49]. Most studies (n = 25) included men and women, four studies [26,30,32,35] reported data in women and two studies [37,38] in men only. The number of participants varied from 30 to 2271, and several studies [19,20,29,31,33-35,39-41,43-47] performed reliability testing in a larger sample than their test of criterion validity. The most common response timeframe was the last seven days, with seven studies [27,30,36,37,44,46,47] using a timeframe covering the last year (Table 1). All PAQs captured some elements of leisure time and recreational activity, although most questionnaires also addressed multiple domains of activity. Sedentary time is also a commonly captured behaviour from the newly developed questionnaires and has been given some extra attention in recent publications and in the current results. Several recent PAQs, such as the EPIC Physical Activity Questionnaire (EPAQ2) and the Recent Physical Activity Questionnaire (RPAQ), aim to measure the totality of physical activity by domains [31,46,47,51]. The final outcome of the majority of PAQs was reported as time-integrated MET values, e.g. MET-min/week.

Reliability

All reliability results for new PAQs are listed in Table 3.

Table 3.

Reliability results of new PAQs

Age Group
Reference
Test-retest period
PAQ
Variables tested
Reliability results
          Correlation coefficients Agreement
Youth
Dwyer (2011)[19]
1 - 2 weeks
Pre-PAQ
Level 5 min/day(Q1) – level 5
min/day(Q2)
ICC = 0.64

 
 
 
 
Level 4 min/day(Q1) – level 4 min/day(Q2)
ICC = 0.44

 
 
 
 
Level 3 min/day(Q1) – level 3 min/day(Q2)
ICC = 0.53

 
 
 
 
Levels 1–2 min/day(Q1) – levels 1–2 min/day(Q2)
ICC = 0.44

Youth
Economos (2010)[20]
1 - 2 hours
BONES PAS
High METs(Q1) – high METs(Q2)
Spearman r (95 % CI) = 0.57 (0.32;0.75), P < 0.001

 
 
 
 
Moderate-high METs(Q1) – moderate-high METs(Q2)
Spearman r (95 % CI) = 0.74 (0.56;0.85), P < 0.001

 
 
 
 
WBF score(Q1) – WBF score(Q2)
Spearman r (95 % CI) = 0.71 (0.51;0.83), P < 0.001

Youth
Martinez-Gomez (2010)[21]
1 hour
RPAR
Total MET-min(Q1) – total MET-min(Q2)
ICC = 0.87

Youth
Philippaerts (2006)[22]
9 days
FPACQ
Total hr/week(Q1) – total hr/week(Q2)
ICC = 0.68
κ = 0.50
 
 
 
 
Total EE(Q1) – total EE(Q2)
ICC = 0.80
κ = 0.53
 
 
 
 
Inactivity(Q1) – inactivity(Q2)
ICC = 0.83
κ = 0.61
Youth
Ridley (2001)[23]
7 days
CDPAQ
Total METs(Q1) – total METs(Q2)
ICC = 0.98 (P < 0.05)

 
 
 
 
Total min(Q1) – total min(Q2)
ICC = 0.91 (P < 0.05)

 
 
 
CDPAQ-HC
Total METs(Q1) – total METs(Q2)
ICC = 0.98 (P < 0.05)

 
 
 
 
Total min(Q1) – total min(Q2)
ICC = 0.96 (P < 0.05)

Youth
Ridley (2006)[24]
Within 24 hours
MARCA
PAL(Q1) – PAL(Q2)
ICC = 0.93
95 % LoA = −0.30 – 0.30
Youth
Telford (2004)[25]
> 14 days
CLASS-parental report
5-6 yrs: frequency(Q1) – frequency(Q2)
ICC = 0.83 (P < 0.001)

 
 
 
 
10-12 yrs: frequency(Q1) – frequency(Q2)
ICC = 0.69 (P < 0.001)

 
 
 
 
5-6 yrs: duration(Q1) – duration(Q2)
ICC = 0.76 (P < 0.001)

 
 
 
 
10-12 yrs: duration(Q1) – duration(Q2)
ICC = 0.74 (P < 0.001)

 
 
 
CLASS-self
10-12 yrs: frequency(Q1) – frequency(Q2)
ICC = 0.36 (P < 0.01)

 
 
 
 
10-12 yrs: duration(Q1) – duration(Q2)
ICC = 0.24

Youth
Treuth (2003)[26]
4 days
GAQ
Yesterday: GAQ score(Q1) – GAQ score(Q2)
Pearson r = 0.7833 (P < 0.0001)

 
 
 
 
Usual: GAQ score(Q1) – GAQ score(Q2)
Pearson r = 0.8187 (P < 0.0001)

 
 
 
 
Yesterday: TV watching(Q1) – TV watching(Q2)
Pearson r = 0.3454 (P = 0.0043)

 
 
 
 
Usual: TV watching(Q1) – TV watching(Q2)
Pearson r = 0.3827 (P = 0.0015)

 
 
 
 
Yesterday: other sedentary(Q1) – other sedentary(Q2)
Pearson r = 0.4695 (P < 0.0001)

 
 
 
 
Usual: other sedentary(Q1) – other sedentary(Q2)
Pearson r = 0.4837 (P < 0.0001)

 
 
3 days
Activitygram
Activitygram score(Q1) – activitygram score(Q2)
ICC = 0.24 (P = 0.005)

Youth
Treuth (2005)[27]
6 days
Fels PAQ
Girls: Fels PAQ score(Q1) – Fels PAQ score(Q2)
ICC = 0.67

 
 
 
 
Boys: Fels PAQ score(Q1) – Fels PAQ score(Q2)
ICC = 0.65

Youth
Welk (2007)[28]
7 days
YMCLS
Total activity(Q1) – total activity(Q2)
ICC (95 % CI) = 0.60 (0.47;0.70)

Youth
Wong (2006)[29]
7 days
SHAPES
Combined activity(Q1) – combined activity(Q2)

κ (±SD) = 0.58 ± 0.17
 
 
 
 
Sedentary activity(Q1) – sedentary activity(Q2)

κ (±SD) = 0.55 ± 0.01
Adults
Ainsworth (2000)[30]
1 month
KPAS
3-point summary index(Q1) – 3-point summary index(Q2)
ICC = 0.82 (P < 0.0001)

 
 
 
 
4-point summary index(Q1) – 4-point summary index(Q2)
ICC = 0.83 (P < 0.0001)

Adults
Besson (2010)[31]
± 2 weeks
RPAQ
PAEE(Q1) – PAEE(Q2)
ICC = 0.76 (P < 0.001)

 
 
 
 
Sedentary time(Q1) – sedentary time(Q2)
ICC = 0.76 (P < 0.001)

Adults
Chasan-Taber (2004)[32]
7 days
PPAQ
Total activity(Q1) – total activity(Q2)
ICC = 0.78

 
 
 
 
Sedentary(Q1) – sedentary(Q2)
ICC = 0.79

Adults
Chinapaw (2009)[33]
2 weeks
AQuAA
Adolescents: AQuAA score(Q1) – AQuAA score(Q2)
ICC (95 % CI) = 0.44 (0.16;0.65)

 
 
 
 
Adults: AQuAA score(Q1) – AQuAA score(Q2)
ICC (95 % CI) = 0.22 (−0.04;0.46)

 
 
 
 
Adolescents: sedentary(Q1) – sedentary(Q2)
ICC (95 % CI) = 0.57 (0.34;0.73)

 
 
 
 
Adults: sedentary(Q1) – sedentary(Q2)
ICC (95 % CI) = 0.60 (0.40;0.74)

Adults
Craig (2003)[34]
3 - 7 days
IPAQ
Long form: total PA(Q1) – total PA(Q2)
Pooled Spearman r (95 % CI) = 0.81 (0.79;0.82), range: 0.46 - 0.96

 
 
 
 
Short form: total PA(Q1) – total PA(Q2)
Pooled Spearman r (95 % CI) = 0.76 (0.73;0.77), range: 0.32 - 0.88

Adults
Fjeldsoe (2009)[35]
7 days
AWAS
Total activity(Q1) – total activity(Q2)
ICC (95 % CI) = 0.73 (0.51;0.86)

 
 
 
 
HEPA(Q1) – HEPA(Q2)
ICC (95 % CI) = 0.80 (0.65;0.89)

 
 
 
 
Sitting(Q1) – sitting(Q2)
ICC (95 % CI) = 0.42 (0.13;0.64)

Adults
Friedenreich (2006)[36]
9 weeks (average)
PYTPAQ
Total MET-hr/week(Q1) – total MET-hr/week(Q2)
ICC (95 % CI) = 0.66 (0.56;0.74), Spearman r = 0.64 (P < 0.0001)

Adults
Kurtze (2007)[37]
7 days
HUNT2
Hard activity(Q1) – hard activity(Q2)
Spearman r = 0.17 (P < 0.01)
κ = 0.41 (0.29;0.54)
 
 
 
 
Occupational activity(Q1) – occupational activity(Q2)
Spearman r = 0.85 (P < 0.01)
κ = 0.80 (0.71;0.89)
 
 
 
 
Light activity(Q1) – light activity(Q2)
Spearman r = 0.17
κ = 0.20 (0.04;0.35)
Adults
Kurtze (2008)[38]
7 days
HUNT1
Frequency(Q1) – frequency(Q2)
Spearman r = 0.87 (P < 0.01)
κ = 0.80
 
 
 
 
Intensity(Q1) – intensity(Q2)
Spearman r = 0.87 (P < 0.01)
κ = 0.82
 
 
 
 
Duration(Q1) – duration(Q2)
Spearman r = 0.76 (P < 0.01)
κ = 0.69
Adults
Lowther (1999)[39]
2 days
SPAQ
Total min(Q1) – total min(Q2)
Pearson r = 0.998 (P < 0.01), repeatability coefficient R = 53 min.
MD (95 % LoA) = 3.09 ± 26.5 min
Adults
Mäder (2006)[40]
14 - 21 days
SHS97
Sweat episodes(Q1) – sweat episodes(Q2)
Spearman r = 0.63 (P < 0.05)

 
 
 
HEPA99
Active/inactive(Q1) – active/inactive(Q2)

κ = 0.46 (P < 005)
 
 
 
IPAQ
Total MET-min/week(Q1) – total MET-min/week(Q2)
Spearman r = 0.54 (P < 0.05)

 
 
 
 
Sitting(Q1) – sitting(Q2)
Spearman r = 0.60 (P < 0.05)

 
 
 
OIMQ
Total MET-min/week(Q1) – total MET-min/week(Q2)
Spearman r = 0.68 (P < 0.05)

Adults
Meriwether (2006)[41]
7 days
PAAT
Total min(Q1) – total min(Q2)
Spearman r = 0.618 (P < 0.001)

Adults
Reis (2005)[42]
2 weeks
OPAQ
Total activity(Q1) – total activity(Q2)
ICC (95 % CI) = 0.76 (0.59;0.86)

 
 
 
 
Sedentary(Q1) – sedentary(Q2)
ICC (95 % CI) = 0.78 (0.62;0.87)

Adults
Rosenberg (2010)[43]
2 weeks
SBQ
Weekday: total score(Q1) – total score(Q2)
ICC (95 % CI) = 0.85 (0.75;0.91), Spearman r (95 % CI) = 0.79 (0.65;0.88)

 
 
 
 
Weekend day: total score(Q1) – total score(Q2)
ICC (95 % CI) = 0.77 (0.63;0.86), Spearman r (95 % CI) = 0.74 (0.58;0.85)

Adults
Sobngwi (2001)[44]
10 - 15 days
SSAAQ
Total min(Q1) – total min(Q2)
Spearman r = 0.95 (P < 0.001)

Adults
Timperio (2003)[45]
3 days
1WPAR
Men: duration(Q1) – duration(Q2)
ICC (95 % CI) = 0.45 (0.20;0.64), P < 0.001

 
 
 
 
Women: duration(Q1) – duration(Q2)
ICC (95 % CI) = 0.80 (0.69;0.87), P < 0.001

 
 
 
 
Men: sufficient PA(Q1) – sufficient PA(Q2)

κ = 0.64 (P < 0.001)
 
 
 
 
Women: sufficient PA(Q1) – sufficient PA(Q2)

κ = 0.55 (P < 0.001)
Adults
Wareham (2002)[46]
3 months
EPAQ2
Men: total MET-hr/week(Q1) – total MET-hr/week(Q2)
Pearson r = 0.74 (P < 0.05)
κ = 0.64
 
 
 
 
Women: total MET-hr/week(Q1) – total MET-hr/week(Q2)
Pearson r = 0.72 (P < 0.05)
κ = 0.70
 
 
 
 
Men: TV time(Q1) – TV time(Q2)
Pearson r = 0.75 (P < 0.05)
κ = 0.71
 
 
 
 
Women: TV time(Q1) – TV time(Q2)
Pearson r = 0.78 (P < 0.05)
κ = 0.74
Adults
Wareham (2003)[47]
18 - 21 months
EPAQ
Physical activity index(Q1) – physical activity index(Q2)

κ = 0.60 (P < 0.0001)
Adults
Yore (2007)[48]
1 - 5 days
BRFSS PAQ
VPA(Q1) – VPA(Q2)

κ (95 % CI) = 0.86 (0.72;0.99)
 
 
 
 
MPA(Q1) – MPA(Q2)

κ (95 % CI) = 0.53 (0.31;0.75)
 
 
 
 
Recommended PA(Q1) – recommended PA(Q2)

κ (95 % CI) = 0.84 (0.69;0.99)
 
 
 
 
Walking(Q1) – walking(Q2)

κ (95 % CI) = 0.56 (0.34;0.77)
 
 
 
 
Strengthening PA(Q1) – strengthening PA(Q2)

κ (95 % CI) = 0.92 (0.81;1.00)
 
 
10 - 19 days
BRFSS PAQ
VPA(Q1) – VPA(Q3)

κ (95 % CI) = 0.80 (0.65;0.95)
 
 
 
 
MPA(Q1) – MPA(Q3)

κ (95 % CI) = 0.35 (0.11;0.59)
 
 
 
 
Recommended PA(Q1) – recommended PA(Q3)

κ (95 % CI) = 0.67 (0.46;0.88)
 
 
 
 
Walking(Q1) – walking(Q3)

κ (95 % CI) = 0.34 (0.10;0.57)
 
 
 
 
Strengthening PA(Q1) – strengthening PA(Q3)

κ (95 % CI) = 0.85 (0.71;0.99)
Elderly
Yasunaga (2007)[49]
1 month
PAQ-EJ
PAQ-EJ score(Q1) – PAQ-EJ score(Q2)
Pearson r = 0.70 (P < 0.05)

 
 
 
 
 
Median ICC = 0.76 (youth: 0.69, adults: 0.765, elderly: –)
 
 
 
 
 
 
Median Spearman r = 0.74 (youth: 0.71, adults: 0.75, elderly: –)
 
 
 
 
 
 
Median Pearson r = 0.76 (youth: 0.80, adults: 0.74, elderly: 0.70)
 
            Median κ = 0.64 (youth: 0.53, adults: 0.655, elderly: –)

Q1 =first completed questionnaire, Q2 = second completed questionnaire, Q3 = third completed questionnaire, r = correlation coefficient (rho), ICC = Intraclass Correlation Coefficient, CI = Confidence Interval (lower;upper), %CV = coefficient of variation (within subjects standard deviation of typical error) as a percentage of the mean score, κ = kappa (i.e. Cohen weighted kappa unless specified otherwise), LoA = Limits of Agreement, MD = Mean Difference, – = not stated.

NB: No calculation of weighted kappa is specified in the papers. Usually the kappa statistic is used for categorical responses and weighted kappa for ordinal responses. Interpretation of values of kappa and weighted kappa were usually based on the classification system developed by Landis and Koch (1977), where <0.10 indicated poor agreement, 0.10-0.20 slight agreement, 0.21-0.40 fair agreement, 0.41-0.60 moderate agreement, 0.61-0.80 substantial agreement, 0.81-1.00 almost perfect agreement.

Ainsworth (2000): 3 point summary index = 3 domains: sports/exercise, occupation, active living habits. 4 point summary index = all 4 domains: sports/exercise, occupation, active living habits, housework/caregiving.

Chinapaw (2009): AQuAA score: all activities above 2 MET in MET-min/week.

Craig (2003): Pooled Spearman = pooled results from data of 22 studies examining the IPAQ long form and 23 studies examining the short form.

Dwyer (2011): Levels 1–2 = stationary, level 3 = moving slowly, level 4 = moving at a medium or moderate pace, level 5 = moving at a fast pace.

Economos (2010): Moderate-high METs = 3–6 METs. High METs = ≥6 METs. WBF score = weight-bearing factor score, calculated by adding the weight-bearing factor of the reported weight-bearing activities.

Fjeldsoe (2009): HEPA = Health Enhancing Physical Activity: brisk walking and moderate- and vigorous activities from the planned activity and transport domains.

Kurtze (2007): Light activity = no sweating or being out of breath. Hard activity = sweating/out of breath.

Lowther (1999): Total min = total minutes measured in the overlapping 4 days of both questionnaires. Repeatability coefficient (twice the standard deviation of the differences) means that 95 % of the differences in SPAQ from one measurement to the next (under similar conditions) would be between zero plus or minus 53 minutes.

Mäder (2006): IPAQ - Total MET-min/week = MET-min/week for total activity excluding sitting. OIMQ - Total MET-min/week = MET-min/week for total activity, i.e. moderate and vigorous activities.

Philippaerts (2006): Total hrs/week = Total hours per week spent in transport and sports participation, excluding sedentary activities. Total EE = Total EE spent in transport and sports participation, excluding sedentary activities.

Reis (2005): Sedentary = sitting or standing activities.

Ridley (2001): CDPAQ-HC = hard copy of CDPAQ.

Rosenberg (2010): Total score = all sedentary behaviors in hours per day for each item were summed separately for weekday and weekend days.

Telford (2004): Reliability results for frequency/duration of overall total PA for 5 to 6 or 10 to 12 year old children in parental proxy-reports or self-administered questionnaires.

Timperio (2003): Duration = duration of total physical activity. Sufficient PA was calculated as 150 minutes of combined walking, moderate- and vigorous-intensity physical activity, with reported duration of vigorous-intensity physical activity weighted by two.

Treuth (2003): GAQ score = MET weighted mean score of 28 activities. Activitygram score = average intensity/min. Other sedentary = sedentary activities excluding TV watching.

Treuth (2005): Fels PAQ score = total activity score; MET weighted sum of sport, leisure, work index.

Wareham (2003): Physical activity index is a four-category index of inactive, moderately inactive, moderately active, active. TV time = hours per week watching television and videos.

Wong (2006): Combined activity = combined score of the SHAPES derived variables which contains the variables: VPA, MPA, MVPA, screen time, PAL and BMI.

Yasunaga (2007): PAQ-EJ score (MET-hr/week) = number of days*time*intensity weight.

Yore (2007): MPA ≥ 30 min/day on 5 days/week. VPA ≥ 20 min/day on 3 days/week. Recommended PA, i.e. ≥ subjects who met the criteria for moderate or vigorous PA. Walking ≥ 30 min/day. Strengthening PA = any muscle-strengthening activity on ≥ 2 days/week. Kappa's are reported for the subsamples who met the criteria for the physical activity intensities.

