Validity of the international physical activity questionnaire short form (IPAQ-SF) in adults : a systematic review

Abstract

Background According to the World Health Organization, sedentary lifestyle is a worldwide phenomenon nowadays and it is associated with many chronic diseases. Thus the promotion of active lifestyle is a public health priority. “The International Physical Activity Questionnaire Short Form” (IPAQ-SF) is recommended as an efficient and cost-effective tool for physical activity (PA) assessment. The validity of IPAQ-SF has been studied with inconsistent results within different age groups. This systematic review is aimed at analyzing and synthesizing validation tests of IPAQ-SF in adults.

Methods Published articles were searched with keywords of “International Physical Activity Questionnaire Short Form”, “IPAQ-SF”, “validation”, “validity”, and “adults” in bibliographic database “PubMed”, “Google scholar”, “Chinese National Knowledge Infrastructure” and “Wanfang Database”. Inclusion and exclusion criteria were applied and the results were extracted and summarized.

Results Twelve studies published from January 2006 to January 2015 were included in this systematic review. Four studies were from North America (USA 2, Canada 1, Mexico 1), 1 study from South America (Brazil), 3 studies from Asia (Japan, Hong Kong, China), 2 studies from Europe (Norway and Greece), and 2 studies from Africa (Nigeria). Sample size ranged from 102 to 629 and subjects were aged from 23 to 51. The 12 papers included 14 validation analyses, using gold standards of objective movement assessments (6), objective fitness assessments (6), double labeled water (1) and physical activity log (1).

For the total PA score, the range of Spearman correlation r were -0.02 to 0.38 (mean 0.21) overall, 0.12 to 0.38 (mean 0.24) for studies using movement-assessment tools as the gold standard, and -0.02 to 0.36 (mean 0.19) for studies using fitness-assessing tools as the gold standard. None of the studies achieved the acceptable level of Spearman correlation r of 0.5.

For the specific PA score, higher Spearman correlation r was obtained for vigorous PA score (range -0.26 to 0.47, mean 0.24) than moderate PA score (range -0.09 to 0.5, mean 0.13), and walking PA score (range -0.05 to 0.17, mean 0.09).

For the accuracy of IPAQ-SF, only 5 papers reported the absolute difference of metabolic equivalent task (MET) between IPAQ-SF and gold standard. IPAQ-SF over-estimated MET in 4 studies, with “IPAQ- SF MET/ Criterion MET” ratio ranged from 1.11 to 6.41; IPAQ-SF under-estimated MET in 1 study, with an “IPAQ-SF MET/ Criterion MET” ratio of 0.52.

Conclusions The validity of IPAQ-SF as measured by Spearman correlation r of 12 studies was low to moderate at best. Higher validity was obtained for vigorous PA than moderate PA and walking. IPAQ-SF also tended to overestimate MET. Given the difficulty of measuring PA objectively, IPAQ-SF is still useful in estimating physical activity, especially in large-scale studies. Future research should investigate the validity of IPAQ-SF in various subgroups (e.g. by age, sex, education level) to identify those with higher validity. Improved versions of IPAQ-SF and new scales could also be developed and examined.