International Physical Activity Questionnaire – Long Form

The IPAQ is a 27-item self-reported measure of physical activity for use with individual adult patients aged 15 to 69 years old. The IPAQ can be used clinically and in population research that compares physical activity levels between populations internationally.

Link to Instrument

Acronym IPAQ

Cost

Populations

Key Descriptions

Duration (minutes) and frequency (days) of physical activity in the last 7 days is measured in domains of:
1) Job-related
2) Transportation
3) Housework, house maintenance, caring for family
4) Recreation, sport, and leisure-time
5) Time spent sitting
Overall score calculated using responses to all questions.
Sub-scores can be calculated for:
1) Walking,
2) Moderate-intensity activity
3) Vigorous-intensity activity
4) Each domain
(Craig, 2003) Amount of physical activity places patient in 1 of 3 categories:
1) Low/inactive – do not meet criteria for categories 2 or 3
2) Moderate –meet 1 the following:
A) or more days with at least 20 minutes of vigorous activity
B) 5 or more days with at least 30 minutes of moderate-intensity activity or walking
C) 5 or more days of any combination of walking, moderate-intensity, or vigorous intensity activities with at least 600 MET-min/week
3) High –meet 1 of the following:
A) 3 or more days of vigorous-intensity activity and at least 1500 MET-minutes/week
B) 7 days of any combination of walking, moderate-intensity or vigorous intensity activities with a at least 3000 MET-minutes/week
Moderate-intensity activities have been established as between 3 and 6 METs.
Vigorous-intensity activities have been established as >6 METs.

Number of Items

Equipment Required

Writing utensil
Copy of IPAQ

Time to Administer

Depends on number of questions

Required Training

Reading an Article/Manual

Instrument Reviewers

Initially reviewed by Dawn Miller PT, ATC in April 2015.

ICF Domain

Considerations

Obese subjects may overestimate activity compared to objective accelerometer data, possibly due to rating intensity based on higher effort needed to perform any physical activity or may move more slowly (Kwak, 2012).
Use with caution in very rural or low literacy populations. (Craig, 2003).
IPAQ overestimates moderate and vigorous activity in the adult population, mainly in the household- and gardening-related activity categories (Bermúdez, 2013).

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Mixed Populations

Test/Retest Reliability

Adults:

(Craig, 2003; n = 2213 [long form]; 12 countries)

Excellent test-retest reliability for overall score (ICC = 0.81)
Excellent test-retest reliability for physical activity (ICC = 0.84-1.00)
Adequate test-retest reliability for sitting (ICC = 0.70)

(Rosenberg, 2008; n = 289; mean age 35.9 years)

Excellent test-retest reliability for sitting items for both sexes combined (ICC = 0.81)
- Excellent for sitting items for men (ICC = 0.83)
- Adequate for sitting items for women (ICC = 0.77)
(Alomari, 1993; n = 111; mean age 20.4 (1.3) years; College-enrolled)
- Excellent test-retest reliability for walking items per week (ICC = 0.97)
- Excellent test-retest reliability for moderate physical activity per week (ICC = 0.96)
- Excellent test-retest reliability for vigorous physical activity per week (ICC = 0.97)
- Excellent test-retest reliability for overall physical activity per week (ICC = 0.96)
- Excellent test-retest reliability for sitting per week (ICC = 0.97)
Criterion Validity (Predictive/Concurrent)

Adults: (Hagströmer, 2006; n = 46, 19-62 years old, mean age 40.7 ± 10.3 years)
- Excellent concurrent validity: correlations of time spent in vigorous physical activity compared to accelerometer monitoring (ρ = 0.71)
- Adequate concurrent validity: correlation of total time spent in physical activity, in combined vigorous and moderate physical activity compared to accelerometer monitoring (ρ = 0.55, ρ = 0.36)
- Poor concurrent validity: correlation of time spent in moderate physical activity and total time spent sitting compared to accelerometer monitoring (ρ = 0.20, ρ = 0.17 respectively)
- Excellent concurrent validity: correlations of time spent in sitting and physical activity at work compared to log book monitoring (ρ = 0.75, ρ = 0.64 respectively)
- Adequate concurrent validity: correlations of time spent in physical activity at home and during leisure time compared to log book monitoring (ρ = 0.47, ρ = 0.58 respectively)
(Rosenberg, 2008; n = 289; mean age 35.9 years)
- Adequate correlation of sitting time and accelerometer recorded measurements for both sexes and for women only (ρ = 0.34, ρ = 0.43 respectively)
- Poor correlation of sitting time for men only (ρ = 0.24) (Kwak, 2012; n = 441; mean age 49.4 years – 18-67 years old)
- Adequate concurrent validity: correlation with time spent on occupational physical activity for both sexes, for men, and for women compared with accelerometer (r = 0.46, r = 0.44, r = 0.49 respectively)
- Adequate concurrent validity: correlation with time spent on occupational physical activity for normal weight and overweight workers compared with accelerometer (r = 0.44, r = 0.55 respectively)
- Poor concurrent validity: correlation with time spent on occupational physical activity for obese workers compared with accelerometer (r = 0.27) (Craig, 2003; n = 744 [long form vs. accelerometer]; 18-65 years old, 12 countries)
- Adequate concurrent validity for all physical activity and total sitting time compared to accelerometer (ρ = 0.33) (Chastin, 2014; n = 69; 18-65 years old)
- Poor concurrent validity: correlation weekday and weekend sitting time compared with accelerometer (r = 0.17, r = 0.01 respectively) (Alomari, 1993)
- Poor concurrent validity of vigorous physical activity compared to:
  - Percent body fat (r = -0.2; p=0.02))
  - Muscle mass (r = 0.3; p <.01)
  - Maximal handgrip strength (r = 0.3; p <.01)
  - Six minute walk distance (r = 0.3; p <.01)
  - Percent body fat (r = -0.11; p = 0.26))
  - Muscle mass (r = 0.2; p <.01)
  - Maximal handgrip strength (r = 0.2; p <.01)
  - Six minute walk distance (r = 0.3; p <.01)
  Construct Validity
  