Reliability was usually reported as ICC (n = 13), Pearson/Spearman correlation (n = 6), kappa statistic (n = 3) or a combination of these statistics (n = 9). Higher reliability coefficients were more often seen in association with shorter periods between test and retest. Poor correlation (ICC or r <0.4) was found only in subcategories of a few PAQs. Median correlations from reported data for recall of sedentary behaviours across all PAQs were acceptable: ICC = 0.68, Spearman r = 0.60, Pearson r = 0.475, kappa = 0.66.

Youth

Median reliability correlations for the youth were as follows: ICC = 0.69, Spearman r = 0.71, Pearson r = 0.80, kappa = 0.53. The Activitygram (ICC = 0.24) [26] and the self-reported CLASS questionnaire (frequency: ICC = 0.36, duration ICC = 0.24) [25] showed fairly low reliability correlations, whereas the MARCA (ICC = 0.93) [52] and both computer and paper versions of the CDPAQ (ICC = 0.91–0.98) [23] demonstrated high reliability.

Adults

Median reliability correlations for adults were as follows: ICC = 0.765, Spearman r = 0.75, Pearson r = 0.74, kappa = 0.655. Reliability was poor for the AQuAA score for adults (ICC = 0.22) [53]. Similarly, reliability coefficients were poor for the HUNT2 [37] components of light (r = 0.17, κ = 0.20) and hard activity (r = 0.17, κ = 0.41). The primary version of this questionnaire (HUNT1), which was designed a decade earlier, however demonstrated high reliability (r = 0.76–0.87, κ = 0.69–0.82) [54]. The majority of the questionnaires showed acceptable to good reliability: KPAS (ICC = 0.82–0.83) [30], RPAQ (ICC = 0.76) [31], PPAQ (ICC = 0.78) [32], IPAQ short (r = 0.76) and long version (r = 0.81) [34], AWAS (ICC = 0.73–0.80) [35], FPACQ (ICC = 0.68–0.80) [22], OPAQ (ICC = 0.78) [42], SBQ (ICC = 0.77-0.85, r = 0.74-0.79) [43], SPAQ (r = 0.998) [39] and SSAAQ (r = 0.95) [44].

Elderly

Median Pearson reliability correlation for the elderly was r = 0.70. The PAQ-EJ was the only new PAQ designed for (Japanese) elderly that reported reliability results and has acceptable recall properties (r = 0.70) [49].

Validity

All validity results for new PAQs are listed in Table 4.

Table 4.

Validity results of new PAQs

Age Group
Reference
Criterion method
Duration of validation
PAQ
Variables tested
Criterion intensity thresholds
Validity results
              Correlation coefficients Agreement
Youth
Dwyer (2011)[19]
Acc (ActiGraph)
4 - 5 days
Pre-PAQ
Level 5 min/day(Q) – VPA min/day(Acc)
>5016 counts/min
Pearson r = 0.17
MD (95 % LoA) = 1.9 ± 39.4 min/day
 
 
 
 
 
Level 4 min/day(Q) – MPA min/day(Acc)
3560-5016 counts/min
Pearson r = 0.13
MD (95 % LoA) = 48.2 ± 73.1 min/day
 
 
 
 
 
Level 3 min/day(Q) – LPA min/day(Acc)
1592-3560 counts/min
Pearson r = −0.07
MD (95 % LoA) = −4.8 ± 100.7 min/day
 
 
 
 
 
Levels 1–2 min/day(Q) – sedentary min/day(Acc)
<1592 counts/min
Pearson r = 0.19
MD (95 % LoA) = −235.4 ± 147.7 min/day
Youth
Economos (2010)[20]
Acc (ActiGraph)
2 days
BONES PAS
High METs(Q) – total counts/min(Acc)

Spearman r (95 % CI) = 0.25 (−0.07;0.52)

 
 
 
 
 
High METs(Q) – VPA(Acc)
6-9 METs, 1952–5724 counts/min
Spearman r (95 % CI) = 0.23 (−0.09;0.51)

 
 
 
 
 
Moderate-high METs(Q) – total counts/min(Acc)

Spearman r (95 % CI) = 0.27 (−0.05;0.54)

Youth
Martinez-Gomez (2010)[21]
Acc (ActiGraph)
1 day
RPAR
Total MET-min(Q) – total counts(Acc)

Pearson r = 0.42 (P = 0.021)
κ = 0.16
 
 
 
 
 
MVPA min(Q) – MVPA counts(Acc)
≥2000 counts/min
Pearson r = 0.52 (P < 0.001)
MD (95 % LoA) = 2.15 ± 7.19 min
 
 
Acc (Biotrainer)
1 day
 
Total MET-min(Q) – total counts(Acc)

Pearson r = 0.40 (P = 0.025)
κ = 0.39
 
 
 
 
 
Total MET-min(Q) – total counts/mov(Acc)

Pearson r = 0.54 (P = 0.004)
κ = 0.16
Youth
Philippaerts (2006)[22]
Acc (ActiGraph)
7 days
FPACQ
Total hr/week(Q) – total counts(Acc)

Pearson r = 0.56 (P < 0.01)

 
 
 
 
 
Total hr/week(Q) – mean counts/min(Acc)

Pearson r = 0.43 (P < 0.05)

 
 
 
 
 
TEE(Q) – total counts(Acc)

Pearson r = 0.58 (P < 0.01)

 
 
 
 
 
TEE(Q) – mean counts/min(Acc)

Pearson r = 0.49 (P < 0.05)

 
 
 
 
 
Inactivity(Q) – total counts(Acc)

Pearson r = −0.13

 
 
 
 
 
Inactivity(Q) – mean counts/min(Acc)

Pearson r = −0.06

Youth
Ridley (2001)[23]
Acc (Caltrac)
2x 1 day
CDPAQ
Total METs(Q) – total counts(Acc)

Pearson r = 0.41 (P < 0.05)

 
 
 
 
 
Total compendium METs(Q) – total counts(Acc)

Pearson r = 0.54 (P < 0.05)

 
 
 
 
 
Total mins(Q) – total counts(Acc)

Pearson r = 0.41 (P < 0.05)

 
 
HR (Polar)
2x 1 day
 
MVPA mins(Q) – MVPA mins(HR)
≥145 bpm
Pearson r = 0.66 (P = 0.01)

 
 
Acc (Caltrac)
2x 1 day
CDPAQ-HC
Total METs(Q) – total counts(Acc)

Pearson r = 0.25 (P < 0.05)

 
 
 
 
 
Total compendium METs(Q) – total counts(Acc)

Pearson r = 0.22 (P < 0.05)

 
 
 
 
 
Total mins(Q) – total counts(Acc)

Pearson r = 0.33 (P < 0.05)

 
 
HR (Polar)
2x 1 day
 
MVPA mins(Q) – MVPA mins(HR)
≥145 bpm
Pearson r = 0.48 (P = 0.05)

Youth
Ridley (2006)[24]
Acc (ActiGraph)
1 day
MARCA
PAL(Q) – total counts(Acc)

Spearman r = 0.45 (P < 0.01)

Youth
Telford (2004)[25]
Acc (ActiGraph)
8 days
CLASS-parental report
5-6 yrs: total min/day(Q) – total min/day(Acc)

Spearman r = −0.04
MD (95 % LoA) = −140.7 (−164.9;-116.6) min/day
 
 
 
 
 
10-12 yrs: total min/day(Q) – total min/day(Acc)

Spearman r = 0.09
MD (95 % LoA) = 11.2 (−6.9;29.4) min/day
 
 
 
 
 
5-6 yrs: total min/day(Q) – total raw counts/day(Acc)

Spearman r = 0.05

 
 
 
 
 
10-12 yrs: total min/day(Q) – total raw counts/day(Acc)

Spearman r = 0.11

 
 
 
 
CLASS-self
10-12 yrs: total min/day(Q) – total min/day(Acc)

Spearman r = −0.04
MD (95 % LoA) = 1.5 (−17.2;20.3) min/day
 
 
 
 
 
10-12 yrs: total min/day(Q) – total raw counts/day(Acc)

Spearman r = 0.06

Youth
Treuth (2003)[26]
Acc (ActiGraph)
4 days
GAQ
Yesterday: GAQ score(Q) – mean counts/min(Acc)

Pearson r = 0.27 (P < 0.05)

 
 
 
 
 
Usual: GAQ score(Q) – mean counts/min(Acc)

Pearson r = 0.29 (P < 0.05)

 
 
 
 
 
Yesterday: TV watching(Q) – mean counts/min(Acc)

Pearson r = −0.145 (P = 0.24)

 
 
 
 
 
Usual: TV watching(Q) – mean counts/min(Acc)

Pearson r = −0.004 (P = 0.98)

 
 
 
 
 
Yesterday: other sedentary(Q) – mean counts/min(Acc)

Pearson r = 0.0227 (P = 0.85)

 
 
 
 
 
Usual: other sedentary(Q) – mean counts/min(Acc)

Pearson r = −0.0916 (P = 0.46)

 
 
 
 
Activitygram
Activitygram score(Q) – mean counts/min(Acc)

Pearson r = 0.37 (P < 0.002)

Youth
Treuth (2005)[27]
Acc (Actiwatch)
6 days
Fels PAQ
Elementary: Fels PAQ score(Q) – mean counts/min(Acc)

Spearman r = 0.34 (P = 0.004)

 
 
 
 
 
Middle: Fels PAQ score(Q) – mean counts/min(Acc)

Spearman r = 0.11 (P = 0.31)

 
 
 
 
 
High: Fels PAQ score(Q) – mean counts/min(Acc)

Spearman r = 0.21 (P = 0.006)

Youth
Welk (2007)[28]
Acc (ActiGraph)
7 days
YMCLS
Weekly PA bouts(Q) – weekly PA bouts(Acc)

r = 0.24 (P < 0.05)
MD (95 % LoA) = −8.4 ± 28.4 min
 
 
 
 
 
Previous day: total MVPA mins(Q) – total MVPA mins(Acc)
3-6 METs
r = 0.53 (P < 0.05)
MD (95 % LoA) = 14.5 ± 173.9 min
Youth
Wong (2006)[29]
Acc (ActiGraph)
7 - 9 days
SHAPES
VPA min/day(Q) – VPA min/day(Acc)
≥8200 counts/min
Spearman r = 0.25 (P = 0.07)

 
 
 
 
 
MVPA min/day(Q) – MVPA min/day(Acc)
≥3200 counts/min
Spearman r = 0.44 (P < 0.01)

 
 
 
 
 
MPA min/day(Q) – MPA min/day(Acc)
3200-8199 counts/min
Spearman r = 0.31 (P = 0.02)

Adults
Ainsworth (2000)[30]
Acc (Caltrac)
2x 7 days
KPAS
3 point summary index(Q) – MET-min/day(Acc)

Spearman r = 0.53 (P < 0.01)

 
 
 
 
 
4 point summary index(Q) – MET-min/day(Acc)

Spearman r = 0.49 (P < 0.01)

Adults
Besson (2010)[31]
DLW
14 days
RPAQ
TEE(Q) – TEE(DLW)

Spearman r = 0.67 (P < 0.0001)
MD (95 % LoA) = −3451.9 ± 2025.1 kJ/day (P < 0.05)
 
 
 
 
 
PAEE(Q) – PAEE(DLW)

Spearman r = 0.39 (P = 0.0004)
MD (95 % LoA) = −12.9 ± 23.9 kJ/day (P < 0.05)
 
 
Acc + HR (Actiheart)
11 days
 
VPA(Q) – VPA(Acc + HR)
>6 METs
Spearman r = 0.70 (P < 0.0001)
MD (95 % LoA) = 0.2 ± 0.4 h/day
 
 
 
 
 
MPA(Q) – MPA(Acc + HR)
3.6-6 METs

MD (95 % LoA) = −0.8 ± 1.0 h/day
 
 
 
 
 
Light PA(Q) – light PA(Acc + HR)
2-3.5 METs

MD (95 % LoA) = −0.1 ± 2.4 h/day
 
 
 
 
 
Sedentary time(Q) – sedentary time(Acc + HR)
<2 METs
Spearman r = 0.27 (P = 0.06)
MD (95 % LoA) = 0.7 ± 2.8 h/day
Adults
Chasan-Taber (2004)[32]
Acc (ActiGraph)
7 days
PPAQ
Total activity(Q) – Swartz cut point min/day(Acc)
≥3 METs, ≥574 counts/min
Spearman r = 0.32

 
 
 
 
 
Total activity(Q) – Hendelman cut point min/day(Acc)
≥3 METs, ≥191 counts/min
Spearman r = 0.43

 
 
 
 
 
Total activity(Q) – Freedson cut point min/day(Acc)
≥3 METs, ≥1952 counts/min
Spearman r = 0.08

 
 
 
 
 
Total activity(Q) – mean counts/min(Acc)

Spearman r = 0.27

 
 
 
 
 
Sedentary(Q) – Swartz cut point min/day(Acc)
<1.5 METs
Spearman r = −0.17

 
 
 
 
 
Sedentary(Q) – Hendelman cut point min/day(Acc)
<1.5 METs
Spearman r = −0.34

 
 
 
 
 
Sedentary(Q) – Freedson cut point min/day(Acc)
<1.5 METs
Spearman r = 0.12

 
 
 
 
 
Sedentary(Q) – mean counts/min(Acc)

Spearman r = −0.10

Adults
Chinapaw (2009)[33]
Acc (ActiGraph)
14 days
AQuAA
Adolescents: AQuAA score(Q) – counts/min(Acc)
≥ 2 METs, ≥699 counts/min
Spearman r = 0.13

 
 
 
 
 
Adults: AQuAA score(Q) – counts/min(Acc)
≥ 2 METs, ≥699 counts/min
Spearman r = −0.16

 
 
 
 
 
Adolescents: sedentary(Q) – counts/min(Acc)
< 2 METs, <699 counts/min
Spearman r = 0.23

 
 
 
 
 
Adults: sedentary(Q) – counts/min(Acc)
< 2 METs, <699 counts/min
Spearman r = 0.15

Adults
Craig (2003)[34]
Acc (ActiGraph)
7 days
IPAQ
Long form: total PA(Q) – total counts(Acc)

Pooled Spearman r (95 % CI) = 0.33 (0.26;0.39), range: -0.27 - 0.61

 
 
 
 
 
Short form: total PA(Q) – total counts(Acc)

Pooled Spearman r (95 % CI) = 0.30 (0.23;0.36), range: -0.12 - 0.57

Adults
Fjeldsoe (2009)[35]
Acc (ActiGraph)
7 days
AWAS
Total activity(Q) – total activity(Acc)
≥100 counts/min
Spearman r = 0.13 (P = 0.24)

 
 
 
 
 
HEPA(Q) – Freedson cut point min/week(Acc)

Spearman r = 0.28 (P = 0.01)

 
 
 
 
 
HEPA(Q) – Swartz cut point min/week(Acc)

Spearman r = 0.06 (P = 0.64)

 
 
 
 
 
Sitting(Q) – sitting(Acc)
<100 counts/min
Spearman r = 0.32 (P = 0.006)

Adults
Friedenreich (2006)[36]
Acc (ActiGraph)
4x 7 days
PYTPAQ
Total MET-hr/week(Q) – total MET-hr/week(Acc)

Spearman r = 0.26 (P < 0.05), ICC (95 % CI) = 0.18 (0.03;0.32)

Adults
Kurtze (2007)[37]
Acc (ActiReg)
7 days
HUNT2
Hard activity(Q) – EE(Acc)

Spearman r = 0.11

 
 
 
 
 
Hard activity(Q) – PAL(Acc)

Spearman r = 0.16

 
 
 
 
 
Light activity(Q) – EE(Acc)

Spearman r = 0.21 (P < 0.05)

 
 
 
 
 
Light activity(Q) – PAL(Acc)

Spearman r = 0.08

 
 
 
 
 
Occupational activity(Q) – EE(Acc)

Spearman r = 0.39 (P < 0.01)

 
 
 
 
 
Occupational activity(Q) – PAL(Acc)

Spearman r = 0.38 (P < 0.01)

Adults
Kurtze (2008)[38]
Acc (ActiReg)
7 days
HUNT1
Summary index(Q) – EE(Acc)

Spearman r = 0.03

 
 
 
 
 
Summary index(Q) – PAL(Acc)

Spearman r = 0.07

 
 
 
 
 
Summary index(Q) – MET-min/day(Acc)

Spearman r = 0.07

Adults
Lowther (1999)[39]
Acc (Caltrac)
4 days
SPAQ
Total mins(Q) – total kcal(Acc)

r = 0.1294, corrected for confounding: r = 0.52 (P < 0.05)

Adults
Mäder (2006)[40]
Acc (ActiGraph)
7 days
SHS97
Sweat episodes/week(Q) – total counts/min(Acc)

Spearman r = 0.23

 
 
 
 
HEPA99




 
 
 
 
IPAQ
Total MET-min/week(Q) – total counts/min(Acc)

Spearman r = 0.39 (P < 0.05)

 
 
 
 
 
Sitting(Q) – sitting(Acc)
<100 counts/min
Spearman r = 0.22

 
 
 
 
OIMQ
Total MET-min/week(Q) – total counts/min(Acc)

Spearman r = 0.44 (P < 0.05)

Adults
Meriwether (2006)[41]
Acc (MTI)
14 days
PAAT
VPA min/week(Q) – VPA min/week(Acc)
≥5 METs, ≥5725 counts/min
Spearman r = 0.380 (P < 0.01)

 
 
 
 
 
MVPA min/week(Q) – MVPA min/week(Acc)
≥5 METs, ≥1952 counts/min
Spearman r = 0.392 (P < 0.01)

 
 
 
 
 
MPA min/week(Q) – MPA min/week(Acc)
3-4.9 METs, 1952–5724 counts/min
Spearman r = 0.392 (P < 0.01)

Adults
Reis (2005)[42]
Acc (ActiGraph)
7 days
OPAQ
Total hr/week(Q) – VPA(Acc)
≥5725 counts/min
Spearman r = −0.02

 
 
 
 
 
Total hr/week(Q) – MPA(Acc)
1952-5724 counts/min
Spearman r = 0.12

 
 
 
 
 
Total hr/week(Q) – light activity(Acc)
<1952 counts/min
Spearman r = 0.22

 
 
 
 
 
Sedentary(Q) – light activity(Acc)
<1952 counts/min
Spearman r = −0.20

Adults
Rosenberg (2010)[43]
Acc (ActiGraph)
7 days
SBQ
Female: total sedentary hr/week(Q) – total sedentary counts(Acc)
<100 counts/min
Partial r = 0.10 (P = 0.07)

 
 
 
 
 
Male: total sedentary hr/week(Q) – total sedentary counts(Acc)
<100 counts/min
Partial r = −0.01 (P = 0.81)

Adults
Sobngwi (2001)[44]
Acc (Caltrac)
1 day
SSAAQ
Female: total METs(Q) – total METs(Acc)

r = 0.74 (P < 0.01)

 
 
 
 
 
Male: total METs(Q) – total METs(Acc)

r = 0.60 (P < 0.01)

 
 
HR (Polar)
1 day
 
Urban female: total METs(Q) – total activity(HR)

r = 0.63 (P < 0.01)

 
 
 
 
 
Rural female: total METs(Q) – total activity(HR)

r = 0.41 (P < 0.05)

 
 
 
 
 
Urban male: total METs(Q) – total activity(HR)

r = 0.54 (P < 0.05)

 
 
 
 
 
Rural male: total METs(Q) – total activity(HR)

r = 0.59 (P < 0.01)

Adults
Timperio (2003)[45]
Acc (ActiGraph)
7 days
1WPAR
Men: total min/day(Q) – total min/day(Acc)
≥3 METs, ≥1952 counts/min
Spearman r = 0.29 (P < 0.05)

 
 
 
 
 
Women: total min/day(Q) – total min/day(Acc)
≥3 METs, ≥1952 counts/min
Spearman r = 0.25 (P < 0.05)

Adults
Wareham (2002)[46]
HR (Polar)
4x 4 days
EPAQ2
Total MET-hr/week(Q) – EE(HR)

Pearson partial r = 0.28 (P < 0.001)

 
 
 
 
 
TV time(Q) – EE(HR)

Pearson partial r = −0.07

Adults
Wareham (2003)[47]
HR (Polar)
4x 4 days
EPAQ-s
Physical activity index(Q) – DayPAR(HR)

P for trend = 0.003

 
 
 
 
 
Total hr/week(Q) – DayPAR(HR)

r = 0.04 (P = 0.59)

Adults
Yore (2007)[48]
Acc (ActiGraph)
7 days
BRFSS PAQ
VPA min/week(Q1) – VPA min/week(Acc)
≥5999 counts/min
Pearson r = 0.52

 
 
 
 
 
VPA min/week(Q2) – VPA min/week(Acc)
≥5999 counts/min
Pearson r = 0.54

 
 
 
 
 
VPA min/week(Q3) – VPA min/week(Acc)
≥5999 counts/min
Pearson r = 0.63

 
 
 
 
 
MPA min/week(Q1) – MPA min/week(Acc)
2020-5998 counts/min
Pearson r = 0.27

 
 
 
 
 
MPA min/week(Q2) – MPA min/week(Acc)
2020-5998 counts/min
Pearson r = 0.20

 
 
 
 
 
MPA min/week(Q3) – MPA min/week(Acc)
2020-5998 counts/min
Pearson r = 0.16

Elderly
Yasunaga (2007)[49]
Acc (Kenz Lifecorder)
1 month
PAQ-EJ
PAQ-EJ score(Q) – MET-min/day(Acc)

Spearman r = 0.41 (P < 0.05)

 
 
 
 
 
 
 
Median Spearman r = 0.25 (youth: 0.22, adults: 0.27, elderly: 0.41)
 
              Median Pearson r = 0.41 (youth: 0.41, adults: 0.28, elderly: –)  

Q1 = first completed questionnaire, Q2 = second completed questionnaire, Q3 = third completed questionnaire, r = correlation coefficient (rho), CI = Confidence Interval (lower;upper), κ = kappa (i.e. Cohen weighted kappa unless specified otherwise), LoA = Limits of Agreement, MD = Mean Difference, – = not stated.

