Sports Medicine

, Volume 40, Issue 7, pp 525–537 | Cite as

Qualitative Attributes and Measurement Properties of Physical Activity Questionnaires

A Checklist
  • Caroline B. Terwee
  • Lidwine B. Mokkink
  • Mireille N. M. van Poppel
  • Mai J. M. Chinapaw
  • Willem van Mechelen
  • Henrica C. W. de Vet
Review Article


The large number of available physical activity (PA) questionnaires makes it difficult to select the most appropriate questionnaire for a certain purpose. This choice is further hampered by incomplete reporting and unsatisfactory evaluation of the content and measurement properties of the questionnaires. We provide a checklist for appraising the qualitative attributes and measurement properties of PA questionnaires, as a tool for selecting the most appropriate PA questionnaire for a certain target population and purpose. The checklist is called the Quality Assessment of Physical Activity Questionnaire (QAPAQ). This review is one of a group of four reviews in this issue of Sports Medicine on the content and measurement properties of physical activity questionnaires.

Part 1 of the checklist can be used to appraise the qualitative attributes of PA questionnaires, i.e. the construct to be measured by the questionnaire, the purpose and target population for which it was developed, the format, interpretability and ease of use.

Part 2 of the checklist can be used to appraise the measurement properties of a PA questionnaire, i.e. reliability (parameters of measurement error and reliability coefficients), validity (face and content validity, criterion validity and construct validity) and responsiveness.

The QAPAQ can be used to select the most appropriate PA questionnaire for a certain purpose, but it can also be used to design or report a study on measurement properties of PA questionnaires. Using such a checklist will contribute to improving the assessment, reporting and appraisal of the content and measurement properties of PA questionnaires.


Physical Activity Measurement Property Qualitative Attribute Recall Period Physical Activity Pattern 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors received no funding for the conduct of this study or the writing of this review. The authors have no conflicts of interest that are directly relevant to the content of this review.