  Adults:
  
  (Rosenberg, 2008; n = 289; mean age 35.9 years)
  - - Poor agreement between time spent sitting and IPAQ categories of activity (kappa = 0.014, P = 0.72; x 2 (4) = 2.52, P = 0.64)
    (Kim, 2013; meta-analysis)
    - - Adequate convergent validity (corrected mean effect size = ESp) with other instruments for walking, total moderate physical activity, vigorous physical activity, and total physical activity (ESp = 0.32, 0.45, 0.49, and 0.39 respectively)
      - Poor convergent validity with other instruments for moderate physical activity (ESp = 0.27)
      - Interviewer administered IPAQ had higher correlated mean effect size compared to self-administered IPAQ
      (Hagströmer , 2006; n = 46, mean age 40.7 years – 19-62 years old)
      - Poor construct validity between physical activity time and moderate-intensity physical activity time compared to aerobic fitness (ρ=0.21, P < 0.05).
        
        Poor construct validity between total amount of physical activity, moderate physical activity, and vigorous physical activity compared to Body Mass Index (ρ= 0.25, ρ=0.27, and ρ=0.17 respectively; P <0.01)
        
        Poor construct validity between time spent in moderate or vigorous physical activity and aerobic fitness or percent body fat (ρ = 0.21, ρ = 0.14 respectively; P < 0.05)
        
        Content Validity
        
        Not assessed. However, because frequency, duration, and intensity of physical activity and sedentary behavior are assessed, the IPAQ is believed to have a high level of content validity (Craig, 2003)
        
        Face Validity
        
        Not assessed. However, excellent to adequate ICC values are consistent with a reliable face validity to assess levels of physical activity
        
        Bibliography
        
        Alomari, M. A., Keewan, E. F., Qhatan, R., Amer, A., Khabour, O. F., Maayah, M. F., & Hurtig-Wennlöf, A. (2011). Blood pressure and circulatory relationships with physical activity level in young normotensive individuals: IPAQ validity and reliability considerations. Clinical And Experimental Hypertension (New York, N.Y.: 1993), 33(5), 345-353. doi:10.3109/10641963.2010.531848
        
        Bermúdez, V. J., Rojas, J. J., Córdova, E. B., Añez, R., Toledo, A., Aguirre, M. A., & . López-Miranda, J. (2013). International physical activity questionnaire overestimation is ameliorated by individual analysis of the scores. American Journal Of Therapeutics, 20(4), 448-458. doi:10.1097/MJT.0b013e318235f1f2
        
        Chastin, S. M., Culhane, B., & Dall, P. M. (2014). Comparison of self-reported measure of sitting time (IPAQ) with objective measurement (activPAL). Physiological Measurement, 35(11), 2319-2328. doi:10.1088/0967-3334/35/11/2319
        
        Craig, C. L., Marshall, A. L., Sjöström, M., Bauman, A. E., Booth, M. L., Ainsworth, B. E., & . Oja, P. (2003). International physical activity questionnaire: 12-country reliability and validity. Medicine Science Sports Exercise, 35(8), 1381-1395.
        
        Hagströmer, M., Oja, P., & Sjöström, M. (2006). The International Physical Activity Questionnaire (IPAQ): a study of concurrent and construct validity. Public Health Nutrition, 9(6), 755-762.
        
        Kim, Y., Park, I., & Kang, M. (2013). Convergent validity of the international physical activity questionnaire (IPAQ): meta-analysis. Public Health Nutrition, 16(3), 440-452. doi:10.1017/S1368980012002996
        
        Kwak, L., Hagströmer, M., & Sjostrom, M. (2012). Can the IPAQ-long be used to assess occupational physical activity?. Journal Physical Activity Health, 9(8), 1130-1137.
        
        Rosenberg, D. E., Bull, F. C., Marshall, A. L., Sallis, J. F., & Bauman, A. E. (2008). Assessment of sedentary behavior with the International Physical Activity Questionnaire. Journal Physical Activity Health, 5 Suppl 1S30-S44.
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