Acc = Accelerometry [NB: ActiGraph (Model 7164) is successor of preceding accelerometer by MTI, formerly CSA]. Accelerometer names as used in the respective papers.

Ainsworth (2000): 3 point summary index = 3 domains: sports/exercise, occupation, active living habits. 4 point summary index = all 4 domains: sports/exercise, occupation, active living habits, housework/caregiving.

Craig (2003): Pooled Spearman = pooled results from data of 22 studies examining the IPAQ long form and 23 studies examining the short form.

Dwyer (2011): Levels 1–2 = stationary, level 3 = moving slowly, level 4 = moving at a medium or moderate pace, level 5 = moving at a fast pace.

Economos (2010): Moderate-high METs = 3–6 METs. High METs = ≥6 METs.

Fjeldsoe (2009): Total activity includes light-, moderate-, and vigorous-intensity activities. HEPA = Health Enhancing Physical Activity: brisk walking and moderate- and vigorous activities from the planned activity and transport domains.

Kurtze (2007): EE = Energy Expenditure in MJ/day. PAL = total EE divided by basal metabolic rate (BMR). Light activity = no sweating or being out of breath. Hard activity = sweating/out of breath.

Kurtze (2008): EE = Energy Expenditure in MJ/day. PAL = total EE divided by basal metabolic rate (BMR).

Lowther (1999): Initial r = 0.1294, but after correction for less reliable high data (occupational walking data, extreme data for 4 participants) the correlation improved to 0.52.

Mäder (2006): IPAQ - Total MET-min/week = MET-min/week for total activity excluding sitting. OIMQ - Total MET-min/week = MET-min/week for total activity, i.e. moderate and vigorous activities.

Martinez-Gomez (2010): Counts/mov = counts adjusted by movement time over the recess time. MD = mean difference between the mean times spent at MVPA by the two instruments. Kappa = agreement between the two instruments among tertiles of total PA.

Reis (2005): ActiGraph only worn during occupational hours. Sedentary = sitting or standing activities.

Ridley (2001): CDPAQ-HC = hard copy of CDPAQ. MVPA = Moderate-to-Vigorous Physical Activity. Total compendium METs = compendium values to derive total METs due to reported problems associated with children's perception of intensity (Compendium of physical activities: classification of energy costs of human physical activities. Ainsworth BE, Haskell WL, Leon AS, Jacobs DR Jr, Montoye HJ, Sallis JF, Paffenbarger RS Jr. Med Sci Sports Exerc. 1993 Jan;25(1):71–80).

Rosenberg (2010): Partial r = partial correlation, adjusted for age, marital status, white or nonwhite ethnicity, number of children, and highest level of education.

Sobngwi (2001): Total activity by Heart Rate monitoring is defined as variability in heart rate measured as area under the minute-to-minute heart rate curve and above individual resting heart rate.

Telford (2004): Validity results for total PA minutes for 5 to 6 or 10 to 12 year old children in parental proxy-reports or self-administered questionnaires.

Timperio (2003): Total activity in min/day is specified as ≥3 METs.

Treuth (2003): GAQ score = MET weighted mean score of 18 more reliable, and more frequently performed, activities. Activitygram score = average intensity/min over 3 day period. Other sedentary = sedentary activities excluding TV watching. The scores are an average of the two days administrations.

Treuth (2005): Fels PAQ score = mean Fels PAQ score (total activity) of both administrations of the PAQ. Counts/min = mean counts/min. Elementary = elementary school. Middle = middle school. High = high school.

Wareham (2002): Subject wore the HR monitor 4x four days across one year. EE = Energy Expenditure in kJ/hr. TV time = hours per week watching television and videos. Partial correlation coefficient is adjusted for age and sex.

Wareham (2003): Subject wore the HR monitor 4x four days across one year. Physical activity index = combined index for the four-level classification of self-reported occupational activity and four-level categorisation of time spent in cycling and other physical exercise. DayPAR = Physical Activity Ratio calculated as the ratio of daytime energy expenditure to resting energy expenditure. P for trend = P for positive trend of the association between DayPAR (measured by calibrated HR data) over four categories of physical activity (i.e. inactive, moderately inactive, moderately active, active) estimated from the EPAQ.

Welk (2007): PA bouts = number of sessions of physical activity performed during the week. Total MVPA mins = total minutes in moderate to vigorous physical activity performed during the previous day. Cut point used is Freedson age-based cut point, calculated as METs = 2.757 + (0.0015*counts per minute) - (0.0896*age[yr]) - (0.000038*counts per minute*age[yr]). Correlation = group-level correlation. No correlation coefficient specified.

Yasunaga (2007): PAQ-EJ score = MET score in MET-hr/week, calculated as number of days*time*intensity weight.

Accelerometry and in particular the ActiGraph accelerometer was the most commonly used criterion method (n = 19), followed by the Caltrac accelerometer (n = 4) and the Polar heart rate monitor (n = 4). DLW was used in one study, where absolute validity was moderate to high for PAEE (r = 0.39) and TEE (r = 0.67) [31]. In general, validity coefficients were considerably lower than reliability coefficients. Median correlations across all PAQs between reported sedentary behaviours and calculated inactivity from objective measures were low: Spearman r = 0.12.

Youth

Median validity correlations for the youth were as follows: Spearman r = 0.22, Pearson r = 0.41. CLASS self- and parental reported physical activity (r = −0.04–0.11) [25] was among the least valid questionnaires for children, although several other PAQs also showed low correlations with objective measures: Pre-PAQ (r = −0.07–0.17) [19], BONES PAS (r = 0.23–0.27) [20], GAQ (r = 0.27–0.29) [26], Fels PAQ (0.11–0.34) [27]. None of the newly developed PAQs for children demonstrated high validity.

Adults

Median validity correlations for adults were as follows: Spearman r = 0.27, Pearson r = 0.28. Highest validity in adults was demonstrated for the SSAAQ when tested against the Caltrac accelerometer (r = 0.60-0.74) [44]. Low validity correlations for total activity or for all subcategories were observed for the HUNT1 (r = 0.03–0.07) [54], and the short EPIC PAQ (r = 0.04), although the main outcome, a 4 category physical activity index, derived from this instrument was significantly associated with objectively measured physical activity energy expenditure (p for trend = 0.003) [47]. A follow-up study in 1941 adults from 10 European countries suggested moderate validity (r = 0.33) of this instrument using physical activity energy expenditure from combined heart rate and movement sensing as the criterion [51].

Rosenberg et al. assessed the validity of sedentary behaviour only, and demonstrated low correlations (partial r = −0.01–0.10) with objectively measured sedentary time (<100 counts/min) by the ActiGraph accelerometer [43].

Elderly

Median Spearman validity correlation for the elderly was r = 0.41. The PAQ-EJ was tested by correlating a total score with MET-min/day calculated from the Kenz Lifecorder accelerometer-based pedometer (r = 0.41) [49].

Existing PAQs

New validity and reliability results for existing PAQs were reported in 35 studies, and 30 studies reported new results on validity only (Table 5). One study is classified as a study testing an existing PAQs, but also reports both validity and reliability data for a new PAQ (SP2PAQ) [55]. Twenty-six of the 65 studies were undertaken in the US with the remaining coming from Australia (n = 5), Sweden (n = 5), China (n = 4), Belgium (n = 3), Spain (n = 3), Canada (n = 2), France (n = 2), Norway (n = 2), Japan (n = 2), Brazil, Portugal, Singapore, South Africa, Turkey, United Kingdom and Vietnam. There were four multi-country studies; three testing the IPAQ modified for adolescents [56,57] and the EPAQ-s in 9–10 European cities [51]. The GPAQ was tested in diverse sample of nine global countries [58]. Eighteen studies were undertaken in youth [57,59-74], 12 in elderly [75-86]; and 35 in adults with a few studies including both older adolescents and adults. In 48 studies men and women were combined, 10 studies examined women only [70,72,87-93], and seven studies included only men [54,75,78,94-97]. All authors concluded that the questionnaires had shown at least satisfactory results for reliability and validity (see results below); seven studies noted considerable limitations in aspects of their questionnaires [56,59,63,90,98-100].

Table 5.

Descriptive characteristics of existing PAQs

Age Group
Reference
Name questionnaire
Country
Domains of activity
Population
Primary outcome
          Size Age (years) Sex Ethnicity  
Youth
Affuso (2011)[59]
SAPAC (modified)
United States
Sedentary
201
11 - 15
M/F
Mixed
Total min/day
Youth
Allor (2001)[60]
PDPAR
United States
Moderate, hard, very hard activity
46
12 ± 0.6
F
Mixed, urban
METs (kcal/hr)
Youth
Corder (2009)[61]
YPAQ, CPAQ, CHASE, SWAPAQ
United Kingdom
All domains, including school and leisure time
62 reliability, 76 validity
4 - 17
M/F
Mainly white
PAEE, lifestyle scores, MET-min/week
Youth
Eisenmann (2002)[62]
GLTEQ
United States
Mild, moderate and strenuous activity in leisure time
31
10.6 ± 0.2
M/F
Mixed
METs
Youth
Gwynn (2010)[63]
MRPARQ
Australia
All organised and non-organised physical activities
86
10 - 12
M/F
Aboriginal, Torres Strait Islander, non-Indigenous
MET-min/day
Youth
Hagströmer (2008)[56]
IPAQ-A
9 countries
Sedentary, leisure, household, occupation, transportation
248
12 - 14, 15 -17
M/F
European
MET-min/day
Youth
Huang (2009)[64]
CLASS (Chinese version)
China
31 physical activities and 14 sedentary activities over weekday and weekends
216 reliability, 99 validity
9 - 12
M/F
Chinese
Total min/day
Youth
Kowalski (1997)[65]
PAQ-C
Canada
Moderate and vigorous PA during school, including sports/exercise
73
8 - 13
M/F

5-point scale of activity
Youth
Martinez-Gomez (2010)[66]
BAD
Spain
Leisure, occupation
37
12 - 16
M/F

MET-min/day
Youth
Martinez-Gomez (2011)[67]
PAQ-A
Spain
Usual moderate and vigorous PA during schooldays and weekend days
203
13 - 17
M/F

PAQ-A score
Youth
Mota (2002)[68]
WAC (modified)
Portugal
Activities outside school
30 reliability, 109 validity
8 - 16
M/F
Hispanic
METs/15 min
Youth
Ottevaere (2011)[57]
IPAQ-A
10 countries
Sedentary, leisure, household, occupation, transportation
2018
12.5 - 17
M/F
European
Total min/day
Youth
Rangul (2008)[69]
HBSC, IPAQ-s
Norway
HBSC: sports/exercise (outside school hours). IPAQ-s: sedentary, leisure, household, occupation, transportation
71
13 - 18
M/F

TEE, PAL
Youth
Scerpella (2002)[70]
GSQ
United States
Habitual activity in strenuous, moderate and light intensity
61
7 - 11
F

Godin-Shephard scores
Youth
Slinde (2003)[71]
MLTPAQ
Sweden
Sedentary, leisure, household
35
15
M/F

TEE
Youth
Treuth (2004)[72]
GAQ
United States
28 physical, 7 sedentary usual activities
90 reliability, 76 comparison validity, 86 intervention validity
8 - 10
F
African-American
GAQ score
Youth
Troped (2007)[73]
YRBS
United States
Leisure, occupation
128 reliability, 125 validity
12.7 ± 0.6
M/F
Mixed
Minutes and bouts of MPA and VPA
Youth
Weston (1997)[74]
PDPAR
United States
Sedentary, leisure, occupation, transportation, sports/exercise
90 reliability, 48 validity
Grades 7 - 12
M/F
Mainly white
METs
Adults
Ainsworth (1999)[87]
TOQ, 7DR-O (modified)
United States
Occupation
46
18 - 60
F
Mainly white
MET-min/week
Adults
Bassett (2000)[101]
CAQ
United States
Stair climbing, walking, sports/exercise, leisure
96
25 - 70
M/F
Mainly Caucasian
MET-min/week
Adults
Brown (2008)[88]
AAS (modified)
Australia
Walking briskly, moderate leisure activity, vigorous leisure activity
44
54 - 59
F
Mainly white
MET-min/week
Adults
Bull (2009)[58]
GPAQ
9 countries
Sedentary, leisure, occupation, transportation
2221 reliability, 298 validity
18-75
M/F
Mixed
Total min/day
Adults
Conway (2002)[94]
7DPAR, S7DR
United States
Household, occupation, walking, light, moderate, vigorous activities
24
27 - 65
M

MET-min/day, EE
Adults
Cust (2008)[102]
EPAQ
Australia
Leisure, household, occupation
182
50 - 65
M/F
Mainly white
Total PA index, Cambridge PA index
Adults
Cust (2009)[103]
EPAQ, IPAQ-s
Australia
Sedentary, leisure, household, occupation, transportation
177
50 - 65
M/F
Mainly white
MET-hr/week
Adults
Duncan (2001)[104]
7DPAR
United States
Sedentary, leisure, household, occupation, sports/exercise
94 reliability, 66 validity
30 - 69
M/F
Mainly Caucasian
TEE, METs
Adults
Ekelund (2006)[95]
IPAQ-s
Sweden
Sedentary, leisure, household, occupation, transportation
87
20 - 69
M

MET-min/day
Adults
Gauthier (2009)[105]
IPAQ-SALVCF
Canada
Sedentary, leisure, household, occupation, transportation
31
20 - 63
M/F
French Canadians
MET-min/week
Adults
Hagströmer (2006)[106]
IPAQ
Sweden
Sedentary, leisure, household, occupation, transportation
46
40.7 ± 10.3
M/F

MET-hr/week
Adults
Hagströmer (2010)[107]
IPAQ
Sweden
Sedentary, leisure, household, occupation, transportation
980
18 - 65
M/F

MET-min/day
Adults
Hallal (2010)[108]
IPAQ (modified)
Brazil
Leisure, transportation
156
≥ 20
M/F

Total min/week, total score
Adults
InterAct Consortium (2011)[51]
EPAQ-s
10 countries
Leisure, household, occupation, transportation
1941
53.8 ± 9.4
M/F
European
MET-hr/week, total PA index, Cambridge index, recreational index
Adults
Jacobi (2009)[109]
MAQ
France
Sedentary, leisure, occupation
160
18 - 74
M/F

MET-hr/week
Adults
Kurtze (2008)[54]
IPAQ-s
Norway
Sedentary, leisure, household, occupation, transportation
108
20 - 39
M

MET-hr/week
Adults
Lee (2011)[98]
IPAQ-s (Chinese version)
China
Sedentary, leisure, household, occupation, transportation
1270
42.9 ± 14.4
M/F
Asian
MET-min/week
Adults
MacFarlane (2007)[99]
IPAQ-s (Chinese version)
China
Sedentary, leisure, household, occupation, transportation
49
15 - 55
M/F
Asian
MET-min/week
Adults
MacFarlane (2010)[110]
IPAQ-LC
China
Sedentary, leisure, household, occupation, transportation
28 reliability, 83 validity
26.2 ± 9.9 (reliability), 40.9 ± 11.1 (validity)
M/F
Asian
MET-min/day
Adults
Mahabir (2006)[89]
HAQ, FCPQ, CAPS-4WR, CAPS-TWR
United States
Leisure, household
65
49 - 78
F

EE, METs
Adults
Matton (2007)[111]
FPACQ
Belgium
Sedentary, leisure, household, occupation, transportation
102 reliability, 111 validity
22 - 78
M/F

Hr/week, EE, PAL (METs)
Adults
Nang (2011)[55]
IPAQ, SP2PAQ
Singapore
Sedentary, leisure, household, occupation, transportation
152
> 21
M/F
Asian
EE (kcal/day), METs
Adults
Nicaise (2011)[90]
IPAQ
United States
Sedentary, leisure, household, occupation, transportation
105
35.9 ± 9.0
F
Latino
MET-min/week
Adults
Pettee-Gabriel (2009)[91]
PMMAQ, PWMAQ, NHS-PAQ, AAS, WHI-PAQ
United States
Sedentary, leisure, sports/exercise
66
45 - 65
F
Mainly white
MET-hr/week, total min/day
Adults
Philippaerts (1999)[96]
BAQ, FCPQ, TCQ
Belgium
Leisure, occupation, sports/exercise
19
40
M

PAL scores
Adults
Philippaerts (2001)[97]
BAQ, TCQ
Belgium
Leisure, occupation, sports/exercise
66
40
M

Activity indices, EE
Adults
Richardson (2001)[100]
S7DR
United States
Leisure, occupation
77
20 - 59
M/F
Mainly white
MET-min/day
Adults
Saglam (2010)[112]
IPAQ (short and long version)
Turkey
Sedentary, leisure, household, occupation, transportation
330 reliability, 80 validity
18 - 32
M/F

MET-min/week
Adults
Schmidt (2006)[92]
KPAS-mod
United States
Household, occupation, active living, sports/exercise
63
18 - 47
F

