Abstract
Objective
To systematically review the evidence evaluating validity or reliability of self-reported
and device-based instruments, to measure physical activity (PA) in individuals who
use a wheelchair, and to make recommendations for the selection of PA outcomes tools.
Data Sources
PubMed, Embase, and CINAHL were systematically searched.
Study Selection
Studies reporting measurement properties of instruments to assess PA in individuals
who use a wheelchair.
Data Extraction
The Consensus-Based Standards for the Selection of Health Status Measurement Instruments
checklist was used to assess the methodological quality of the included studies. The
measurement properties of instruments assessing PA were examined.
Data Synthesis
The search yielded 5341 records, 61 were considered relevant, 21 articles were included.
A best evidence synthesis was performed on 9 studies including 4 self-reported instruments
and 13 studies including 8 device-based instruments. One study evaluated both self-reported
and device-based instruments. The overall methodological quality of all studies ranged
from poor to excellent. Variable levels of evidence were found for both the validity
and reliability for self-reported instruments and for criterion validity for device-based
instruments.
Conclusions
The Physical Activity Scale for Individuals with Disabilities (PASIPD) and The Physical
Activity Recall Assessment for People with Spinal Cord Injury (PARA-SCI) seem the
most promising self-reported instruments for measuring the intensity of PA. Device-based
instruments that can be used for measuring both the intensity and type of PA are the
GENEActiv, Actigraph GT3X+, Actiheart, or the Physical Activity Monitor System (PAMS),
showing moderate evidence for a positive rating of criterion validity. For measuring
the type of PA, the PAMS and VitaMove are suitable, showing both good evidence for
a positive rating of criterion validity.
Keywords
List of abbreviations:
COSMIN (Consensus-Based Standards for the Selection of Health Measurement Instruments), CP (cerebral palsy), EE (energy expenditure), ICC (intraclass correlation coefficient), LTPAQ-SCI (Leisure Time Physical Activity Questionnaire for people with spinal cord injury), MWU (manual wheelchair user), PA (physical activity), PAEE (physical activity–associated energy expenditure), PAI-SCI (Physical Activity Inventory for patients with spinal cord injury), PAMS (Physical Activity Monitor System), PARA-SCI (Physical Activity Recall Assessment for People with Spinal Cord Injury), PASIPD (Physical Activity Scale for Individuals with Physical Disabilities), SB (spina bifida), SCI (spinal cord injury)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Physical activity, sedentary behaviours, and cardiovascular health: when will cardiorespiratory fitness become a vital sign?.Can J Cardiol. 2016; 32: 505-513
- Prevalence of risk factors for cardiovascular disease stratified by body mass index categories in patients with wheelchair-dependent paraplegia after spinal cord injury.J Rehabil Med. 2012; 44: 440-443
- Self-reported physical activity and risk markers for cardiovascular disease after spinal cord injury.J Rehabil Med. 2014; 46: 886-890
- Different risk factor patterns for metabolic syndrome in men with spinal cord injury compared with able-bodied men despite similar prevalence rates.Arch Phys Med Rehabil. 2007; 88: 1198-1204
- Physical activity for the chronically ill and disabled.Sports Med. 2000; 30: 207-219
- Sedentary behaviors and health outcomes among adults: a systematic review of prospective studies.Am J Prev Med. 2011; 40: 174-182
- Sedentary behaviors and subsequent health outcomes in adults a systematic review of longitudinal studies, 1996-2011.Am J Prev Med. 2011; 41: 207-215
- Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis.Diabetologia. 2012; 55: 2895-2905
- Valid detection of self-propelled wheelchair driving with two accelerometers.Physiol Meas. 2014; 35: 2297-2306
- Physical and sedentary activity in adolescents with cerebral palsy.Dev Med Child Neurol. 2007; 49: 450-457
- Duration and patterns of habitual physical activity in adolescents and young adults with cerebral palsy.Dev Med Child Neurol. 2014; 56: 673-680
- Measurement and description of physical activity in adult manual wheelchair users.Disabil Health J. 2008; 1: 236-244
- Development of a methodological PubMed search filter for finding studies on measurement properties of measurement instruments.Qual Life Res. 2009; 18: 1115-1123
- Measurement in medicine.3rd ed. Cambridge University Press, New York2014
- Guideline for systematic reviews of outcome measurement instruments.(Available at:) (Accessed May 5, 2017)
- Find duplicates among the PubMed, EMBASE, and Cochrane Library databases in systematic review.PLoS One. 2013; 8e71838
- To total amount of activity..... and beyond: perspectives on measuring physical behavior.Front Psychol. 2013; 4: 463
- The physical activity scale for individuals with physical disabilities: development and evaluation.Arch Phys Med Rehabil. 2002; 83: 193-200
