Abstract
Denkinger MD, Lindemann U, Nicolai S, Igl W, Jamour M, Nikolaus T. Assessing physical
activity in inpatient rehabilitation: validity, practicality, and sensitivity to change
in the Physical Activity in Inpatient Rehabilitation Assessment.
Objective
To validate a novel assessment of inpatient physical activity.
Design
Prospective cohort study for the evaluation of a novel questionnaire for physical
activity in geriatric inpatients.
Setting
German geriatric inpatient rehabilitation unit.
Participants
Patients (N=96; 67 [72%] women; median age, 81y) with a variety of main underlying
diagnoses, including musculoskeletal diseases, hip fracture, cardiovascular diseases,
stroke, and others.
Interventions
Not applicable.
Main Outcome Measures
Ceiling and floor effects and administration time were measured. For criterion-related
concurrent validity (convergent and discriminative), the Physical Activity in Inpatient
Rehabilitation Assessment (PAIR) was administered in parallel to self-rated, proxy-rated,
and performance-based measures of physical function at admission. Measurements were
repeated at discharge and 4-month follow-up in the home environment, including a standard
physical activity questionnaire to determine predictive validity. Spearman correlation
coefficients were calculated to describe associations between parameters. Sensitivity
to change was estimated using standardized response means (SRMs).
Results
Administration time of the PAIR ranged from less than 1 to 4 minutes. Ceiling effects
occurred mainly at discharge (5%–14%), and floor effects (5%–11%), at admission. There
were no missing values. Associations between convergent and predictive validity measures
and functional measures (r=.43–.53, r=.49–.54, respectively) were clearly better when cognition was intact. Discriminative
validity expressed as effect sizes ranged from .27 to 1.44. The SRM to describe sensitivity
to change was .65 for the total score.
Conclusions
The PAIR is the first validated questionnaire to assess physical activity in geriatric
inpatients. It is practical and its validity and sensitivity to change are similar
to existing physical activity questionnaires for community-dwelling older persons.
Key Words
List of Abbreviations:
BAS (Brief Alzheimer Scale), BI (Barthel Index), IRIE (Inpatient Rehabilitation in Ehingen (study)), PAIR (Physical Activity in Inpatient Rehabilitation Assessment), PASE (Physical Activity Scale for the Elderly), SF-LLFDI (Short Form-Late Life Function and Disability Index), SPPB (Short Physical Performance Battery), SRM (standardized response mean)To read this article in full you will need to make a payment
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Article info
Footnotes
Supported by the Robert Bosch Foundation, Stuttgart, Germany and the Ministry of Science, Research and Arts, state of Baden-Württemberg, as part of the Geriatric Competence Center at Ulm University.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Reprints are not available from the author.
Identification
Copyright
© 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