KPAS activity indexes
Adults
Smitherman (2009)[113]
JPAC
United States
Leisure, household, occupation, sports/exercise
40 reliability, 404 validity
54.4 ± 15.7 (reliability), 57.1 ± 11.54 (validity)
M/F
African American
JPAC index scores
Adults
Staten (2001)[93]
AAFQ
United States
Leisure, household, occupation
35
31 - 60
F
Mixed
TEE, PAEE, RMR, MET-hr/day
Adults
Strath (2004)[114]
CAQ-PAI
United States
Leisure
25
20 - 56
M/F
Mainly Caucasian
MET-min/week
Adults
Trinh (2009)[115]
GPAQ
Vietnam
Sedentary, leisure, occupation, transportation
169 dry season, 162 wet season
25 - 64
M/F
Asian
Total min/day
Adults
Washburn (2003)[116]
S7DR
United States
Sleep, moderate, hard and very hard physical activities
46
17 - 35
M/F
Mixed
TEE, PAEE
Adults
Wolin (2008)[117]
IPAQ-s
United States
Sedentary, leisure, household, occupation, transportation
142
24 - 67
M/F
Black or African American
MET-min/week
Elderly
Bonnefoy (2001)[75]
MLTPAQ, YPAS, BAQ-mod, CAQ, 7DR, DQ-mod, LRC, SUA, PASE, QAPSE
France
Light, moderate, vigorous intensity PA, walking, specific activities
19
73.46 ± 4.1
M

TEE, PAL, PAEE
Elderly
De Abajo (2001)[76]
YPAS (Spanish version)
Spain
Sedentary, occupation, sports/exercise
108
61 - 80
M/F
Hispanic
Total time, EE
Elderly
Dinger (2004)[77]
PASE
United States
Leisure, household, occupation
56
75.7 ± 7.9
M/F
Mainly Caucasian
Subscale and total PASE scores
Elderly
Dubbert (2004)[78]
7DPAR
United States
Shopping, household, occupation, sports/exercise
220 reliability, 42 validity
60 - 80
M
Mixed
TEE, METs
Elderly
Giles (2009)[79]
CHAMPS-MMSCV
Australia
Leisure, household
47
≥ 65
M/F
Mainly non-Indigenous Australian
MET-min/week (volume), times/week (frequency), min/week (duration)
Elderly
Hagiwara (2008)[80]
PASE
Japan
Leisure, household, occupation
257 reliability, 200 validity
72.6 ± 4.9
M/F
Japanese
Total PASE score, hr/day
Elderly
Harada (2001)[81]
CHAMPS, PASE, YPAS
United States
Leisure, household
87
65 - 89
M/F
Mixed
EE, total PASE score
Elderly
Hurtig-Wennlöf (2010)[82]
IPAQ-E
Sweden
Sedentary, leisure, household, occupation, transportation
54
66 - 85
M/F

Total min/day
Elderly
Kolbe-Alexander (2006)[83]
IPAQ-s, YPAS
South Africa
Sedentary, leisure, household, occupation, transportation
122
> 60
M/F
Mixed
MET-min/week, EE
Elderly
Starling (1999)[84]
MLTPAQ, YPAS
United States
MLTPAQ: Leisure, household. YPAS: leisure, household, sports/exercise
67
45 - 84
M/F
Caucasian
TEE
Elderly
Tomioka (2011)[85]
IPAQ-s (Japanese version)
Japan
Sedentary, leisure, household, occupation, transportation
325
65 - 89
M/F
Japanese
MET-min/week
Elderly Washburn (1999)[86] PASE United States Leisure, household, occupation 20 67 - 80 M/F Total PASE scores

Domains named in paper were reclassified, unless the activities were very different from categories used, according to the following system: Occupation: work, school, labour. Transportation: travel, commuting, employment. Household: home/life, housework, caregiving, domestic life, child/elder/self care, cooking, chores, gardening, stair climbing. Leisure: leisure, recreation time. Sports/exercise: play, sports, exercise, workout. Sedentary: sedentary behaviours, e.g. sitting, TV viewing activities, eating, sleeping, bathing, inactivity.

– = not stated, M = Male, F = Female.

Reliability

All reliability results for existing PAQs are listed in Table 6.

Table 6.

Reliability results of existing PAQs

Age Group
Reference
Test-retest period
PAQ
Variables tested
Reliability results
          Correlation coefficients Agreement
Youth
Allor (2001)[60]
Within 1 week
PDPAR
METs(Q1) – METs(Q2)
ICC = 0.98

Youth
Corder (2009)[61]
1 week
YPAQ
12-13 yrs: PAEE(Q1) – PAEE(Q2)
ICC = 0.86 (P < 0.001)

 
 
 
 
16-17 yrs: PAEE(Q1) – PAEE(Q2)
ICC = 0.79 (P < 0.001)

 
 
 
CPAQ
PAEE(Q1) – PAEE(Q2)
ICC = 0.25

 
 
 
CHASE
Lifestyle score(Q1) – lifestyle score(Q2)
ICC = 0.02

 
 
 
SWAPAQ
PAEE(Q1) – PAEE(Q2)
ICC = 0.64 (P < 0.001)

Youth
Eisenmann (2002)[62]
Same day
GLTEQ
Total leisure activity score(Q1) – total leisure activity score(Q2)
Pearson r = 0.62 (P < 0.05)
MD (95 % LoA) = −33.4 ± 10.28
Youth
Huang (2009)[64]
1 week
CLASS
VPA min/week(Q1) – VPA min/week(Q2)
ICC (95 % CI) = 0.73 (0.64;0.79), P < 0.05

 
 
 
 
MVPA min/week(Q1) – MVPA min/week(Q2)
ICC (95 % CI) = 0.71 (0.61;0.77), P < 0.05

 
 
 
 
MPA min/week(Q1) – MPA min/week(Q2)
ICC (95 % CI) = 0.61 (0.49;0.70), P < 0.05

 
 
 
 
Sedentary min/week(Q1) – sedentary min/week(Q2)
ICC (95 % CI) = 0.69 (0.59;0.77), P < 0.05

Youth
Mota (2002)[68]
7 days
WAC
Total activity(Q1) – total activity(Q2)
ICC = 0.71

Youth
Rangul (2008)[69]
8 - 12 days
HBSC
Frequency: sessions/week(Q1) – sessions/week(Q2)
ICC (95 % CI) = 0.73 (0.60;0.82)

 
 
 
 
Duration: hr/week(Q1) – hr/week(Q2)
ICC (95 % CI) = 0.71 (0.57;0.81)

 
 
 
IPAQ-s
VPA min/day(Q1) – VPA min/day(Q2)
ICC (95 % CI) = 0.30 (−0.07;0.56)

 
 
 
 
MPA min/day(Q1) – MPA min/day(Q2)
ICC (95 % CI) = 0.34 (0.22;0.60)

 
 
 
 
Walking min/day(Q1) – walking min/day(Q2)
ICC (95 % CI) = 0.10 (−0.10;0.39)

 
 
 
 
Sitting min/day(Q1) – sitting min/day(Q2)
ICC (95 % CI) = 0.27 (−0.50;0.54)

Youth
Treuth (2004)[72]
12 weeks
GAQ
Yesterday: GAQ score(Q1) – GAQ score(Q2)
Pearson r = 0.59 (P < 0.001)

 
 
 
 
Usual: GAQ score(Q1) – GAQ score(Q2)
Pearson r = 0.59 (P < 0.001)

 
 
 
 
Yesterday: TV watching(Q1) – TV watching(Q2)
Pearson r = 0.13 (P < 0.373)

 
 
 
 
Usual: TV watching(Q1) – TV watching(Q2)
Pearson r = 0.31 (P < 0.024)

 
 
 
 
Yesterday: other sedentary(Q1) – other sedentary(Q2)
Pearson r = 0.32 (P < 0.019)

 
 
 
 
Usual: other sedentary(Q1) – other sedentary(Q2)
Pearson r = 0.30 (P < 0.032)

Youth
Troped (2007)[73]
5 - 40 days
YRBS
VPA(Q1) – VPA(Q2)
ICC = 0.46

 
 
 
 
MPA(Q1) – MPA(Q2)
ICC = 0.51

Youth
Weston (1997)[74]
Within 1 hour
PDPAR
TEE(Q1) – TEE(Q2)
Pearson r = 0.98 (P < 0.01)

Adults
Brown (2008)[88]
7 - 28 days
AAS
Frequency/week(Q1) – frequency/week(Q2)
Spearman r = 0.58

 
 
 
 
Total min/week(Q1) – total min/week(Q2)
Spearman r = 0.64

Adults
Bull (2009)[58]
3 - 7 days
GPAQ
Leisure: total min(Q1) – total min(Q2)
Spearman r = 0.78 (P < 0.01)

 
 
 
 
Occupation: total min(Q1) – total min(Q2)
Spearman r = 0.77 (P < 0.01)

 
 
 
 
Transportation: total min(Q1) – total min(Q2)
Spearman r = 0.81 (P < 0.01)

 
 
 
 
Leisure: sedentary(Q1) – sedentary(Q2)

κ (% agreement) = 0.68 (85.6)
 
 
 
 
Occupation: sedentary(Q1) – sedentary(Q2)

κ (% agreement) = 0.73 (86.9)
Adults
Cust (2008)[102]
10 months
EPAQ
Total MET-hr/week(Q1) – total MET-hr/week(Q2)
Spearman r (95 % CI) = 0.65 (0.55;0.72), P < 0.0001

 
 
 
 
Total PA index(Q1) – total PA index(Q2)

κ (95 % CI) = 0.62 (0.53;0.71), P < 0.0001
 
 
 
 
Cambridge PA index(Q1) – Cambridge PA index(Q2)

κ (95 % CI) = 0.66 (0.58;0.74), P < 0.0001
Adults
Cust (2009)[103]
10 months
EPAQ
High confidence: total PA index(Q1) – total PA index(Q2)

κ (95 % CI) = 0.65 (0.53;0.76)
 
 
 
 
Low confidence: total PA index(Q1) – total PA index(Q2)

κ (95 % CI) = 0.58 (0.45;0.71)
 
 
 
 
High confidence: Cambridge PA index(Q1) – Cambridge PA index(Q2)

κ (95 % CI) = 0.73 (0.61;0.84)
 
 
 
 
Low confidence: Cambridge PA index(Q1) – Cambridge PA index(Q2)

κ (95 % CI) = 0.59 (0.47;0.71)
 
 
 
IPAQ-s
High confidence: total MET-hr/week(Q1) – total MET-hr/week(Q2)
Spearman r (95 % CI) = 0.53 (0.36;0.67)

 
 
 
 
Low confidence: total MET-hr/week(Q1) – total MET-hr/week(Q2)
Spearman r (95 % CI) = 0.33 (0.11;0.52)

 
 
 
 
High confidence: sitting hr/day(Q1) – sitting hr/day(Q2)
Spearman r (95 % CI) = 0.50 (0.32;0.65)

 
 
 
 
Low confidence: sitting hr/day(Q1) – sitting hr/day(Q2)
Spearman r (95 % CI) = 0.65 (0.51;0.75)

Adults
Duncan (2001)[104]
7 days
7DPAR
TEE(Q1) – TEE(Q2)
ICC (95 % CI) = 0.44 (0.26;0.59)

Adults
Gauthier (2009)[105]
1 day
IPAQ-SALVCF
Total MET-min/week(Q1) – total MET-min/week(Q2)
ICC (95 % CI) = 0.929 (0.860;0.965), P < 0.01

 
 
 
 
Sitting(Q1) – sitting(Q2)
ICC (95 % CI) = 0.899 (0.800;0.950), P < 0.01

Adults
Hallal (2010)[108]
5 days
IPAQ
Total score(T1) – total score(T2)
Spearman r = 0.90
MD = 3 min, κ (% agreement) = 0.78 (90.0)
 
 
 
 
Total score(T1T2) – total score(FTF)
Spearman r = 0.87
MD = 30 min, κ (% agreement) = 0.69 (85.5)
Adults
Kurtze (2008)[54]
1 week
IPAQ-s
VPA hr/day(Q1) – VPA hr/day(Q2)
ICC (95 % CI) = 0.62 (0.47;0.73)

 
 
 
 
MPA hr/day(Q1) – MPA hr/day(Q2)
ICC (95 % CI) = 0.30 (0.09;0.49)

 
 
 
 
Walking hr/day(Q1) – walking hr/day(Q2)
ICC (95 % CI) = 0.42 (0.23;0.59)

 
 
 
 
Sitting hr/day(Q1) – sitting hr/day(Q2)
ICC (95 % CI) = 0.80 (0.70;0.87)

Adults
MacFarlane (2007)[99]
3 days
IPAQ-s
Total MET-min/week(Q1) – total MET-min/week(Q2)
ICC (95 % CI) = 0.79 (0.66;0.88), %CV (95 % CI) = 26 (22;33)

 
 
 
 
Sitting MET-min/week(Q1) – sitting MET-min/week(Q2)
ICC (95 % CI) = 0.97 (0.95;0.98), %CV (95 % CI) = 15 (12;18)

Adults
MacFarlane (2010)[110]
3 days
IPAQ-LC
Total MET-min/week(Q1) – total MET-min/week(Q2)
ICC = 0.93, %CV = 22.8

 
 
 
 
Sitting MET-min/week(Q1) – sitting MET-min/week(Q2)
ICC = 0.71, %CV = 15.0

Adults
Matton (2007)[111]
2 weeks
FPACQ
Employed/unemployed men: total EE(Q1) – total EE(Q2)
ICC (95 % CI) = 0.95 (0.89;0.97)

 
 
 
 
Employed/unemployed women: total EE(Q1) – total EE(Q2)
ICC (95 % CI) = 0.92 (0.85;0.96)

 
 
 
 
Retired men: total EE(Q1) – total EE(Q2)
ICC (95 % CI) = 0.90 (0.76;0.96)

 
 
 
 
Retired women: total EE(Q1) – total EE(Q2)
ICC (95 % CI) = 0.96 (0.90;0.99)

 
 
 
 
Employed/unemployed men: PAL(Q1) – PAL(Q2)
ICC (95 % CI) = 0.92 (0.84;0.96)

 
 
 
 
Employed/unemployed women: PAL(Q1) – PAL(Q2)
ICC (95 % CI) = 0.78 (0.61;0.88)

 
 
 
 
Retired men: PAL(Q1) – PAL(Q2)
ICC (95 % CI) = 0.89 (0.76;0.96)

 
 
 
 
Retired women: PAL(Q1) – PAL(Q2)
ICC (95 % CI) = 0.77 (0.47;0.91)

 
 
 
 
Employed/unemployed men: TV hr/week(Q1) – TV hr/week(Q2)
ICC (95 % CI) = 0.93 (0.86;0.97)

 
 
 
 
Employed/unemployed women: TV hr/week(Q1) – TV hr/week(Q2)
ICC (95 % CI) = 0.92 (0.84;0.96)

 
 
 
 
Retired men: TV hr/week(Q1) – TV hr/week(Q2)
ICC (95 % CI) = 0.76 (0.49;0.89)

 
 
 
 
Retired women: TV hr/week(Q1) – TV hr/week(Q2)
ICC (95 % CI) = 0.89 (0.72;0.96)

Adults
Nang (2011)[55]
2 - 10 months
IPAQ
VPA(Q1) – VPA(Q2)
Spearman r = 0.38 (P < 0.05)

 
 
 
 
MPA(Q1) – MPA(Q2)
Spearman r = 0.58 (P < 0.0001)

 
 
 
SP2PAQ
VPA(Q1) – VPA(Q2)
Spearman r = 0.75 (P < 0.0001)

 
 
 
 
MPA(Q1) – MPA(Q2)
Spearman r = 0.55 (P < 0.0001)

Adults
Pettee-Gabriel (2009)[91]
1 - 4 weeks
PMMAQ
MET-hr/week(Q1) – MET-hr/week(Q2)
ICC (95 % CI) = 0.64 (0.48;0.77), P < 0.0001

 
 
 
PWMAQ
MET-hr/week(Q1) – MET-hr/week(Q2)
ICC (95 % CI) = 0.74 (0.60;0.83), P < 0.0001

 
 
 
NHS-PAQ
MET-hr/week(Q1) – MET-hr/week(Q2)
ICC (95 % CI) = 0.48 (0.26;0.65), P < 0.0001

 
 
 
AAS
Min/day(Q1) – min/day(Q2)
ICC (95 % CI) = 0.32 (0.09;0.52), P < 0.01

 
 
 
WHI-PAQ
MET-hr/week(Q1) – MET-hr/week(Q2)
ICC (95 % CI) = 0.91 (0.86;0.95), P < 0.0001

Adults
Richardson (2001)[100]
1 month
S7DR
Men: total MET-min/day(Q1) – total MET-min/day(Q2)
Spearman r = 0.60 (P < 0.01)

 
 
 
 
Women: total MET-min/day(Q1) – total MET-min/day(Q2)
Spearman r = 0.36 (P < 0.05)

Adults
Saglam (2010)[112]
3 - 7 days
IPAQ
Total MET-min/week(Q1) – total MET-min/week(Q2)
Spearman r (95 % CI) = 0.64 (0.56;0.72), P < 0.001

 
 
 
 
Sitting min(Q1) – sitting min(Q2)
Spearman r (95 % CI) = 0.83 (0.77;0.89), P < 0.001

 
 
 
IPAQ-s
Total MET-min/week(Q1) – total MET-min/week(Q2)
Spearman r (95 % CI) = 0.69 (0.61;0.77), P < 0.001

 
 
 
 
Sitting min(Q1) – sitting min(Q2)
Spearman r (95 % CI) = 0.78 (0.71;0.85), P < 0.001

Adults
Schmidt (2006)[92]
7 days
KPAS-mod
Total activity score(Q1) – total activity score(Q2)
ICC = 0.84

 
 
 
 
Weighted activity score(Q1) – weighted activity score(Q2)
ICC = 0.76

Adults
Smitherman (2009)[113]
2 weeks
JPAC
JPAC total score(Q1) – JPAC total score(Q2)
ICC = 0.99

Adults
Trinh (2009)[115]
2 weeks (dry season)
GPAQ
GPAQ total score(Q1) – GPAQ total score(Q2)
Spearman r = 0.69 (P < 0.001)
MD (95 % LoA) = 1.00 (0.03;31.82), κ (95 % CI) = 0.66 (0.53;0.79)
 
 
2 months (wet season)
 
GPAQ total score(Q1) – GPAQ total score(Q2)
Spearman r = 0.55 (P < 0.001)
MD (95 % LoA) = 1.12 (0.02;71.09), κ (95 % CI) = 0.57 (0.46;0.65)
 
 
2 weeks (dry season)
 
Sedentary time(Q1) – sedentary time(Q2)
Spearman r = 0.69 (P < 0.001)
κ (95 % CI) = 0.61 (0.58;0.70)
 
 
2 months (wet season)
 
Sedentary time(Q1) – sedentary time(Q2)
Spearman r = 0.50 (P < 0.001)
κ (95 % CI) = 0.45 (0.36;0.54)
Elderly
De Abajo (2001)[76]
2 weeks
YPAS
Total time(Q1) – total time(Q2)
ICC = 0.66 (P = 0.001)

 
 
 
 
Total EE(Q1) – total EE(Q2)
ICC = 0.65 (P = 0.001)

 
 
 
 
YPAS summary index(Q1) – YPAS summary index(Q2)
ICC = 0.31 (P = 0.002)

 
 
 
 
Sitting(Q1) – sitting(Q2)
ICC = 0.29 (P = 0.003)

Elderly
Dinger (2004)[77]
3 days
PASE
Total PASE score(Q1) – total PASE score(Q2)
ICC (95 % CI) = 0.91 (0.83;0.94)

