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

  • Hendrik Hendrik JF Helmerhorst1, 2,

    Affiliated with

    • Søren Brage1,

      Affiliated with

      • Janet Warren3, 4,

        Affiliated with

        • Herve Besson1 and

          Affiliated with

          • Ulf Ekelund1, 5Email author

            Affiliated with

            International Journal of Behavioral Nutrition and Physical Activity20129:103

            DOI: 10.1186/1479-5868-9-103

            Received: 19 February 2012

            Accepted: 15 August 2012

            Published: 31 August 2012

            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 [1012] 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.
            http://static-content.springer.com/image/art%3A10.1186%2F1479-5868-9-103/MediaObjects/12966_2012_Article_635_Fig1_HTML.jpg
            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 [1929] 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, 3335, 3941, 4347] 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, 5974], 12 in elderly [7586]; 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, 8793], and seven studies included only men [54, 75, 78, 9497]. 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, 98100].
            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 [119121], 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 [127129] 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.

            Declarations

            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].

            Authors’ Affiliations

            (1)
            Medical Research Council Epidemiology Unit
            (2)
            Academic Medical Center, University of Amsterdam
            (3)
            Medical Research Council Human Nutrition Resource centre
            (4)
            Danone Baby Nutrition (Nutricia Ltd)
            (5)
            Department of Sports Medicine, Norwegian School of Sport Sciences

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