Identification and evaluation of self-reported physical activity instruments in adults with osteoarthritis: a systematic review.

Abstract

OBJECTIVE
To identify and evaluate the measurement properties of self-report physical activity (PA) instruments suitable for those with osteoarthritis (OA).

METHODS
A comprehensive two-stage systematic review using multiple electronic databases from inception until July 2018. Stage One sought to identify all self-reported PA instruments used in populations with joint pain attributable to OA in the foot, knee, hip or hand. Stage Two searched for and appraised studies investigating the measurement properties of the instruments identified. For both stages all articles were screened for study eligibility criteria, completed data extraction using the Qualitative Attributes and Measurement Properties of Physical Activity Questionnaires (QAPAQ) checklist, and conducted methodology quality assessments using a modified COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist. Measurement properties for each physical activity instrument were evaluated and combined using narrative synthesis.

RESULTS
Stage One identified 23 unique self-report PA instruments. Stage Two identified 53 studies that evaluated the measurement properties of 13 of the 23 instruments identified. Instrument reliability varied from inadequate to adequate (ICC==0.7). Instrument construct and criterion validity assessment demonstrated small to moderate correlations with direct measures of PA. Responsiveness was assessed in only 1 instrument and was unable to detect changes in comparison to accelerometers.

CONCLUSION
While many instruments were identified as potentially suitable for use in individuals with OA, none demonstrated adequate measurement properties across all domains of reliability, validity and responsiveness. Further high-quality assessment of self-reported PA instruments is required before such measures can be recommended for use in OA research.