Elderly
Dubbert (2004)[78]
2 - 4 weeks
7DPAR
TEE(Q1) – TEE(Q2)
ICC = 0.89 (P < 0.001)

Elderly
Giles (2009)[79]
1 - 2 weeks
CHAMPS-MMSCV
Volume: MET-min/week(Q1) – MET-min/week(Q2)
ICC (95 % CI) = 0.84 (0.69;0.91), Spearman r = 0.62

 
 
 
 
Frequency: sessions/week(Q1) – sessions/week(Q2)
ICC (95 % CI) = 0.89 (0.77;0.95), Spearman r = 0.79

 
 
 
 
Duration: min/week(Q1) – min/week(Q2)
ICC (95 % CI) = 0.81 (0.63;0.90), Spearman r = 0.57

Elderly
Hagiwara (2008)[80]
3 - 4 weeks
PASE
Total PASE score(Q1) – total PASE score(Q2)
ICC (95 % CI) = 0.65 (0.58;0.72)

Elderly
Harada (2001)[82]
2 weeks
CHAMPS
EE(Q1) – EE(Q2)
ICC = 0.62, Pearson r = 0.62

Elderly
Kolbe-Alexander (2006)[83]
3 - 5 days
IPAQ-s
Men: total MET-min/week(Q1) – total MET-min/week(Q2)
Spearman r = 0.54 (P = 0.0001)
MD (95 % LoA) = 324.58 ± 7534.85 MET-min/week
 
 
 
 
Women: total MET-min/week(Q1) – total MET-min/week(Q2)
Spearman r = 0.60 (P = 0.0000)
MD (95 % LoA) = 347.14 ± 4016.88 MET-min/week
 
 
 
 
Men: sitting MET-hr/week(Q1) – sitting MET-hr/week(Q2)
Spearman r = 0.76 (P = 0.0000)

 
 
 
 
Women: sitting MET-hr/week(Q1) – sitting MET-hr/week(Q2)
Spearman r = 0.77 (P = 0.0000)

 
 
 
YPAS
Men: total MET-min/week(Q1) – total MET-min/week(Q2)
Spearman r = 0.57 (P = 0.00001)
MD (95 % LoA) = −582.17 ± 4867.14 MET-min/week
 
 
 
 
Women: total MET-min/week(Q1) – total MET-min/week(Q2)
Spearman r = 0.62 (P = 0.0000)
MD (95 % LoA) = 26.77 ± 4474.64 MET-min/week
Elderly
Tomioka (2011)[85]
2 weeks
IPAQ-s
Young old men: MET-min/week(Q1) – MET-min/week(Q2)
ICC (95 % CI) = 0.65 (0.46;0.78)

 
 
 
 
Young old women: MET-min/week(Q1) – MET-min/week(Q2)
ICC (95 % CI) = 0.57 (0.34;0.72)

 
 
 
 
Old old men: MET-min/week(Q1) – MET-min/week(Q2)
ICC (95 % CI) = 0.50 (0.22;0.68)

 
 
 
 
Old old women: MET-min/week(Q1) – MET-min/week(Q2)
ICC (95 % CI) = 0.56 (0.30;0.72)

 
 
 
 
Young old men: sitting hr/day(Q1) – sitting hr/day(Q2)
ICC (95 % CI) = 0.82 (0.71;0.88)

 
 
 
 
Young old women: sitting hr/day(Q1) – sitting hr/day(Q2)
ICC (95 % CI) = 0.70 (0.54;0.80)

 
 
 
 
Old old men: sitting hr/day(Q1) – sitting hr/day(Q2)
ICC (95 % CI) = 0.66 (0.48;0.78)

 
 
 
 
Old old women: sitting hr/day(Q1) – sitting hr/day(Q2)
ICC (95 % CI) = 0.67 (0.48;0.80)

 
 
 
 
 
Median ICC = 0.71 (youth: 0.64, adults: 0.79, elderly: 0.65)
 
 
 
 
 
 
Median Spearman r = 0.62 (youth: –, adults: 0.64, elderly: 0.60)
 
 
 
 
 
 
Median Pearson r = 0.62 (youth: 0.605, adults: –, elderly: 0.62)
 
            Median κ = 0.655 (youth: –, adults: 0.655, elderly: –)

Q1 = first completed questionnaire, Q2 = second completed questionnaire, r = correlation coefficient (rho), ICC = Intraclass Correlation Coefficient, CI = Confidence Interval (lower;upper), %CV = coefficient of variation (within subjects standard deviation of typical error) as a percentage of the mean score, κ = kappa (i.e. Cohen weighted kappa unless specified otherwise), LoA = Limits of Agreement, MD = Mean Difference, – = not stated.

Bull (2009): Total min = total time per domain of the pooled data (n = 2221) of 7 countries (Bangladesh, China, Ethiopia, Indonesia, South Africa, Japan, Taiwan). Leisure = discretionary domain, occupation = work domain, transportation = transport domain. Sedentary = categorical variable of pooled data (n = 1524) for no physical activity in the discretionary or work domain.

Corder (2009): PAEE in kJ/kg/day for total group, or for 12 – 13 or 16 – 17 year old children. Lifestyle score = summed score of four multiple choice questions regarding active transport, school break activities, activity outside school, and the amount of "exercise that makes you out of breath".

Cust (2008): Total MET-hr/week = total MET hours per week of non-occupational activity. Total PA index = cross-tabulation of level of occupational activity with combined recreational and household activities - inactive, moderately inactive, moderately active, active. Cambridge PA index = index based on occupational, cycling and sports activity (generally more intense activities).

Cust (2009): Results are stratified according to the group of participants reporting high or low confidence in recall of PA. High confidence = group of participants reporting high self-reported confidence in recall of physical activity. Low confidence = group of participants reporting low self-reported confidence in recall of physical activity.

De Abajo (2001): EE in kJ/day. YPAS summary index = summed time for each activity, expressed in hours per week for each subject. Individual indices were created by multiplying a frequency score by a duration score and multiplying again by a weighting factor.

Dinger (2004): Total PASE score = weighted and summed score of individual items using the PASE scoring algorithm.

Eisenmann (2002): Same day = beginning and end of the day. Total leisure activity score was calculated by multiplying the frequency of each category by the MET value and summing the score.

Gauthier (2009): Total MET-min/week = total activity excluding sitting.

Hagiwara (2008): PASE score was calculated by adding the score for each component determined on the basis of the time spent on each activity or the presence or absence of activity over the past 7 days. In the paper more details (κ or weighted κ and the proportion of consistency) are reported for each separate activity component.

Hallal (2010): Total score = sum of minutes spent on MPA (including walking) per week, and twice the number of minutes spent on VPA. T1 = telephone interview on day 1. T2 = telephone interview on day 6. FTF = face-to-face interview on day 1.

Harada (2001): EE in kcal/week.

Huang (2009): Activity intensities classified according to a compendium of physical activities.

Kolbe-Alexander (2006): sitting = time spent sitting during a week and weekend day.

Kurtze (2008): VPA = 8 METs, MPA = 4 METs, Walking = 3.3 METs on average.

MacFarlane (2007/2010): Total MET-min/week = total activity excluding sitting (1 MET).

Matton (2007): EE in kcal/week. PAL is calculated as total EE divided by 168 (number of hours per week) and the reported body weight. TV hr/week = time per week spent watching television or videos or playing computer games during weekdays and weekends.

Nang (2011): VPA(Q) = 3–6 METs kcal/day, MPA(Q) = >6 METs kcal/day.

Pettee-Gabriel (2009): Test-retest period = 1 week for PWMAQ (n = 65), NHS-PAQ (n = 62), AAS (n = 65), WHI-PAQ (n = 63) and 1 month for PMMAQ (n = 65).

Schmidt (2006): Total activity score = activity score of all four domains, calculated as: (household/caregiving index*0.25 + occupational index*0.25 + active living index*0.25 + sports/exercise index*0.25)*4. Weighted activity score = activity score of all four domains, calculated as: (household/caregiving index*0.50 + occupational index*0.20 + active living index*0.25 + sports/exercise index*0.05)*4.

Smitherman (2009): JPAC total score = total score calculated by summing the 4 index scores (active living, work, home/family/yard/garden, sport/exercise index) and can range from 3 to 20.

Tomioka (2011): Young old = age 65–74, old old = age 75–89.

Treuth (2004): GAQ score yesterday = summary score estimated from 28 physical activities performed on the previous day (yesterday), applying the code 0 for the response "none", 1 for the response "less than 15 min", and 10 for the response "15 min or more". GAQ score usual = summary score estimated from usual activities, based on frequency of physical activities performed, applying the code 0 for the response "none", 1 for the response "a little", and 10 for the response "a lot". The GAQ summary scores were computed as the total MET-weighted score divided by the number of nonmissing items. TV watching = time spent watching TV or video. Other sedentary = time spent performing computer or video games, arts and crafts, board games, homework or reading, talking on phone or hanging out.

Trinh (2009): GPAQ total score = score of 19 items following the GPAQ analysis protocol. Sedentary time = time spent sitting or reclining. MD (95 % LoA) = log-transformed average difference with 95 % limits of agreement. Compared with the baseline assessment, the GPAQ score was on average not different and 12 % higher, respectively, 2 weeks later.

Troped (2007): MPA = number of days participating in ≥ 30 min of moderate PA during past 7 days. VPA = number of days participating in ≥ 20 min of vigorous PA during past 7 days.

Weston (1997): TEE in kcal/kg/day.

Most studies examining the reliability of existing PAQs reported reliability as ICC (n = 20), Pearson/Spearman correlation coefficients (n = 8); some studies also used a combination of correlation statistics (n = 7). Similar to the new PAQs, the existing PAQs demonstrated moderate correlations for reliability. Median correlations from reported data for recall of sedentary behaviours were divergent: ICC = 0.76, Spearman r = 0.725, Pearson r = 0.305, kappa = 0.645.

Youth

Median reliability correlations for the youth were as follows: ICC = 0.64, Pearson r = 0.605. The CHASE (ICC = 0.02) and the CPAQ (ICC = 0.25) showed poor test-retest reliability, whereas the reliability was strong for YPAQ (ICC = 0.79–0.86) in the same study [61]. Previous day physical activity recall instruments proved to be highly reliable in children (ICC = 0.98 [60], r = 0.98 [74]).

Adults

Median reliability correlations for adults were as follows: ICC = 0.79, Spearman r = 0.64, kappa = 0.655. The IPAQ-SALVCF (ICC = 0.929) [105], IPAQ long version (r = 0.87–0.90 [108], ICC = 0.93 [110]), IPAQ short version (ICC = 0.79) [99], FPACQ (ICC = 0.77–0.96) [111], KPAS-mod (ICC = 0.76–0.84) [92] and the JPAC (ICC = 0.99) [113] showed acceptable or strong reliability. Notably, the IPAQ-s showed a wide range of results for reliability, with ICCs ranging from 0.27–0.97 for sitting [54,69,83,85,99,103,112], 0.10–0.42 for walking [54,69], 0.30–0.34 for MPA [54,69], 0.30–0.62 for VPA [54,69], and 0.33–0.79 for total PA [83,85,99,103,112]. For sedentary time the short IPAQ appeared to be the most reliable questionnaire when the test retest duration was short (i.e. 3 days, [ICC = 0.97]) [99]. All existing PAQs for adults reported acceptable to high reliability properties, overall.

Elderly

Median reliability correlations for the elderly were as follows: ICC = 0.65, Spearman r = 0.60, Pearson r = 0.62. Similarly, all existing PAQs for elderly also showed overall acceptable to high reliability, with the PASE (ICC = 0.91) [77], 7DPAR (ICC = 0.89) [78] and CHAMPS-MMSCV (ICC = 0.81–0.89) [79] performing best.

Validity

All validity results for existing PAQs are listed in Table 7.

Table 7.

Validity results of existing PAQs

Age Group
Reference
Criterion method
Duration of validation
PAQ
Variables tested
Criterion intensity thresholds
Validity results
              Correlation coefficients Agreement
Youth
Affuso (2011)[59]
Acc (ActiGraph)
3 days
SAPAC
Sedentary mins(Q) – sedentary mins(Acc)
<100 counts/min
Pearson r (95 % CI) = 0.18 (0.07;0.28), Spearman r (95 % CI) = 0.14 (0.05;0.23)

Youth
Allor (2001)[60]
Acc (Caltrac)
2 days
PDPAR
EE(Q) – EE(Acc)

Pearson r = 0.76 (P < 0.01)
MD = ~100 kcal/hr (P < 0.01)
 
 
HR
2 days
 
EE(Q) – EE(HR)

Pearson r = 0.50 (P < 0.01)
MD = ~100 kcal/hr
Youth
Corder (2009)[61]
DLW
11 days
YPAQ
12-13 yrs: PAEE(Q) – PAEE(DLW)

Spearman r = 0.09 (P = 0.67)
MD (95 % LoA) = 0.59 ± 6.3 kJ/kg/day
 
 
 
 
 
16-17 yrs: PAEE(Q) – PAEE(DLW)

Spearman r = 0.46 (P = 0.03)
MD (95 % LoA) = 0.32 ± 4.6 kJ/kg/day
 
 
Acc (ActiGraph)
11 days
 
12-13 yrs: MVPA(Q) – MVPA(Acc)
≥1952 counts/min
Spearman r = 0.42 (P = 0.04)
MD (95 % LoA) = 2.01 ± 2.25 min/week
 
 
 
 
 
16-17 yrs: MVPA(Q) – MVPA(Acc)
≥1952 counts/min
Spearman r = 0.11 (P = 0.61)
MD (95 % LoA) = 1.38 ± 2.97 min/week
 
 
DLW
11 days
CPAQ
PAEE(Q) – PAEE(DLW)

Spearman r = 0.22 (P = 0.28)
MD (95 % LoA) = 0.76 ± 3.1 kJ/kg/day
 
 
Acc (ActiGraph)
11 days
 
MVPA(Q) – MVPA(Acc)
≥1952 counts/min
Spearman r = 0.42 (P = 0.04)
MD (95 % LoA) = 1.63 ± 2.24 min/week
 
 
DLW
11 days
CHASE
Lifestyle score(Q) – PAEE(DLW)

Spearman r = 0.45 (P = 0.02)

 
 
Acc (ActiGraph)
11 days
 
Lifestyle score(Q) – MVPA(Acc)
≥1952 counts/min
Spearman r = 0.12 (P = 0.57)

 
 
DLW
11 days
SWAPAQ
PAEE(Q) – PAEE(DLW)

Spearman r = 0.40 (P = 0.04)
MD (95 % LoA) = 0.46 ± 8.5 kJ/kg/day
 
 
Acc (ActiGraph)
11 days
 
MVPA(Q) – MVPA(Acc)
≥1952 counts/min
Spearman r = 0.23 (P = 0.27)
MD (95 % LoA) = 1.03 ± 2.58 min/week
Youth
Eisenmann (2002)[62]
Acc (Caltrac)
1 day
GLTEQ
Total leisure activity score(Q) – counts/hr(Acc)

Pearson r = 0.50

Youth
Gwynn (2010)[63]
Acc (ActiGraph)
7 days
MRPARQ
MVPA min/day(Q) – MVPA min/day(Acc)
≥1952 counts/min
Pearson r = 0.37 (P < 0.05), ICC = 0.25 (P < 0.05)

Youth
Hagströmer (2008)[56]
Acc (ActiGraph)
7 days
IPAQ-A
Total MET-min/day(Q) – total counts/min(Acc)

Spearman r = 0.20 (P < 0.01)

Youth
Huang (2009)[64]
Acc (ActiGraph)
7 days
CLASS
Boys: VPA min/week(Q) – VPA min/week(Acc)
≥6 METs
Spearman r = 0.29
MD (95 % LoA) = 12.6 ± 47.4 min/week
 
 
 
 
 
Girls: VPA min/week(Q) – VPA min/week(Acc)
≥6 METs
Spearman r = 0.43 (P < 0.05)
MD (95 % LoA) = 12.6 ± 47.4 min/week
 
 
 
 
 
Boys: MVPA min/week(Q) – MVPA min/week(Acc)
≥3 METs
Spearman r = 0.27
MD (95 % LoA) = −6.2 ± 95.3 min/week
 
 
 
 
 
Girls: MVPA min/week(Q) – MVPA min/week(Acc)
≥3 METs
Spearman r = 0.48 (P < 0.05)
MD (95 % LoA) = −6.2 ± 95.3 min/week
 
 
 
 
 
Boys: MPA min/week(Q) – MPA min/week(Acc)
3-5.9 METs
Spearman r = 0.33
MD (95 % LoA) = −18.9 ± 70.4 min/week
 
 
 
 
 
Girls: MPA min/week(Q) – MPA min/week(Acc)
3-5.9 METs
Spearman r = 0.29 (P < 0.05)
MD (95 % LoA) = −18.9 ± 70.4 min/week
 
 
 
 
 
Boys: sedentary min/week(Q) – sedentary min/week(Acc)
<100 counts/min
Spearman r = 0.06

 
 
 
 
 
Girls: sedentary min/week(Q) – sedentary min/week(Acc)
<100 counts/min
Spearman r = 0.25 (P < 0.05)

Youth
Kowalski (1997)[65]
Acc (Caltrac)
7 days
PAQ-C
PAQ-C score(Q) – total counts(Acc)

Pearson r = 0.39 (P < 0.05)

Youth
Martinez-Gomez (2010)[66]
Acc (ActiGraph)
3 days
BAD
Total MET-min/day(Q) – total counts/day(Acc)

Spearman r = 0.29

 
 
 
 
 
Total MET-min/day(Q) – total counts/min/day(Acc)

Spearman r = 0.33

Youth
Martinez-Gomez (2011)[67]
Acc (ActiGraph)
7 days
PAQ-A
PAQ-A score(Q) – total counts/min(Acc)

Spearman r = 0.39 (P < 0.001)

 
 
 
 
 
PAQ-A score(Q) – MVPA mins(Acc)
≥1952 counts/min
Spearman r = 0.31 (P < 0.001)

Youth
Mota (2002)[68]
Acc (ActiGraph)
3 days
WAC
METs/15 min(Q) – counts/min(Acc)

Pearson r = 0.30 (P = 0.01)

Youth
Ottevaere (2011)[57]
Acc (ActiGraph)
7 days
IPAQ-A
VPA min/day(Q) – VPA min/day(Acc)
≥4000 counts/min
Spearman r = 0.25 (P < 0.01)
MD (95 % LoA) = 13.2 ± 78.2 min/day
 
 
 
 
 
MVPA min/day(Q) – MVPA min/day(Acc)
≥2000 counts/min
Spearman r = 0.21 (P < 0.01)

 
 
 
 
 
MPA min/day(Q) – MPA min/day(Acc)
2000-3999 counts/min
Spearman r = 0.15 (P < 0.01)
MD (95 % LoA) = 31.6 ± 105.6 min/day
Youth
Rangul (2008)[69]
Acc (ActiReg)
7 days
HBSC
Frequency(Q) – TEE(Acc)

Spearman r = 0.20

 
 
 
 
 
Frequency(Q) – PAL(Acc)

Spearman r = 0.02

 
 
 
 
 
Duration(Q) – TEE(Acc)

Spearman r = 0.23

 
 
 
 
 
Duration(Q) – PAL(Acc)

Spearman r = 0.01

 
 
 
 
IPAQ-s
VPA min/day(Q) – TEE(Acc)

Spearman r = −0.14

 
 