  1. 1.
    Chinapaw MJM, Mokkink LB, Poppel MNM, et al. Physical activity questionnaires for youth: a systematic review ofmeasurement properties. Sports Med 2010; 40 (7): 539–63PubMedCrossRefGoogle Scholar
  2. 2.
    Forsen L, Waaler Loland N, Vuillemin A, et al. Self-administered physical activity questionnaires for elderly: asystematic review of measurement properties. Sports Med 2010; 40 (7): 601–23PubMedCrossRefGoogle Scholar
  3. 3.
    van Poppel MNN, Chinapaw MJM, Mokkink LB, et al. Physical activity questionnaires for adults: a systematicreview of measurement properties. Sports Med 2010; 40 (7): 565–600PubMedCrossRefGoogle Scholar
  4. 4.
    Lagerros YT, Lagiou P. Assessment of physical activity and energy expenditure in epidemiological research of chronicdiseases. Eur J Epidemiol 2007; 22 (6): 353–62PubMedCrossRefGoogle Scholar
  5. 5.
    Altschuler A, Picchi T, Nelson M, et al. Physical activity questionnaire comprehension: lessons from cognitive interviews. Med Sci Sports Exerc 2009; 41 (2): 336–43PubMedCrossRefGoogle Scholar
  6. 6.
    Lagerros YT. Physical activity: the more we measure, the more we know how to measure. Eur J Epidemiol 2009; 24 (3): 119–22PubMedCrossRefGoogle Scholar
  7. 7.
    Pols MA, Peeters PH, Kemper HC, et al. Methodological aspects of physical activity assessment in epidemiologicalstudies. Eur J Epidemiol 1998; 14 (1): 63–70PubMedCrossRefGoogle Scholar
  8. 8.
    Feinstein AR. Clinimetrics. New Haven (CT): Yale University Press, 1987Google Scholar
  9. 9.
    Terwee CB, Bot SDM, de Boer MR, et al. Quality criteria were proposed for measurement properties of health statusquestionnaires. J Clin Epidemiol 2007; 60: 34–42PubMedCrossRefGoogle Scholar
  10. 10.
    Mokkink LB, Terwee CB, Knol DL, et al. Protocol of the COSMIN study: COnsensus-based Standards for the selectionof health Measurement INstruments. BMC Med Res Methodol 2006; 6: 2PubMedCrossRefGoogle Scholar
  11. 11.
    Rennie KL, Wareham NJ. The validation of physical activity instruments for measuring energy expenditure: problemsand pitfalls. Public Health Nutr 1998; 1 (4): 265–71PubMedCrossRefGoogle Scholar
  12. 12.
    Martinez SM, Ainsworth BE, Elder JP. A review of physical activity measures used among US Latinos: guidelines fordeveloping culturally appropriate measures. Ann Behav Med 2008; 36 (2): 195–207PubMedCrossRefGoogle Scholar
  13. 13.
    Wareham NJ, Rennie KL. The assessment of physical activity in individuals and populations: why try to be moreprecise about how physical activity is assessed? Int J Obes Relat Metab Disord 1998; 22 Suppl. 2: S30–8Google Scholar
  14. 14.
    Vanhees L, Lefevre J, Philippaerts R, et al. How to assess physical activity? How to assess physical fitness? Eur J Cardiovasc Prev Rehabil 2005; 12 (2): 102–14PubMedCrossRefGoogle Scholar
  15. 15.
    Ainsworth BE. How do I measure physical activity in my patients? Questionnaires and objective methods. Br JSports Med 2009; 43 (1): 6–9CrossRefGoogle Scholar
  16. 16.
    Craig CL, Marshall AL, Sjostrom M, et al. International physical activity questionnaire: 12-country reliability andvalidity. Med Sci Sports Exerc 2003; 35 (8): 1381–95PubMedCrossRefGoogle Scholar
  17. 17.
    Staten LK, Taren DL, Howell WH, et al. Validation of the Arizona Activity Frequency Questionnaire using doublylabeled water. Med Sci Sports Exerc 2001; 33 (11): 1959–67PubMedCrossRefGoogle Scholar
  18. 18.
    Baecke JA, Burema J, Frijters JE. A short questionnaire for the measurement of habitual physical activity inepidemiological studies. Am J Clin Nutr 1982; 36 (5): 936–42PubMedGoogle Scholar
  19. 19.
    Dolan SH, Williams DP, Ainsworth BE, et al. Development and reproducibility of the bone loading history questionnaire. Med Sci Sports Exerc 2006; 38 (6): 1121–31PubMedCrossRefGoogle Scholar
  20. 20.
    Tsubono Y, Tsuji I, Fujita K, et al. Validation of walking questionnaire for population-based prospective studiesin Japan: comparison with pedometer. J Epidemiol 2002; 12 (4): 305–9PubMedCrossRefGoogle Scholar
  21. 21.
    Ainsworth BE, Sternfeld B, Richardson MT, et al. Evaluation of the kaiser physical activity survey in women. Med Sci Sports Exerc 2000; 32 (7): 1327–38PubMedCrossRefGoogle Scholar
  22. 22.
    Gionet NJ, Godin G. Self-reported exercise behavior of employees: a validity study. J Occup Med 1989; 31 (12): 969–73PubMedCrossRefGoogle Scholar
  23. 23.
    Ainsworth BE, Jacobs Jr DR, Leon AS, et al. Assessment of the accuracy of physical activity questionnaire occupationaldata. J Occup Med 1993; 35 (10): 1017–27PubMedGoogle Scholar
  24. 24.
    Chasan-Taber L, Erickson JB, McBride JW, et al. Reproducibility of a self-administered lifetime physical activityquestionnaire among female college alumnae. Am JEpidemiol 2002; 155 (3): 282–9CrossRefGoogle Scholar
  25. 25.
    Kirschner B, Guyatt G. A methodological framework for assessing health indices. J Chron Dis 1985; 38: 27–36CrossRefGoogle Scholar
