Daily physical activity in ankylosing spondylitis: validity and reliability of the IPAQ and SQUASH and the relation with clinical assessments.

INTRODUCTION: The aim of this study was to investigate the construct validity and test-retest reliability of the International Physical Activity Questionnaire (IPAQ; long form) and the Short QUestionnaire to Assess Health-enhancing physical activity (SQUASH) and to investigate the relation between daily physical activity and clinical assessments in patients with ankylosing spondylitis (AS). METHODS: For validity, the self-report questionnaires IPAQ and SQUASH were compared with daily physical activity assessed with the ActiGraph accelerometer during 7 consecutive days in 63 AS outpatients. For reliability, the IPAQ and SQUASH were administered twice approximately 1 week apart in 52 AS outpatients. In all 115 patients, clinical assessments were performed at the outpatient clinic. RESULTS: IPAQ and SQUASH total scores correlated significantly with accelerometer outcome: ρ = 0.38 and r = 0.35, respectively. Intraclass correlation coefficients between first and second assessments of the IPAQ and SQUASH were 0.83 and 0.89, respectively. Bland-Altman analyses showed no systemic bias, but in particular for the IPAQ the 95% limits of agreement were wide. Daily physical activity assessed by accelerometer, IPAQ, and SQUASH correlated significantly with disease activity, physical activity, and quality of life. A relation with spinal mobility was found only for the accelerometer and SQUASH. The direction of these correlations indicates that higher daily physical activity is related to lower disease activity and better physical function, spinal mobility and quality of life. CONCLUSIONS: Both physical activity questionnaires showed modest construct validity. The SQUASH showed good test-retest reliability, superior to the IPAQ. These results indicate that the SQUASH is more suitable than the IPAQ to assess daily physical activity in AS population studies. However, it is desirable to add questions on AS-specific physical activity. Further studies are needed to investigate the causality of the relation between daily physical activity and clinical assessments.

Participation in sports by lower limb amputees in the Province of Drenthe, The Netherlands.

The numbers of lower limb amputees participating in recreational activity date back more than 25 years. Previous studies have shown that 60% of lower limb amputees participated in recreational activities, including sports. To date, research in The Netherlands into sports participation of this specific amputee population is insufficient. The purpose of the reported survey was to investigate the sports participation habits of lower limb amputees in the Province of Drenthe, The Netherlands, using a self-constructed questionnaire. A total of 105 lower limb amputees responded (36%), a large proportion of whom were traumatic amputees (31%). Of the respondents, 34 (32%) participated in some form of sport. Results indicated that participation in sport before the amputation was a predetermining factor for amputees to participate in sports whilst the level of amputation, age and etiology were not predetermining factors of participation in sports after a lower limb amputation.