 
 
 
VPA min/day(Q) – PAL(Acc)

Spearman r = −0.08

 
 
 
 
 
MPA min/day(Q) – TEE(Acc)

Spearman r = 0.01

 
 
 
 
 
MPA min/day(Q) – PAL(Acc)

Spearman r = 0.01

 
 
 
 
 
Walking min/day(Q) – TEE(Acc)

Spearman r = 0.24

 
 
 
 
 
Walking min/day(Q) – PAL(Acc)

Spearman r = 0.43 (P < 0.01)

 
 
 
 
 
Sitting min/day(Q) – TEE(Acc)

Spearman r = −0.04

 
 
 
 
 
Sitting min/day(Q) – PAL(Acc)

Spearman r = −0.29

Youth
Scerpella (2002)[70]
Acc (Caltrac)
2x 3 days
GSQ
Godin-Shephard score(Q) – Caltrac score(Acc)

Spearman r = 0.102 (P = 0.422)

Youth
Slinde (2003)[71]
DLW
14 days
MLTPAQ
TEE(Q) – TEE(DLW)

Spearman r = 0.49 (P < 0.01)

 
 
 
 
eMLTPAQ
TEE(Q) – TEE(DLW)

Spearman r = 0.65 (P < 0.01)
MD (95 % LoA) = 2.8 ± 2.8 MJ/day
 
 
 
 
 
Sedentary min/day(Q) – TEE(DLW)

Spearman r = 0.030 (P = 0.86)

Youth
Treuth (2004)[72]
Acc (ActiGraph)
3 days
GAQ
Baseline: yesterday GAQ score(Q) – mean counts/min(Acc)

Pearson r = 0.06 (P = 0.42)

 
 
 
 
 
Follow-up: yesterday GAQ score(Q) – mean counts/min(Acc)

Pearson r = 0.08 (P = 0.28)

 
 
 
 
 
Baseline: usual GAQ score(Q) – mean counts/min(Acc)

Pearson r = 0.12 (P = 0.10)

 
 
 
 
 
Follow-up: usual GAQ score(Q) – mean counts/min(Acc)

Pearson r = 0.07 (P = 0.36)

Youth
Troped (2007)[73]
Acc (ActiGraph)
7 days
YRBS
Total VPA min/day(Q) – total VPA min/day(Acc)
>6 METs
Sensitivity = 0.86, specificity: 0.26
κ = −0.002 – 0.06
 
 
 
 
 
Total MPA min/day(Q) – total MPA min/day(Acc)
3-6 METs
Sensitivity = 0.23, specificity: 0.92
κ = −0.05 – 0.03
Youth
Weston (1997)[74]
Acc (Caltrac)
1 day (after school)
PDPAR
TEE(Q) – total counts(Acc)

Pearson r = 0.77 (P < 0.01)

 
 
HR (Polar)
1 day (after school)
 
EE(Q) – %HRR(HR)

Pearson r = 0.53 (P < 0.01)

Adults
Ainsworth (1999)[87]
Acc (Caltrac)
7 days
TOQ
MPA MET-min/week(Q) – EE(Acc)

Pearson r = 0.34 (P < 0.05)

 
 
 
 
7DR-O
7DR scores(Q) – EE(Acc)

Low correlations (P > 0.05)

Adults
Bassett (2000)[101]
Ped (Yamax)
7 days
CAQ
Men: distance(Q) – distance(Ped)

r = 0.346 (P = 0.02)

 
 
 
 
 
Women: distance(Q) – distance(Ped)

r = 0.481 (P = 0.001)

Adults
Brown (2008)[88]
Acc (ActiGraph)
7 days
AAS
Frequency/week(Q) – frequency(Acc)
≥3 METs, ≥1952 counts/min
Spearman r = 0.48 (P = 0.001)

 
 
 
 
 
Total min/week(Q) – MVPA(Acc)
≥3 METs, ≥1952 counts/min
Spearman r = 0.52 (P < 0.001)

 
 
 
 
 
Total min/week(Q) – total counts(Acc)

Spearman r = 0.23 (P = 0.14)

Adults
Bull (2009)[58]
Acc (MTI)
> 7 days
GPAQ
China: VPA(Q) – mean VPA counts/day(Acc)

Spearman r = 0.23 (P < 0.05)

 
 
 
 
 
South Africa: VPA(Q) – mean VPA counts/day(Acc)

Spearman r = 0.26 (P < 0.05)

 
 
 
 
 
China: MPA(Q) – mean MPA counts/day(Acc)

Spearman r = 0.23 (P < 0.05)

 
 
 
 
 
South Africa: MPA(Q) – mean MPA counts/day(Acc)

Spearman r = −0.03

 
 
 
 
 
China: sedentary min/day(Q) – mean sedentary counts/day(Acc)
<100 counts/min
Spearman r = 0.40 (P < 0.05)

 
 
 
 
 
South Africa: sedentary min/day(Q) – mean sedentary counts/day(Acc)
<100 counts/min
Spearman r = −0.02

Adults
Conway (2002)[94]
DLW
14 days
7DPAR
TEE(Q) – TEE(DLW)

R2 = 0.10
MD (±SEM) = 0.91 ± 0.42 (7.9 ± 3.2 %) MJ/day
 
 
 
 
S7DR
TEE(Q) – TEE(DLW)

R2 = 0.14
MD (±SEM) = 4.14 ± 1.36 (30.6 ± 9.9 %) MJ/day
Adults
Cust (2008)[102]
Acc (ActiGraph)
3x 7 days
EPAQ
Total MET-hr/week(Q) – total MET-hr/week(Acc)
≥574 counts/min
Spearman r (95 % CI) = 0.21 (0.07;0.35), P < 0.01

 
 
 
 
 
Total PA index(Q) – total MET-hr/week(Acc)
≥574 counts/min
Spearman r (95 % CI) = 0.29 (0.15;0.42), P < 0.0001

 
 
 
 
 
Cambridge PA index(Q) – total MET-hr/week(Acc)
≥574 counts/min
Spearman r (95 % CI) = 0.32 (0.19;0.45), P < 0.0001

Adults
Cust (2009)[103]
Acc (ActiGraph)
3x 7 days
EPAQ
High confidence: total PA index(Q) – total MET-hr/week(Acc)
≥574 counts/min
Spearman r (95 % CI) = 0.37 (0.17;0.54)

 
 
 
 
 
Low confidence: total PA index(Q) – total MET-hr/week(Acc)
≥574 counts/min
Spearman r (95 % CI) = 0.22 (0.02;0.41)

 
 
 
 
 
High confidence: Cambridge PA index(Q) – total MET-hr/week(Acc)
≥574 counts/min
Spearman r (95 % CI) = 0.30 (0.10;0.48)

 
 
 
 
 
Low confidence: Cambridge PA index(Q) – total MET-hr/week(Acc)
≥574 counts/min
Spearman r (95 % CI) = 0.35 (0.15;0.52)

 
 
 
 
IPAQ-s
High confidence: total MET-hr/week(Q) – total MET-hr/week(Acc)
≥574 counts/min
Spearman r (95 % CI) = 0.26 (0.04;0.45)

 
 
 
 
 
Low confidence: total MET-hr/week(Q) – total MET-hr/week(Acc)
≥574 counts/min
Spearman r (95 % CI) = 0.27 (0.07;0.46)

 
 
 
 
 
High confidence: sitting hr/day(Q) – sedentary(Acc)
<100 counts/min
Spearman r (95 % CI) = 0.36 (0.18;0.52)

 
 
 
 
 
Low confidence: sitting hr/day(Q) – sedentary(Acc)
<100 counts/min
Spearman r (95 % CI) = 0.45 (0.25;0.62)

Adults
Duncan (2001)[104]
HR (Polar)
1 weekday
7DPAR
Very hard activity(Q) – very hard activity(HR)
≥ 85 % HRR

MD = 0.00 hours
 
 
 
 
 
Hard activity(Q) – hard activity(HR)
60-84 % HRR

MD = 0.02 hours
 
 
 
 
 
Moderate activity(Q) – moderate activity(HR)
45-59 % HRR

MD = 0.21 hours
Adults
Ekelund (2006)[95]
Acc (ActiGraph)
7 days
IPAQ-s
Total MET-min/day(Q) – mean counts/min(Acc)

Pearson r = 0.34 (P < 0.001)
MD (95 % CI) = −25.9 (−172;120) min/day, P < 0.001
 
 
 
 
 
Sitting(Q) – sedentary min/day(Acc)
<100 counts/min
Pearson r = 0.16 (P < 0.05)

Adults
Gauthier (2009)[105]
Ped (Yamax)
7 days
IPAQ-SALVCF
Walking(Q) – step counts(Ped)

Pearson r = 0.493 (P < 0.005)

Adults
Hagströmer (2006)[106]
Acc (ActiGraph)
7 days
IPAQ
Total MET-hr/week(Q) – total counts/min(Acc)

Spearman r = 0.55 (P < 0.001)
MD (95 % LoA) = 1.0 ± 16.7 hr/week
 
 
 
 
 
Sitting hr/week(Q) – inactivity hr/week(Acc)
<101 counts/min
Spearman r = 0.17

Adults
Hagströmer (2010)[107]
Acc (ActiGraph)
7 days
IPAQ
Total min/day(Q) – total min/day(Acc)

Spearman r = 0.28 (P < 0.01)

 
 
 
 
 
Total MET-min/day(Q) – total counts/min(Acc)

Spearman r = 0.30 (P < 0.01)

 
 
 
 
 
Sitting min/day(Q) – sitting min/day(Acc)
<100 counts/min
Spearman r = 0.23 (P < 0.01)
MD (±SD) = 130  ±  207 min/day, P < 0.001, R2 = 0.50
Adults
Hallal (2010)[108]
Acc (ActiGraph)
4 days
IPAQ
Total score(Q) – total score(Acc)
≥1952 counts/min
Spearman r = 0.22

Adults
InterAct Consortium (2011)[51]
Acc + HR (Actiheart)
≥ 4 days
EPAQ-s
Total PA index(Q) – PAEE(Acc + HR)

Pearson r (95 % CI) = 0.14 (0.04;0.24), P = 0.000

 
 
 
 
 
Cambridge index(Q) – PAEE(Acc + HR)

Pearson r (95 % CI) = 0.33 (0.28;0.38), P = 0.118

 
 
 
 
 
Recreational index(Q) – PAEE(Acc + HR)

Pearson r (95 % CI) = 0.22 (0.16;0.28), P = 0.042

Adults
Jacobi (2009)[109]
Acc (ActiGraph)
7 days
MAQ
Total MET-hr/week(Q) – total counts/day(Acc)

Spearman r = 0.18 (P < 0.05)

 
 
 
 
 
Sedentary hr/week(Q) – sedentary hr/week(Acc)
<100 counts/min
Spearman r = 0.14 (P < 0.1)

Adults
Kurtze (2008)[54]
Acc (ActiReg)
7 days
IPAQ-s
Total MET-min/week(Q) – EE(Acc)

Spearman r = 0.26 (P < 0.05)
MD (95 % LoA) = −433 ± 2038 min/week
 
 
 
 
 
Total MET-min/week(Q) – PAL(Acc)

Spearman r = 0.29 (P < 0.05)

 
 
 
 
 
Sitting hr/day(Q) – EE(Acc)

Spearman r = −0.25 (P < 0.05)

 
 
 
 
 
Sitting hr/day(Q) – PAL(Acc)

Spearman r = −0.35 (P < 0.01)

Adults
Lee (2011)[98]
Acc (ActiGraph)
4 days
IPAQ-s
Total MET-min/week(Q) – total MET-min/week(Acc)

Spearman r (±SE) = 0.11 ± 0.03, P < 0.001
MD (±SE) = 2966.3 ± 140.1 MET-min/week, P < 0.001
 
 
 
 
 
Total MET-min/week(Q) – total counts/min(Acc)

Spearman r (±SE) = 0.16 ± 0.03, P < 0.001

Adults
MacFarlane (2007)[99]
Acc (ActiGraph)
7 days
IPAQ-s
Total min/week(Q) – total MVPA min/week(Acc)
≥1952 counts/min
Spearman r = 0.09 (P = 0.52)
R2 = 0.78, slope = 1.59 (P < 0.01); %bias = −102, %LoA = 176
Adults
MacFarlane (2010)[110]
Acc (ActiTrainer)
7 days
IPAQ-LC
Total MET-min/day(Q) – total MET-min/day(Acc)

Spearman r = 0.35 (P = 0.001)
MD (95 % LoA) = −21.6 ± 575.5 MET-min/day, P = 0.643
Adults
Mahabir (2006)[89]
DLW

HAQ
EE(Q) – EE(DLW)

Spearman r = 0.36 (P < 0.05)
MD (95 % LoA) = 1782.5 ± 2237.4 kcal/day
 
 
 
 
FCPQ
EE(Q) – EE(DLW)

Spearman r = 0.47 (P < 0.05)
MD (95 % LoA) = 732.8 ± 2126.7 kcal/day
 
 
 
 
CAPS-4WR
EE(Q) – EE(DLW)

Spearman r = 0.16
MD (95 % LoA) = 1765.8 ± 8973.7 kcal/day
 
 
 
 
CAPS-TWR
EE(Q) – EE(DLW)

Spearman r = 0.15
MD (95 % LoA) = −413.4 ± 2958.6 kcal/day
Adults
Matton (2007)[111]
Acc (RT3)
7 days
FPACQ
Employed/unemployed men: total EE(Q) – total EE(Acc)

Pearson r = 0.80 (P < 0.001)
t-test = 9.02 (P < 0.001)
 
 
 
 
 
Employed/unemployed women: total EE(Q) – total EE(Acc)

Pearson r = 0.65 (P < 0.001)
t-test = 10.18 (P < 0.001)
 
 
 
 
 
Retired men: total EE(Q) – total EE(Acc)

Pearson r = 0.55 (P < 0.01)
t-test = 11.48 (P < 0.001)
 
 
 
 
 
Retired women: total EE(Q) – total EE(Acc)

Pearson r = 0.85 (P < 0.001)
t-test = 10.79 (P < 0.001)
 
 
 
 
 
Employed/unemployed men: PAL(Q) – PAL(Acc)

Pearson r = 0.56 (P < 0.01)
t-test = 9.87 (P < 0.001)
 
 
 
 
 
Employed/unemployed women: PAL(Q) – PAL(Acc)

Pearson r = 0.44 (P < 0.05)
t-test = 11.68 (P < 0.001)
 
 
 
 
 
Retired men: PAL(Q) – PAL(Acc)

Pearson r = 0.39 (P < 0.05)
t-test = 11.91 (P < 0.001)
 
 
 
 
 
Retired women: PAL(Q) – PAL(Acc)

Pearson r = 0.50 (P < 0.05)
t-test = 13.93 (P < 0.001)
 
 
 
 
 
Employed/unemployed men: TV hr/week(Q) – TV hr/week(Acc)

Pearson r = 0.69 (P < 0.001)
t-test = −0.75
 
 
 
 
 
Employed/unemployed women: TV hr/week(Q) – TV hr/week(Acc)

Pearson r = 0.83 (P < 0.001)
t-test = −3.32 (P < 0.01)
 
 
 
 
 
Retired men: TV hr/week(Q) – TV hr/week(Acc)

Pearson r = 0.78 (P < 0.001)
t-test = −3.98 (P < 0.001)
 
 
 
 
 
Retired women: TV hr/week(Q) – TV hr/week(Acc)

Pearson r = 0.80 (P < 0.001)
t-test = −2.41 (P < 0.05)
Adults
Nang (2011)[55]
Acc (Actical)
5 days
IPAQ
VPA(Q) – VPA(Acc)

Spearman r = 0.18 (P < 0.05)
MD (95 % CI) = 139 (82;196) kcal/day
 
 
 
 
 
MPA(Q) – MPA(Acc)

Spearman r = 0.13
MD (95 % CI) = −169 (−236;-90) kcal/day
 
 
 
 
SP2PAQ
VPA(Q) – VPA(Acc)

Spearman r = 0.42 (P < 0.0001)
MD (95 % CI) = 81 (47;116) kcal/day
 
 
 
 
 
MPA(Q) – MPA(Acc)

Spearman r = 0.24 (P < 0.05)
MD (95 % CI) = −196 (−295;-97) kcal/day
Adults
Nicaise (2011)[90]
Acc (ActiGraph)
7 days
IPAQ
VPA(Q) – VPA(Acc)
≥5725 counts/min
Pearson r = −0.01

 
 
 
 
 
MPA(Q) – MPA(Acc)
1952-5724 counts/min
Pearson r = 0.08

 
 
 
 
 
Walking(Q) – steps(Acc)

Pearson r = 0.07

 
 
 
 
 
Weekday: sitting(Q) – light PA(Acc)
≤1951 counts/min
Pearson r = −0.17

 
 
 
 
 
Weekend: sitting(Q) – light PA(Acc)
≤1951 counts/min
Pearson r = −0.08

Adults
Pettee-Gabriel (2009)[91]
Acc (ActiGraph)
≥ 4 days
PMMAQ
Total MET-hr/week(Q) – total counts/day(Acc)

Spearman r = 0.60 (P < 0.0001)

 
 
 
 
 
Total MET-hr/week(Q) – mean counts/min/day(Acc)

Spearman r = 0.59 (P < 0.0001)

 
 
 
 
PWMAQ
Total MET-hr/week(Q) – total counts/day(Acc)

Spearman r = 0.60 (P < 0.0001)

 
 
 
 
 
Total MET-hr/week(Q) – mean counts/min/day(Acc)

Spearman r = 0.56 (P < 0.0001)

 
 
 
 
NHS-PAQ
Total MET-hr/week(Q) – total counts/day(Acc)

Spearman r = 0.46 (P < 0.001)

 
 
 
 
 
Total MET-hr/week(Q) – mean counts/min/day(Acc)

Spearman r = 0.42 (P < 0.001)

 
 
 
 
AAS
Total min/day(Q) – total counts/day(Acc)

Spearman r = 0.46 (P < 0.001)

 
 
 
 
 
Total min/day(Q) – mean counts/min/day(Acc)

Spearman r = 0.50 (P < 0.0001)

 
 
 
 
WHI-PAQ
Total MET-hr/week(Q) – total counts/day(Acc)

Spearman r = 0.47 (P < 0.001)

 
 
 
 
 
Total MET-hr/week(Q) – mean counts/min/day(Acc)

Spearman r = 0.45 (P < 0.001)

Adults
Philippaerts (1999)[96]
DLW
14 days
BAQ
Total activity index(Q) – ADMR(DLW)

Pearson r = 0.68 (P < 0.01)

 
 
 
 
 
Total activity index(Q) – PAL(DLW)

Pearson r = 0.69 (P < 0.001)

 
 
 
 
FCPQ
7 day index(Q) – ADMR(DLW)

Pearson r = 0.61 (P < 0.01)

 
 
 
 
 
7 day index(Q) – PAL(DLW)

Pearson r = 0.34

 
 
 
 
TCQ
TEE(Q) – ADMR(DLW)

Pearson r = 0.63 (P < 0.01)

 
 
 
 
 
TEE(Q) – PAL(DLW)

Pearson r = 0.64 (P < 0.01)

Adults
Philippaerts (2001)[97]
Acc (Tracmor)
4 days
BAQ
Total activity index(Q) – mean counts(Acc)

Pearson r = 0.47 (P < 0.001)

 
 
 
 
TCQ
TEE(Q) – mean counts(Acc)