- Comparison of methods to assess energy expenditure and physical activity in people with spinal cord injury.J Spinal Cord Med. 2012; 35: 35-45
- Validation of the physical activity scale for individuals with physical disabilities.Arch Phys Med Rehabil. 2011; 92: 923-928
- Evaluation of the physical activity scale for individuals with physical disabilities in people with spinal cord injury.Spinal Cord. 2010; 48: 542-547
- The physical activity recall assessment for people with spinal cord injury: validity.Med Sci Sports Exerc. 2006; 38: 208-216
- Quantification of physical activity and sedentary time in adults with cerebral palsy.Med Sci Sports Exerc. 2015; 47: 1719-1726
- Development and evaluation of an activity measure for people with spinal cord injury.Med Sci Sports Exerc. 2005; 37: 1099-1111
- Reliability and validity tests of the leisure time physical activity questionnaire for people with spinal cord injury.Arch Phys Med Rehabil. 2012; 93: 677-682
- Physical activity inventory for patients with spinal cord injury.SCI Nursing. 2008; 25: 20-29
- Validation of the use of Actigraph GT3X accelerometers to estimate energy expenditure in full time manual wheelchair users with spinal cord injury.Spinal Cord. 2013; 51: 898-903
- Predicting physical activity energy expenditure in manual wheelchair users.Med Sci Sports Exerc. 2014; 46: 1849-1858
- Influence of accelerometer type and placement on physical activity energy expenditure prediction in manual wheelchair users.PLoS One. 2015; 10e0126086
- Evaluation of activity monitors in manual wheelchair users with paraplegia.J Spinal Cord Med. 2011; 34: 110-117
- Estimation of energy expenditure for wheelchair users using a physical activity monitoring system.Arch Phys Med Rehabil. 2016; 97: 1146-1153
- Predicting physical activity energy expenditure in wheelchair users with a multisensor device.BMJ Open Sport Exerc Med. 2015; 1
- Validity of the detection of wheelchair propulsion as measured with an activity monitor in patients with spinal cord injury.Spinal Cord. 2005; 43: 550-557
- Fit for the Future Consortium. Validation of an activity monitor for children who are partly or completely wheelchair-dependent.J Neuroeng Rehabil. 2015; 12: 11
- Detection of physical activities using a physical activity monitor system for wheelchair users.Med Eng Phys. 2015; 37: 68-76
- Actigraphy as a measure of physical activity for wheelchair users with spinal cord injury.Nurs Res. 2004; 53: 136-143
- Identifying physical activity type in manual wheelchair users with spinal cord injury by means of accelerometers.Spinal Cord. 2015; 53: 772-777
- Measuring physical activity in spinal cord injury using wrist-worn accelerometers.Am J Occup Ther. 2019; 73 (7301205090p1-730120509010)
- Manual wheeled mobility - current and future developments from the human engineering research laboratories.Disabil Rehabil. 2010; 32: 2210-2221
- Quality criteria were proposed for measurement properties of health status questionnaires.J Clin Epidemiol. 2007; 60: 34-42
- Validity of consumer-grade activity monitor to identify manual wheelchair propulsion in standardized activities of daily living.PLoS ONE. 2018; 13e0194864
- The accuracy of the detection of body postures and movements using a physical activity monitor in people after a stroke.Sensors (Basel). 2018; 18: E2167
- A systematic review of the clinimetric properties of measures of habitual physical activity in primary school aged children with cerebral palsy.Res Dev Disabil. 2013; 34: 2419-2432
- Should we reframe how we think about physical activity and sedentary behaviour measurement? Validity and reliability reconsidered.Int J Behav Nutr Phys Act. 2016; 13: 32
- 6.4 Criterion validity.Measurement in medicine. practical guide to biostatistics and epidemiology. 3rd ed. Cambridge University Press, New York2013: 159
- Development and evaluation of a gyroscope-based wheel rotation monitor for manual wheelchair users.J Spinal Cord Med. 2013; 36: 347-356
- Estimation of energy expenditure in wheelchair-bound spinal cord injured individuals using inertial measurement units.Front Neurol. 2018; 9: 478
- The six-minute walk test in chronic pediatric conditions: A systematic review of measurement properties.Phys Ther. 2013; 93: 529-541
- Measurement properties of performance-based measures to assess physical function in hip and knee osteoarthritis: a systematic review.Osteoarthritis Cartilage. 2012; 20: 1548-1562
- Evaluation of custom energy expenditure models for SenseWear armband in manual wheelchair users.J Rehabil Res Dev. 2015; 52: 793-803
- Physical activity classification utilizing SenseWear activity monitor in manual wheelchair users with spinal cord injury.Spinal Cord. 2013; 51: 705-709
- Predicting energy expenditure of manual wheelchair users with spinal cord injury using a multisensor-based activity monitor.Arch Phys Med Rehabil. 2012; 93: 1937-1943
Article info
Publication history
Published online: October 10, 2019
Footnotes
Supported by the Dutch Foundation Innovation Alliance (grant no. PRO-4-03), part of the Dutch Organization for Scientific Research.
Disclosures: none.
Identification
Copyright
© 2019 by the American Congress of Rehabilitation Medicine