  26. 26.
    Lohr KN, Aaronson NK, Alonso J, et al. Evaluating quality of life and health status instruments: development ofscientific review criteria. Clin Ther 1996; 18 (5): 979–92PubMedCrossRefGoogle Scholar
  27. 27.
    Altman DG. Practical statistics for medical research. London: Chapman and Hall, 1991Google Scholar
  28. 28.
    Giraudeau B, Mary JY. Planning a reproducibility study: how many subjects and how many replicates per subject foran expected width of the 95 per cent confidence interval ofthe intraclass correlation coefficient. Stat Med 2001; 20: 3205–14PubMedCrossRefGoogle Scholar
  29. 29.
    Mokkink LB, Terwee CB, Patrick DL, et al. International consensus on taxonomy, terminology, and definitionsof measurement properties for health-related patientreportedoutcomes: results of the COSMIN study. J Clin Epidemiol. In pressGoogle Scholar
  30. 30.
    de Vet HCW, Terwee CB, Knol DL, et al. When to use agreement versus reliability measures. J Clin Epidemiol 2006; 59: 1033–9PubMedCrossRefGoogle Scholar
  31. 31.
    Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1 (8476): 307–10PubMedCrossRefGoogle Scholar
  32. 32.
    Wilbur J, Holm K, Dan A. A quantitative survey to measure energy expenditure in midlife women. J Nurs Meas 1993; 1 (1): 29–40PubMedGoogle Scholar
  33. 33.
    Streiner DL, Norman GR. Health measurement scales: a practical guide to their development and use. New York: Oxford University Press, 2003Google Scholar
  34. 34.
    McGraw KO, Wong SP. Forming inferences about some intraclass correlation coefficients. Psychol Method 1996; 1: 30–46CrossRefGoogle Scholar
  35. 35.
    Matton L, Wijndaele K, Duvigneaud N, et al. Reliability and validity of the Flemish Physical Activity Computerized Questionnaire in adults. Res Q Exerc Sport 2007; 78 (4): 293–306PubMedCrossRefGoogle Scholar
  36. 36.
    Rigby AS. Statistical methods in epidemiology: v. Towards an understanding of the kappa coefficient. Disabil Rehabil 2000; 22 (8): 339–44PubMedCrossRefGoogle Scholar
  37. 37.
    Nunnally JC, Bernstein IH. Psychometric theory. 3rd ed. New York: McGraw-Hill, 1994Google Scholar
  38. 38.
    McHorney CA, Tarlov AR. Individual-patient monitoring in clinical practice: are available health status surveysadequate? Qual Life Res 1995; 4: 293–307PubMedCrossRefGoogle Scholar
  39. 39.
    Patterson P. Reliability, validity, and methodological response to the assessment of physical activity via self-report. Res Q Exerc Sport 2000; 71 (2 Suppl.): S15–20Google Scholar
  40. 40.
    Plasqui G, Westerterp KR. Physical activity assessment with accelerometers: an evaluation against doubly labeledwater. Obesity (Silver Spring) 2007; 15 (10): 2371–9CrossRefGoogle Scholar
  41. 41.
    Brown WJ, Burton NW, Marshall AL, et al. Reliability and validity of a modified self-administered version of theActive Australia physical activity survey in a sample ofmid-age women. Aust N Z J Public Health 2008; 32 (6): 535–41PubMedCrossRefGoogle Scholar
  42. 42.
    Terwee CB, Dekker FW, Wiersinga WM, et al. On assessing responsiveness of health-related quality of life instruments:guidelines for instrument evaluation. Qual Life Res 2003; 12 (4): 349–62PubMedCrossRefGoogle Scholar
  43. 43.
    Deyo RA, Centor RM. Assessing the responsiveness of functional scales to clinical change: an analogy to diagnostictest performance. J Chron Dis 1986; 39: 897–906PubMedCrossRefGoogle Scholar
  44. 44.
    Troiano RP. Can there be a single best measure of reported physical activity? Am J Clin Nutr 2009; 89 (3): 736–7PubMedCrossRefGoogle Scholar
  45. 45.
    Cortina JM. What is coefficient alpha? An examination of theory and applications. J Appl Psychol 1993; 78: 98–104CrossRefGoogle Scholar
  46. 46.
    Fayers PM, Hand DJ. Causal variables, indicator variables and measurement scales: an example from quality of life. J R Statist Soc A 2002; 165: 233–61CrossRefGoogle Scholar
  47. 47.
    Streiner DL. Being inconsistent about consistency: when coefficient alpha does and doesn’t matter. J Pers Assess 2003; 80 (3): 217–22PubMedCrossRefGoogle Scholar
  48. 48.
    Mokkink LB, Terwee CB, Patrick DL, et al. The COSMIN checklist for assessing the methodological quality of studieson measurement properties of health status measurementinstruments: an international Delphi study. Qual Life Res 2010; 19: 539–49PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2010

Authors and Affiliations

  • Caroline B. Terwee
    • 1
  • Lidwine B. Mokkink
    • 1
  • Mireille N. M. van Poppel
    • 2
  • Mai J. M. Chinapaw
    • 2
  • Willem van Mechelen
    • 2
  • Henrica C. W. de Vet
    • 1
  1. 1.Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care ResearchVU University Medical CenterAmsterdamthe Netherlands
  2. 2.Department of Public and Occupational Health and the EMGO Institute for Health and Care ResearchVU University Medical CenterAmsterdamthe Netherlands

Personalised recommendations