Pearson r = 0.22

Adults
Richardson (2001)[100]
Acc (Caltrac)
14x 2 days
S7DR
Men, visit 10: total MET-min/day(Q) – total MET-min/day(Acc)

Spearman r = 0.54 (P < 0.01)

 
 
 
 
 
Men, visit 11: total MET-min/day(Q) – total MET-min/day(Acc)

Spearman r = 0.45 (P < 0.05)

 
 
 
 
 
Women, visit 10: total MET-min/day(Q) – total MET-min/day(Acc)

Spearman r = 0.20

 
 
 
 
 
Women, visit 11: total MET-min/day(Q) – total MET-min/day(Acc)

Spearman r = 0.06

Adults
Saglam (2010)[112]
Acc (Caltrac)
4 days
IPAQ
Total MET-min/week(Q) – TEE(Acc)

Spearman r (95 % CI) = 0.29 (0.05;0.47), P = 0.009

 
 
 
 
IPAQ-s
Total MET-min/week(Q) – TEE(Acc)

Spearman r (95 % CI) = 0.30 (0.07;0.49), P = 0.008

Adults
Schmidt (2006)[92]
Acc (ActiGraph)
7 days
KPAS-mod
Total activity score(Q) – mean counts/min(Acc)

Spearman r = 0.52

 
 
 
 
 
Weighted activity score(Q) – mean counts/min(Acc)

Spearman r = 0.59

Adults
Smitherman (2009)[113]
Acc (ActiGraph)
1 day
JPAC
JPAC total score(Q) – mean counts/min(Acc)

Spearman r = 0.24 (P < 0.0001)

Adults
Staten (2001)[93]
DLW
8 days
AAFQ
TEE-ic(Q) – TEE(DLW)

Pearson r = 0.40 (P < 0.001)
MD = 1935 kJ/day
 
 
 
 
 
TEE-mif(Q) – TEE(DLW)

Pearson r = 0.45 (P < 0.001)
MD = 697 kJ/day
 
 
 
 
 
TEE-met(Q) – TEE(DLW)

Pearson r = 0.58 (P < 0.001)
MD = 3595 kJ/day
Adults
Strath (2004)[114]
Acc + HR (ActiGraph + Polar)
7 days
CAQ-PAI
MET-min/week(Q) – MET-min/week(Acc + HR)

Spearman r = 0.35

Adults
Trinh (2009)[115]
Acc (ActiGraph)
7 days
GPAQ
Dry season: GPAQ total score(Q) – total counts(Acc)

Spearman r = 0.33
MD (95 % LoA) = 2.6 (0.03;224)
 
 
 
 
 
Wet season: GPAQ total score(Q) – total counts(Acc)

Spearman r = 0.19
MD (95 % LoA) = 2.6 (0.03;224)
 
 
 
 
 
Dry season: sedentary time(Q) – sedentary time(Acc)
<100 counts/min
Spearman r = 0.22

 
 
 
 
 
Wet season: sedentary time(Q) – sedentary time(Acc)
<100 counts/min
Spearman r = 0.31

Adults
Washburn (2003)[116]
DLW
14 days
S7DR
TEE(Q) – TEE(DLW)

Pearson r = 0.58 (P < 0.01)
MD (95 % LoA) = −96 ± 4161 kJ/day
 
 
 
 
 
PAEE(Q) – PAEE(DLW)

Pearson r = 0.12
MD (95 % LoA) = −222 ± 4144 kJ/day
Adults
Wolin (2008)[117]
Acc (Actical)
6 days
IPAQ-s
1-min bout: MET-min/week(Q) – counts/day(Acc)

Spearman r = 0.36 (P < 0.001)
κ (95 % CI) = 0.21 (−0.04;0.47)
 
 
 
 
 
10-min bout: MET-min/week(Q) – counts/day(Acc)

Spearman r = 0.26 (P = 0.002)
κ (95 % CI) = 0.04 (0.01;0.06)
Elderly
Bonnefoy (2001)[75]
DLW
14 days
MLTPAQ
Total activity(Q) – TEE(DLW)

Pearson r = 0.23, Spearman r = 0.17

 
 
 
 
YPAS
Summary index(Q) – TEE(DLW)

Pearson r = 0.11, Spearman r = 0.10

 
 
 
 
BAQ-mod
Questionnaire score(Q) – TEE(DLW)

Pearson r = 0.21, Spearman r = 0.28

 
 
 
 
CAQ
Total activity(Q) – TEE(DLW)

Pearson r = 0.39, Spearman r = 0.37

 
 
 
 
7DR
Total activity(Q) – TEE(DLW)

Pearson r = 0.37, Spearman r = 0.51 (P < 0.05)

 
 
 
 
DQ-mod
Total score(Q) – TEE(DLW)

Pearson r = 0.21, Spearman r = 0.34

 
 
 
 
LRC
Enhanced LRC score(Q) – TEE(DLW)

Pearson r = 0.33, Spearman r = 0.29

 
 
 
 
SUA
MPA(Q) – TEE(DLW)

Pearson r = 0.65 (P < 0.05), Spearman r = 0.46

 
 
 
 
 
VPA(Q) – TEE(DLW)

Pearson r = 0.63 (P < 0.05), Spearman r = 0.64 (P < 0.05)

 
 
 
 
PASE
Total score(Q) – TEE(DLW)

Pearson r = 0.28, Spearman r = 0.23

 
 
 
 
QAPSE
Mean habitual DEE(Q) – TEE(DLW)

Pearson r = 0.32, Spearman r = 0.25

Elderly
De Abajo (2001)[76]
Acc (Caltrac)
3 days
YPAS
Total hr/week(Q) – activity units/day(Acc)

Pearson r = 0.20 (P = 0.049)

 
 
 
 
 
TEE(Q) – activity units/day(Acc)

Pearson r = 0.23 (P = 0.022)

 
 
 
 
 
YPAS summary index(Q) – activity units/day(Acc)

Pearson r = 0.24 (P = 0.018)

 
 
 
 
 
Sitting(Q) – activity units/day(Acc)

Pearson r = −0.06 (P = 0.54)

Elderly
Dinger (2004)[77]
Acc (ActiGraph)
7 days
PASE
Total PASE score(Q) – mean counts/min(Acc)

Spearman r = 0.43 (P = 0.001)

Elderly
Dubbert (2004)[78]
Acc (Tritrac R3D)
3 days
7DPAR
TEE(Q) – counts/min(Acc)

Spearman r = 0.49 (P < 0.01)

Elderly
Giles (2009)[79]
Ped (Yamax)
7 days
CHAMPS-MMSCV
Volume T1: walking(Q) – step counts(Ped)

Spearman r = 0.40 (P < 0.01)

 
 
 
 
 
Frequency T1: walking(Q) – step counts(Ped)

Spearman r = 0.57 (P < 0.01)

 
 
 
 
 
Volume T2: walking(Q) – step counts(Ped)

Spearman r = 0.53 (P < 0.01)

 
 
 
 
 
Frequency T2: walking(Q) – step counts(Ped)

Spearman r = 0.60 (P < 0.01)

Elderly
Hagiwara (2008)[80]
Acc (Kenz Lifecorder)
3 days
PASE
Total PASE score(Q) – EE(Acc)

Spearman r = 0.16 (P = 0.02)

 
 
 
 
 
Total PASE score(Q) – walking steps(Acc)

Spearman r = 0.17 (P = 0.01)

Elderly
Harada (2001)[81]
ML (Mini-Mitter)
7 days
CHAMPS
EE(Q) – ankle counts(ML)

Pearson r = 0.36 (P < 0.01)

 
 
 
 
 
EE(Q) – waist counts(ML)

Pearson r = 0.42 (P < 0.001)

 
 
 
 
PASE
Total PASE score(Q) – ankle counts(ML)

Pearson r = 0.59 (P < 0.001)

 
 
 
 
 
Total PASE score(Q) – waist counts(ML)

Pearson r = 0.52 (P < 0.001)

 
 
 
 
YPAS
EE(Q) – ankle counts(ML)

Pearson r = 0.46 (P < 0.001)

 
 
 
 
 
EE(Q) – waist counts(ML)

Pearson r = 0.61 (P < 0.001)

Elderly
Hurtig-Wennlöf (2010)[82]
Acc (ActiGraph)
7 days
IPAQ-E
Walking + MPA min/day(Q) – mean counts/min(Acc)

Spearman r = 0.347 (P < 0.01)
κ (95 % CI) = 0.448 (0.18;0.72), P < 0.001
 
 
 
 
 
VPA min/day(Q) – VPA counts/min(Acc)
>4944 counts/min
Spearman r = 0.369 (P < 0.01)

 
 
 
 
 
MPA min/day(Q) – MPA counts/min(Acc)
760-4944 counts/min
Spearman r = 0.396 (P < 0.01)

 
 
 
 
 
Sitting min/day(Q) – sitting counts/min(Acc)
<100 counts/min
Spearman r = 0.277 (P < 0.05)

Elderly
Kolbe-Alexander (2006)[83]
Acc (ActiGraph)
7 days
IPAQ-s
Men: vigorous MET-min/week(Q) – high counts(Acc)
≥5725 counts/min
Spearman r = 0.43 (P = 0.05)

 
 
 
 
 
Women: vigorous MET-min/week(Q) – high counts(Acc)
≥5725 counts/min
Spearman r = 0.05

 
 
 
 
 
Men: moderate MET-min/week(Q) – moderate min(Acc)
1952-5724 counts/min
Spearman r = 0.31 (P = 0.004)

 
 
 
 
 
Women: moderate MET-min/week(Q) – moderate min(Acc)
1952-5724 counts/min
Spearman r = −0.09

 
 
 
 
 
Men: walking MET-min/week(Q) – total counts(Acc)

Spearman r = 0.57 (P = 0.00007)

 
 
 
 
 
Women: walking MET-min/week(Q) – total counts(Acc)

Spearman r = 0.42 (P = 0.006)

 
 
 
 
 
Men: sitting MET-min/week(Q) – total counts(Acc)

Spearman r = −0.40 (P = 0.001)

 
 
 
 
 
Women: sitting MET-min/week(Q) – total counts(Acc)

Spearman r = −0.35 (P = 0.005)

 
 
 
 
YPAS
Men: total MET-min/week(Q) – total counts(Acc)

Spearman r = 0.54 (P = 0.0002)

 
 
 
 
 
Women: total MET-min/week(Q) – total counts(Acc)

Spearman r = 0.13

Elderly
Starling (1999)[84]
DLW
10 day
MLTPAQ
Men: TEE(Q) – TEE(DLW)


MD (95 % LoA) = 752 ± 972 kcal/day
 
 
 
 
 
Women: TEE(Q) – TEE(DLW)


MD (95 % LoA) = 487 ± 698 kcal/day
 
 
 
 
YPAS
Men: TEE(Q) – TEE(DLW)


MD (95 % LoA) = 104 ± 1414 kcal/day
 
 
 
 
 
Women: TEE(Q) – TEE(DLW)


MD (95 % LoA) = 9 ± 972 kcal/day
Elderly
Tomioka (2011)[85]
Acc (Kenz Lifecorder)
2 weeks
IPAQ-s
Young old men: MET-min/week(Q) – MET-min/week(Acc)

Spearman r = 0.42 (P < 0.01)
κ (95 % CI) = 0.49 (0.34;0.64)
 
 
 
 
 
Young old women: MET-min/week(Q) – MET-min/week(Acc)

Spearman r = 0.49 (P < 0.01)
κ (95 % CI) = 0.39 (0.22;0.56)
 
 
 
 
 
Old old men: MET-min/week(Q) – MET-min/week(Acc)

Spearman r = 0.53 (P < 0.01)
κ (95 % CI) = 0.46 (0.29;0.63)
 
 
 
 
 
Old old women: MET-min/week(Q) – MET-min/week(Acc)

Spearman r = 0.49 (P < 0.01)
κ (95 % CI) = 0.47 (0.28;0.66)
Elderly
Washburn (1999)[86]
Acc (ActiGraph)
3 days
PASE
Total PASE score(Q) – mean counts/5 min epoch(Acc)

Spearman r = 0.49 (P < 0.05)

 
 
 
 
 
 
 
Median Spearman r = 0.30 (youth: 0.25, adults: 0.30, elderly: 0.40)
 
              Median Pearson r = 0.39 (youth: 0.38, adults: 0.46, elderly: 0.345)  

Q1 = first completed questionnaire, Q2 = second completed questionnaire, Q3 = third completed questionnaire, r = correlation coefficient (rho), CI = Confidence Interval (lower;upper), κ = kappa (i.e. Cohen weighted kappa unless specified otherwise), LoA = Limits of Agreement, MD = Mean Difference, – = not stated.

Acc = Accelerometry [NB: ActiGraph (Model 7164) is successor of preceding accelerometer by MTI, formerly CSA]. Accelerometer names as used in the respective papers.

Affuso (2011): Sedentary mins = total minutes TV/video watching, computer/internet use, talking on phone, playing video/computer games.

Ainsworth (1999): MPA MET-min/week = energy expended in moderate-intensity occupational standing activities. 7DR-scores = scores of occupational activity only. EE = Energy Expenditure in kcal/day. All other associations between the TOQ and Caltrac scores were low and non significant.

Allor (2001): HR monitor brand not specified. EE = Energy Expenditure in kcal/hr.

Bonnefoy (2001): MLTPAQ total activity = light, moderate, heavy, household activity. YPAS summary index = sum of vigorous, walking, moving, standing, sitting scores. BAQ-mod questionnaire score = sum of household, sports, leisure activity scores. CAQ total activity = sum of walking, stairs, sports. 7DR total activity = weighted sum of sleep, light, moderate, hard, very hard activity. Dallosso-mod total score = weighted sum of walking standing, productive, leisure, muscle-loading activity. Enhanced LRC score = self report of usual activity. SUA MPA = six habitual moderate activities. SUA VPA = five habitual vigorous activites. PASE total score = activity weight*frequency across work-related leisure, household activities. QAPSE mean habitual DEE = activity weight*duration as daily energy expenditure.

Brown (2008): Frequency/week = frequency of total activity per week. Total min/week = minutes per week of total activity ≥3 METs. Total counts = all accelerometer recorded minutes.

Bull (2009): VPA/MPA = total vigorous/moderate intensity activity across all domains. Sedentary min/day = time spent sitting per day in minutes. Data categorized for studies in China (n = 215) and South Africa (n = 83).

Conway (2002): R2 = regression against PAR; explained variance is 10 % for 7DPAR and 14 % for S7DR. MD = mean differences ± SEM (percentages in parentheses) between each method and EE(DLW).

Cust (2008): Total MET-hr/week = total MET hours per week of non-occupational activity. Total PA index = cross-tabulation of level of occupational activity with combined recreational and household activities - inactive, moderately inactive, moderately active, active. Cambridge PA index = index based on occupational, cycling and sports activity (generally more intense activities).

Cust (2009): Results are stratified according to the group of participants reporting high or low confidence in recall of PA. High confidence = group of participants reporting high self-reported confidence in recall of physical activity. Low confidence = group of participants reporting low self-reported confidence in recall of physical activity. Remarkably, the correlation for the Cambridge index is slightly higher compared to the total PA index (MET-hrs) comparing accelerometry with the EPAQ. Total MET-hr/week(Acc) = total physical activity in MET-hr/week, calculated as light + moderate + vigorous activity (no sedentary time). Data are averages of three 7-day accelerometer periods.

De Abajo (2001): Total hr/week = total activity time. Activity units = kilocalorie score divided by resting metabolic rate. TEE = Total Energy Expenditure in kJ/day. YPAS summary index = summed time for each activity, expressed in hours per week for each subject. Individual indices were created by multiplying a frequency score by a duration score and multiplying again by a weighting factor.

Dinger (2004): Total PASE score = weighted and summed score of individual items using the PASE scoring algorithm.

Duncan (2001): HRR = each subject's individual heart rate reserve (individual maximal MET capacity), where HRmax was determined from the graded exercise test and HRrest from the average of three measures after a 10-min seated test. Mean difference = 0.21, i.e. 0.21 hours overreported in PAR.

Eisenmann (2002): Total leisure activity score was calculated by multiplying the frequency of each category by the MET value and summing the score.

Ekelund (2005): MD = mean difference between objectively measured accelerometry time in MVPA and self-reported time in MVPA and walking.

Giles (2009): Volume T1/T2 = walking MET-min per week at first/second administration (T1/T2) of the CHAMPS. Frequency T1/T2 = walking sessions per week at first/second administration (T1/T2) of the CHAMPS.

Hagiwara (2008): PASE score was calculated by adding the score for each component determined on the basis of the time spent on each activity or the presence or absence of activity over the past 7 days. EE = Energy Expenditure divided by bodyweight in kcal/day/wt. Walking steps = daily number of walking steps measured by the Lifecorder accelerometer.

Hagströmer (2008): Data shown is data from the average intensity measured by the accelerometer.

Hagströmer (2006): Bland-Altman results from analysis for time spent in at least moderate physical activity (hr/week) as assessed by the IPAQ and measured using an activity monitor.

Hallal (2010): Total score(Q) = sum of minutes spent on MPA (including walking) per week, and twice the number of minutes spent on VPA, calculated from the IPAQ data. Total score(Acc) = accelerometer-based total score: moderate + vigorous-intensity counts.

Harada (2001): MiniLogger measures activity by counting the number of mercure switch closures, resulting in a 'count' of activity, over a predetermined time interval. EE = Energy Expenditure in kcal/week. Total PASE score = total score computed by 1) multiplying an activity frequency value from a conversion of hours per day in six categories of activity (e.g., moderate sports) by the respective weight and summing over these activities and 2) adding a weight to this summated score for each six other household activities if the activity was reported over the past 7 days.

Huang (2009): Results from Bland-Altman analysis are combined results for boys and girls (no results for sedentary time). Cut points used are Freedson age-based cut point, calculated as METs = 2.757 + (0.0015*counts per minute) - (0.0896*age[yr]) - (0.000038*counts per minute*age[yr]).

Hurtig-Wennlöf (2010): Agreement (κ) = Cohen's kappa for testing total agreement between the IPAQ-E and accelerometry.

InterAct Consortium (2011): Total PA index = cross-tabulation of level of occupational activity with combined recreational and household activities (MET-hr/week) - inactive, moderately inactive, moderately active, active. Cambridge index = index based on occupational, cycling and sports activity (h/week). Recreational index = index based on quartiles of the sum of walking, cycling, and sports (MET-hr/week). Fisher-transformed correlations were estimated for each country, and random effect meta-analysis methods were used to calculate the overall combined correlation of PAEE (kJ/kg/day) measured by the combined HR and movement sensor with the three PA indices from the EPAQ-s.

Jacobi (2009): Sedentary time = time spent watching TV/video or playing video games and time spent using a computer.

Kolbe-Alexander (2006): High counts = counts in high-intensity physical activity. Moderate min = time spent in moderate-intensity activity. Total counts = total counts for physical activity. Sitting = time spent sitting during a weekend day.

Kowalski (1997): PAQ-C score = calculated as the mean of the nine items, ranging from 1 to 5. Total counts = total counts measured by the Caltrac that reflect vertical acceleration of the body.

Kurtze (2008): EE = Energy Expenditure in MJ/day. PAL = average Physical Activity Level in 7 days, calculated as total EE divided by basal metabolic rate (BMR). Results from Bland-Altman analysis are combined results for total moderate, vigorous and walking activity.

