Abstract
Objectives
Physical activity (PA) research during pregnancy relies heavily on indirect/subjective measures of PA, which may be less accurate than directly measured PA. We tested whether the Pregnancy Physical Activity Questionnaire (PPAQ) could accurately estimate PA by comparing PPAQ results to directly measured PA.
Methods
In a sample of 29 women who completed the PPAQ, PA was directly measured in the second trimester of pregnancy using Actical® accelerometers (valid day = 10+ hours; 4–7 valid days). Activity variables from the PPAQ were calculated using all questions, and also by only considering the leisure time section. Women were classified as ‘active’ or ‘non-active’ using Canadian PA guidelines for adults (150 minutes moderate to vigorous PA (MVPA)/ week, bouts of 10+ minutes). Bonferroni corrections were used to adjust for multiple comparisons. Data presented as mean ± standard deviation or median (interquartile range).
Results
The PPAQ overestimated MVPA by 12.12 (14.34) hours/week in the combined sample, and the difference remained substantial when investigating the non-active [overestimate = 11.54 (10.10) hrs/wk] and the active women [overestimate = 16 ± 11 hrs/wk] separately. PPAQ-measured PA variables did not correlate with any of their respective Actical®-measured variables (p > 0.008). The leisure time PPAQ questions overestimated MVPA by 1 ± 3 hrs/wk, with a positive correlation between PPAQ-leisure time MVPA and Actical®-measured MVPA (r= 0.565, p = 0.001).
Conclusion
The PPAQ significantly overestimates MVPA and does not provide an accurate estimate of PA in pregnancy. While PPAQ leisure time questions may help distinguish trends in PA, data from subjective questionnaires may result in misinterpretation of relationships between prenatal PA and health outcomes.
Key Words: Maternal health, accelerometry, quantitative evaluation, qualitative evaluation, physical activity
Résumé
Objectifs
La recherche sur l’activité physique (AP) durant la grossesse recourt largement aux indicateurs indirects/subjectifs de l’AP, lesquels peuvent être moins exacts que l’AP directement mesurée. Nous avons testé l’outil Pregnancy Physical Activity Questionnaire (PPAQ) pour voir s’il estime l’AP de façon exacte, en comparant les résultats du PPAQ aux résultats obtenus à partir de mesures directes de l’AP.
Méthode
Dans un échantillon de 29 femmes ayant rempli le PPAQ, nous avons directement mesuré l’AP au deuxième trimestre de la grossesse à l’aide d’accéléromètres Actical® (jour admissible = 10+ heures; 4–7 jours admissibles). Les variables d’activité du PPAQ ont été calculées en utilisant toutes les questions, et aussi en ne tenant compte que de la section sur le temps libre. Les femmes ont été classées comme étant «actives» ou «non actives» selon les Directives canadiennes en matière d’AP à l’intention des adultes (150 minutes d’activité physique d’intensité modérée à élevée (APIME)/semaine, en épisodes de 10+ minutes). Nous avons appliqué la correction de Bonferroni pour permettre les comparaisons multiples. Les données ont été présentées sous forme de moyenne ± écart type ou de médiane (écart interquartile).
Résultats
Le PPAQ a surestimé l’APIME par 12,12 (14,34) heures/semaine dans l’échantillon combiné, et la différence est demeurée importante lorsque nous avons étudié séparément les femmes non actives [surestimation = 11,54 (10,10) h/sem] et les femmes actives [surestimation = 16 ± 11 h/sem]. Les variables d’AP mesurées selon le PPAQ n’étaient en corrélation avec aucune des variables correspondantes mesurées par Actical® (p > 0,008). Les questions du PPAQ (temps libre) surestimaient l’APIME de 1 ± 3 h/sem, avec une corrélation positive entre l’APIME mesurée selon les questions du PPAQ (temps libre) et l’APIME mesurée par Actical® (r = 0,565, p = 0,001).
Conclusion
Le PPAQ surestime l’APIME de façon significative et n’offre pas une estimation exacte de l’AP durant la grossesse. Les questions du PPAQ portant sur le temps libre peuvent aider à dégager des tendances dans l’AP, mais les données de questionnaires subjectifs peuvent entraîner une fausse interprétation des relations entre l’AP prénatale et les résultats de santé.
Mots Clés: santé maternelle, accélérométrie, évaluation quantitative, évaluation qualitative, activité physique
Footnotes
Acknowledgements: The authors thank The Canadian Foundation for Women’s Health for funding this research through The W. Garfield Weston Foundation Award. We also acknowledge the Ontario Ministry of Research and Innovation Early Researcher Award for supporting the trainees of Kristi Adamo. Kendra Brett was supported by an Ontario Graduate Scholarship and an Ontario Graduate Scholarship in Science and Technology. Zachary Ferraro was supported by a Canadian Institutes of Health (CIHR) Postdoctoral Fellowship from the Institute of Human Development, Child and Youth Health. Adamo was supported by a CIHR Institute of Human Development, Child and Youth Health New Investigator Award.
Conflict of Interest: None to declare
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