MacFarlane (2007): Total MVPA min/week(Q) = total weighted minutes, calculated as moderate + (2*vigorous). R2, slope = result from regression analysis between the Bland-Altman differences and averages. %Bias, LoA = bias and limits of agreement expressed as percentage of the mean score.

Mahabir (2006): Duration of validation not stated, likely to be 14 days. EE = Energy Expenditure in kcal/day.

Martinez-Gomez (2010): Correlation coefficient = correlation between the two instruments for the 3 day mean.

Martinez-Gomez (2011): PAQ-A score = mean score of 8 activity items scored on a 5-point scale.

Matton (2007): EE = Energy Expenditure in kcal/week. PAL = Physical Activity Level, calculated as total EE divided by 168 (number of hours per week) and the reported body weight. TV hr/week = time per week spent watching television or videos or playing computer games; this time was recalled in the FPACQ and also directly coded in the written activity log of the accelerometer reflecting the same activity domain. T-test = paired t-test to compare the magnitude of activity variables calculated from the RT3 and FPACQ (absolute validity).

Nang (2011): VPA(Q) = 3–6 METs kcal/day, MPA(Q) = >6 METs kcal/day. VPA(Acc), MPA(Acc) = moderate and vigorous physical activity using cutoff points of 3 METs between light and moderate activity, and 6 METs between moderate and vigorous activity.

Nicaise (2011): PA variables from questionnaire assessed in MET-min/week. Steps(Acc) = number of steps taken per day (from the dual mode function).

Pettee-Gabriel (2009): Participants wore the accelerometer on average 6.3 ± 0.7 days/week or 30.7 ± 4.8 days during 35 days of observation and 14.4 ± 1.1 hours/day.

Philippaerts (1999): Total activity index = index calculated from the work, sport and leisure time index. ADMR = Average Daily Metabolic Rate in MJ/day. PAL = Physical Activity Level, determined as the ratio of ADMR (Average Daily Metabolic Rate) over SMR (Sleeping Metabolic Rate). 7 day index = index in kcal/day calculated from hours spent on vigorous (8 times resting metabolic rate) and moderate (4 times resting metabolic rate) activities and including sleeping time and the time spent on light activities (remaining time) during the last seven days. TEE = Total Energy Expenditure in kcal/day.

Philippaerts (2001): Total activity index = index calculated from the work, sport and leisure time index. TEE = Total Energy Expenditure in kcal/day.

Rangul (2008): Frequency = out of breath or sweat sessions per week. Duration = out of breath or sweat hours per week. TEE = Total Energy Expenditure in MJ/week. PAL = Average Physical Activity Level for 7 days, calculated as total energy expenditure divided by basal metabolic rate.

Richardson (2001): Visit 10/11 = comparison for direct validation at study visit 10/11. Caltrac MET-min/day are obtained by dividing average 24-hour Caltrac readings (kcal/day) by the Caltrac's estimate of 24-hour resting energy expenditure and multiplying by 1440 min/day.

Scerpella (2002): 2x 3 Days = two measurement periods of 2 weekdays and 1 weekend day. Score calculations not specifically reported.

Schmidt (2006): Total activity score = activity score of all four domains, calculated as: (household/caregiving index*0.25 + occupational index*0.25 + active living index*0.25 + sports/exercise index*0.25)*4. Counts/min = mean accelerometer output per 1-min epoch, reflecting raw accelerometer output without any categorization according to activity intensity. Weighted activity score = activity score of all four domains, calculated as: (household/caregiving index*0.50 + occupational index*0.20 + active living index*0.25 + sports/exercise index*0.05)*4.

Slinde (2003): eMLTPAQ = extended MLTPAQ with additional questions about inactivity during leisure time. TEE = Total Energy Expenditure in MJ/day. Sedentary min/day = time spent watching TV, videos and computer time.

Smitherman (2009): JPAC total score = total score calculated by summing the 4 index scores (active living, work, home/family/yard/garden, sport/exercise index) and can range from 3 to 20.

Starling (1999): TEE = Total Energy Expenditure in kcal/day.

Staten (2001): TEE = Total Energy Expenditure in kJ/day, -ic = average total energy expenditure with RMR measured by indirect calorimetry, -mif = average total energy expenditure with RMR calculated using the Mifflin et al. Equation, -met = average total energy expenditure with RMR calculated using the MET conversion.

Tomioka (2011): Young old = age 65–74, old old = age 75–89.

Treuth (2004): GAQ score yesterday = summary score estimated from 18 physical activities reliably recalled and frequently performed on the previous day (yesterday) or usually. The GAQ summary scores were computed as the total MET-weighted score divided by the number of nonmissing items. Average counts/min: all counts measured between 6 AM to 12 midnight averaged per minute. Baseline: n = 197, follow-up: n = 168.

Trinh (2009): Dry season is baseline (n = 135). Measurements in wet season (n = 116) were performed 2 months after baseline during dry season. Sedentary time = time spent sitting or reclining. Mean (95 % LoA) = log-transformed average difference between the time spent in MVPA measured with GPAQ (averaged over dry and wet season) and accelerometer with 95 % limits of agreement.

Troped (2007): MPA = number of days participating in ≥ 30 min of moderate PA during past 7 days. VPA = number of days participating in ≥ 20 min of vigorous PA during past 7 days. Sensitivity = probability of the YRBS items correctly classifying students as meeting recommendations. Specificity = probability of YRBS items correctly classifying students as not meeting the recommended level of PA. Kappa range = range of kappa coefficients between Actigraph measures (accumulated minutes, minutes in bouts ≥ 5 min, minutes in bouts ≥ 10 min, sustained minutes of PA) and the YRBS measure. Cut points used are based on the Freedson age-dependent equation; METs = 2.757 + (0.0015*counts per minute) - (0.0896*age[yr]) - (0.000038*counts per minute*age[yr]).

Washburn (1999): Total PASE score was computed by multiplying the amount of time spent in each activity (hours/week) or participation (yes/no) in an activity by the empirically derived item weights and summing over all activities. Accelerometer readings are averaged over five-minute epoch periods.

Washburn (2003): Interviewer reliability tested: ICC = 0.85. TEE = Total Energy Expenditure, including sleep, in kJ/day. PAEE = Physical Activity Energy Expenditure, i.e. light, moderate, hard and very hard activities, excluding sleep.

Weston (1997): 1 Day = 1 day after school hours. TEE = Total relative Energy Expenditure in kcal/kg/day. EE = mean estimated rate of Energy Expenditure in kcal/kg/hr for the entire after school period, derived from both mode and intensity. %HRR = mean percent of heart rate range. HRR was calculated as HRmax - HRrest, where HRmax was estimated from the formula 220 - age, and HRrest was taken from the mean of the five lowest 1-min heart rates recorded during the measurement period. All heart rates (HRraw) were converted to a %HRR using the formula HRraw/HRR*100 and averaged to produce mean %HRR.

Wolin (2008): 1-Min bout = accelerometer bout lasting at least 1 minute. 10-Min bout = accelerometer bout lasting at least 10 minutes.

Of the 65 studies that report new results for the validity of existing questionnaires, 14 studies [55,61,69,75,81,83,84,87,89,91,94,96,97,103] tested two or more questionnaires. Forty-five studies used accelerometry as the criterion, and the remaining used DLW (n = 8) [71,75,84,89,93,94,96,116], pedometry (n = 3) [79,101,105], HR monitoring (n = 1) [104], MiniLogger (n = 1) [81] or a combination of methods (n = 5) [51,60,61,74,114]. Spearman and Pearson correlations were the most commonly used statistical measures for assessing validity; four studies reported 95 % confidence intervals with these correlations [51,102,103,112] and three studies solely reported results using the Bland-Altman levels of agreement method [84,94,104]. Median correlations between reported sedentary behaviours and inactivity from objective measures were calculated: Spearman r = 0.23, Pearson r = 0.435.

Youth

Median validity correlations for the youth were as follows: Spearman r = 0.25, Pearson r = 0.38. Many PAQs (SAPAC [59], HBSC [54], IPAQ-s [54], GSQ [70] and GAQ [118]) demonstrated low validity coefficients (r < 0.2) in youth and only one instrument (PDPAR [60]) was regarded as highly valid (r = 0.76) when compared with physical activity assessed by the Caltrac accelerometer.

Adults

Median validity correlations for adults were as follows: Spearman r = 0.30, Pearson r = 0.46. Validity correlations were generally low for most PAQs, except for the FPACQ [111] compared with accelerometry in multiple subcategories (r = 0.39–0.85) and the BAQ (r = 0.68–0.69), FCPQ (r = 0.34–0.61) and TCQ (r = 0.63–0.64) for estimated TEE compared with TEE measured with the DLW method [96]. Pettee-Gabriel et al. compared five different PAQs with accelerometry from the Actigraph accelerometer and showed acceptable validity for all instruments; PMMAQ (r = 0.59–0.60), PWMAQ (r = 0.56–0.60), NHS-PAQ (r = 0.42–0.46), AAS (r = 0.46–0.50), WHI-PAQ (r = 0.45–0.47) [91]. Several studies, including the 7DR-O [87], MAQ [109], CAPS [89], IPAQ [55,90] and the IPAQ-s [54,98,99], demonstrated poor validity.

Elderly

Median validity correlations for the elderly were as follows: Spearman r = 0.40, Pearson r = 0.345. Bonnefoy et al. tested the validity of 10 previously developed well known PAQs using DLW as the criterion measure [75]. The results of this study suggested that the Stanford Usual Activity questionnaire performed best (r = 0.63–0.65). Other studies in elderly generally found low correlations between self-reported PA with objective measures, also demonstrated by the generally weak performances of the YPAS in several studies (r = 0.11–0.61) [75,76,81,83,84], and PASE in one of the studies (r = 0.16–0.17) [80].

Discussion

This systematic review covered the most recent 15-year period. We identified 31 studies that adequately tested newly developed PAQs for both validity and reliability during this period. This suggests that whilst assessing physical activity by means of objective monitoring has become widespread also when examining population levels of activity [119-121], PAQs remain an active area of research and are now generally considered complementary to any objective measure. Several previous reviews have assessed the reliability and validity of PAQs with a special focus on their overall performance [9], or performance in specific age groups [11,14,15]. Conversely, we compared whether newly developed PAQs performed better than older PAQs, as this will inform researchers and practitioners when choosing an existing PAQ or developing a new instrument for assessing physical activity. We therefore comprehensively summarized the results to allow an adequate appraisal of the existing PAQs performance across domains and physical activity intensities.

In concordance with previous reviews [11,14,15], very few questionnaires showed acceptable reliability and validity across age groups. Developing new PAQs requires careful consideration of the study design in terms of target population, sample size, age group, recall period, dimension and intensity of PA, relative and absolute validity, standardized quality criteria and appropriate comparison measures. The lack of formulating a priori hypotheses was recently highlighted as a limitation in most studies examining the validity of PAQs [11] and comprehensive key criteria for physical activity and sedentary behaviour validation studies have been proposed [122,123].

Since the comprehensive review by Kriska and Caspersen [9], it is apparent that more appropriate criterion methods, in particular accelerometry, have been used to test the validity of PAQs. Yet, a considerable number of studies were excluded from the present review due to an inappropriate criterion method (e.g. aerobic fitness). Many studies reported reliability and validity results for existing and well established questionnaires, which suggests that these instruments are still frequently used. Importantly, newly developed PAQs do not seem to perform any better than existing instruments in terms of reliability and validity. Unfortunately, we were not able to conduct a formal meta-analysis due to differences in reported outcomes, different criterion measures and different time frames between questionnaires.

Total energy expenditure (TEE) was frequently used as the outcome measure of the PAQ and the validity scores from these types of instruments are usually high. However, the results from many of these studies should be interpreted carefully. This is because TEE from any self-report incorporates an estimate of resting energy expenditure (REE) generally calculated from body weight, sex and age. REE explains most of the variation in TEE and, consequently, high correlations may be generated when comparing TEE from self-report with measured or estimated TEE from the criterion method. This is particularly problematic when those same predictions of REE are used by both the criterion method and the self-reported calculation of energy expenditure. Therefore, other outputs (e.g. time spent in different intensity levels, physical activity energy expenditure normalised for body size) from the criterion method appear more appropriate to serve as criterion measures. In these studies correlations between the criterion measure and self-reported PA are considerably weaker than those for TEE, although the concerning PAQs may still be considered valid as demonstrated in some studies [31,116]. The notion of validity, however, is a matter of degree, rather than an all-or-nothing determination.

The validity correlation coefficients from the vast majority of existing and newly developed PAQs were considered poor to moderate and usually only acceptable when results were presented as Pearson or Spearman correlation coefficients. This suggests that most PAQs may be valid for ranking individuals’ behaviour whereas their absolute validity is limited to quantify PA. Although our summary of the correlations in a single median value should be interpreted with caution, we did not observe any substantial difference between newly and existing PAQs. This may suggest that, despite considerable effort, accurate and precise self-report physical activity instruments are still scarce [124]. Many of the newly developed instruments collected information in various domains of physical activity including transportation and housework. Despite this, it appears almost impossible to obtain a valid estimation of a highly variable behaviour such as free-living physical activity by self-report. While results from large scale observational cohort studies have convincingly demonstrated the beneficial effects of self-reported physical activity on various health outcomes including all-cause mortality, coronary and cardiovascular disease morbidity and mortality, some types of cancer, and type 2 diabetes, the detailed dose–response associations are still unknown [125]. Increased sample size is usually considered to improve precision but may not overcome issues about accuracy. Further, a large sample size does not overcome misclassification due to differential measurement error. Therefore, future studies should consider including an objective measure of physical activity in addition to self-report or consider recommendations to reduce self-report error [126].

With few exceptions, most PAQs reviewed showed acceptable to good reliability with only minor differences between existing and newly developed PAQs. The median reliability correlations were acceptable to good in youth (0.64 – 0.65), adults (0.64 – 0.79), and the elderly (0.60 – 0.65) for existing PAQs; and marginally higher for newly developed PAQs in youth (0.69 – 0.80), adults (0.74 – 0.765), and the elderly (0.70). However, only 3 of 11 newly developed PAQs [21,23,24] showed consistently good reliability.

For existing PAQs, median validity correlations were poor to acceptable in youth (0.25 – 0.38), adults (0.30 – 0.46), and elderly (0.345 – 0.40); and essentially similar for newly developed PAQs in youth (0.22 – 0.41), adults (0.27 – 0.28), and the elderly (0.41).

Only four of the reviewed questionnaires, the IPAQ-s (existing) [85], the FPACQ (existing) [111], PDPAR (existing) [60] and the RPAR (new) [21] showed acceptable to good results for both reliability and validity. Sedentary behaviour appeared to be one of the most difficult domains to assess with questionnaires as demonstrated by the poor correlations with objectively measured sedentary time, although arguably, there are also limitations of the criterion measures, which contribute to poorer agreement between methods. About one third (n = 11) of the studies reporting data on newly developed PAQs assessed both validity and reliability for sedentary behaviour. 17 and 15 studies reported data on validity and reliability for sedentary behaviour from existing PAQs, respectively.

Accuracy of PA recall may be increased at the second retest administration by an increased physical activity awareness as a result of completing the questionnaire previously [105]. Many of the reviewed studies did not specify details about their reliability testing, making it difficult to distinguish test-retest reliability of the instrument from a measure of stability of physical activity. It is therefore complex to assign the correlations to either the reliability of the instrument or to the stability of the behaviour of the participant. Assessing test-retest reliability for a last seven day PAQ is generally more straight forward compared to a PAQ assessing usual or last year physical activity. This is because when examining the reliability of a last seven days instrument the respondents should be prompted to report their PA during exactly the same week at two different occasions separated in time. However, this must be weighed against administering the test and retest too close in time that the respondent remembers the answers given to the first administration, resulting in inflation of reliability estimates from correlated error. Several other study details than timeframe of recall can be identified to have a marked influence on the study results, such as socio-cultural background, sex, age, literacy, and cognitive abilities.

The DLW method is usually considered the most accurate criterion method available for measuring TEE and PAEE. However, as discussed above, when using the DLW method and other objective methods which provide outputs in TEE as the criterion instrument, individual variability in body weight needs to be considered. It is therefore recommended that data from these methods should be expressed as PAEE, with and without normalisation for body weight in subsequent validation studies. Combined heart rate and movement sensing may be more accurate than either of the methods used alone for measuring time spent at different intensity levels [31]. However, most of the newly developed PAQs used a single accelerometer mounted at the hip as the criterion method, possibly due to its reasonable costs and feasibility in large study groups. Accelerometry also has some inherent limitations including its inability to accurately assess the intensity of specific types such as weight-bearing activities, cycling, and swimming [33]. Further, the choice of somewhat arbitrary cut-off points [127-129] to classify intensities of activity when using accelerometry as a criterion method has been documented before. The use of accelerometers is especially problematic to validate time spent in different intensities of physical activity from PAQs and this also hampers comparison of studies [33]. Usually criterion measures assess overall PA (e.g. time in MVPA, PAEE) which precludes a direct test of the validity of self-reported domain specific activity (e.g. occupation). It is therefore not surprising that some PAQs [e.g. 86] which only asses a specific domain of activity demonstrate low validity when compared with overall physical activity from the criterion instrument. More research is therefore needed to compare time stamped criterion data with domain specific self-reported activity and to develop criterion instruments which can accurately categorise types of activities. Adopting a conceptual framework for physical activity [130] in combination with standardized procedures when developing and validating PAQs [122,123] is highly recommended.

Pearson and Spearman correlations may not be the most appropriate statistical methods to use for reporting results on the validity of PAQs. ICC is considered a more appropriate method for continuous measures on the same scale, whereas weighted kappa is a better choice of method for categorical measures [131,132]. When reporting validation results researchers are encouraged to report absolute validity in terms of mean bias with limits of agreement as well as the error structure of the instrument across the measurement range. We noted that many of the newly developed instruments reported results on absolute validity by means of the Bland-Altman method, which is a simple, intuitive and easy to interpret method to analyse assess measurement error [133]. Descriptive details of the study population may be helpful to explain any heterogeneity in the findings from different studies. Researchers can individually interpret all data for quality and applicability.

In summary, we systematically reviewed studies assessing both reliability and validity of PAQs in various domains, across age groups, and with a focus on total PA and sedentary time. PAQs are inherently subject to many limitations and the choice of PAQs should be dictated by the research question and the population under study. Considerations for researchers when using PAQs in practice have been identified and new research should consider including an objective method for assessing physical activity in addition to any self-report [134]. This review has identified a limited number of PAQs that appear to have both acceptable reliability and validity. Newly developed PAQs do not appear to perform substantially better than existing PAQs in terms of reliability and validity.

Competing interest

The authors declare they have no competing interest to declare.

Authors’ contribution

HH performed an updated literature search and drafted the manuscript. SB contributed to the design of the study and critically revised the manuscript. JW and HB contributed to the design of the study and performed the original literature search.UE contributed to the design of the study, contributed to the literature search and solved issues about inclusion of manuscripts, and critically revised the manuscript.All authors approved the final version of the manuscript.

Contributor Information

Hendrik JF Helmerhorst, Email: hendrik_j_f@yahoo.com.

Søren Brage, Email: soren.brage@mrc-epid.cam.ac.uk.

Janet Warren, Email: janetwarren73@yahoo.co.uk.

Herve Besson, Email: bessonherve@googlemail.com.

Ulf Ekelund, Email: ulf.ekelund@nih.no.

Acknowledgments

Some of the questionnaires in this review have been made available to the authors and are available on the recently launched UK Medical Research Council Toolkit of Diet and Physical Activity Measurement [8].

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