the PASE physical activity scale for the elderly is the one i use, but all self reported measures are problamatic as various unfluences on recall affect the results. have you thiought about putting an accelerometer on them. for a few days before and after the intervention and measuring sedentary time that is trying to reduce sedentary time, rather than trying to measure moderate/vigirous.

Thanks for your answer. Yes, I am aware of the bias of subjective measures and I have to decide for one that is most suitable then. Well, I have introduced the accelerometer idea to my pilot participants. They said that not many would wear such a device, because it is too invasive. I might have encountered also a cultural issue, because people here prefer less physical contact. However, I am thinking of a pedometer because people can use it also to monitor their own progress.

I would definitely agree with the view that objective measurements are more reliable than subjective questionnaires (e.g. recall error etc.). There is a whole indistry providing a range of pedometers and accelerometers so that the choice of the 'right' tool depends on a mixture of what you want to measure, what you want to spend and how much compliance you need from your subjects. We like to use the Step Watch Activity Monitor, an accelerometric step counter (thus very reliable, virtually no interference possible) and have applied it in a range of patients from children to elderly (TKA,THA,spine).

I have used the sense wear band and had great results. My subjects actually found them to be comfortable, non-invasive, and they were very interested in the data from their daily usage. I highly recommend them over questionnaires as recall is not always effective.

Thank you for your contributions. I am sure the data is much better and am hoping to be able to use objective instruments. Well, resources are limited but some accelerometers are on the way. Will see how to creatively make things work.

You can get a quantitative outcome with simple step counters – you need to demonstrate them for each individual and be open for questions – people love to use them and they work very well.

Consider the Physical Activity Scale for the Elderly (PASE)

Hi, Center for Technology and Aging has a great overview of technology for older adults. http://www.techandaging.org/ConnectedAgingFramework.pdf The first section is about wearable devices for objective data collection. I think it's a great resource for mining research ideas.

Hi, Is this study to review pre and post interventions? If so, what type of interventions do you have in mind already out there or are you measuring something not already out there, or seeking something new?

Hi..it is indeed an experimental design that I will use. The intervention is in its development. Bottom line, I want to intervene in order to increase Physical Activity. It will be something new. However, need to smoothen the whole thing before I am going out.

Andre, thought my research had already been uploaded years back! Really very sorry as just discovered going through my IT data storage systems that my work must have been lost in one of my many previous laptops! The copy in existence is 'hard' and in the library of the University of Brighton.

A brief summary was that I found the importance of the philosophical framework within which my research was located is vital. There were plenty of assumptions made due to the lack of importance normally applied in the methodology I implemented. This was in conjunction with the importance of critical reflect practice combined with a more in-depth importance placed on philosophical schools of thought and their differing approaches.

These core findings I am utilising in my research over the last 12 years. My long term project being the development of a technology that promotes and sustains healthy levels of physical activity; with an emphasis on those experiencing poverty.

I have successfully used six minute walking test to measure physical activity in older adults.If you are looking at using latest technology sensors that could be inserted into shoes that connect by blue tooth to smartphones can measure physical activity around the clock and also maintain app enabled logs.Some apps can trace pace of activity as well.

For older adults, one of the best known instrument is the PASE - Physical Activity Scale for the Elderly. Washburn RA et al, 1993, J Clinical Epidemiology. this is widely used in many epidemiological studies and is validated through doubly labeled water. It does not provide any "absolute" metrics, but for describing the population, it is a must. If possible, I would pair this with a pedometer or other actigraphy tools.

It seem that the combi of objective and subjective measures is really the best way to go. Even though this will increase the administrative burden. Looking at a recent paper on subjective measures of PA for elderly (Helmerhorst, 2012), there are just a few choices and it pretty much depends on the design and the burden you can impose on participants. I am usually a bit careful giving long instruments, because of obvious reasons.PASE might still work.

I have been a part of an RCT which used the PASE and actigraphy in a neurological populaiton see http://www.ncbi.nlm.nih.gov/pubmed/21382866. I would note that the calculations required for the PASE score can be challenging and would suggest reviews around outcome measures in the population of interest are valuable e.g. for individuals with severe mental illness I undertook a specalist review of PA outcome measures see http://www.sciencedirect.com/science/article/pii/S0883941713001532.

BW

Andy

"Get up and go" was a simple physical test I have seen used. Not sure the variables you hope to collect, Best regards!

The Human Activity Profile is a good instrument we have been working with (J Aging Phys Act. 2013 Jul 30. [Epub ahead of print] Validation of the Human Activity Profile Questionnaire as a Measure of Physical Activity Levels in Older Community-Dwelling Women. Bastone AC, Moreira BS, Vieira RA, Kirkwood RN, Dias J MD, Dias RC.), but if you need something easier to admininster I would suggest the questionnaire described by Frändin, K., & Grimby, G. (1994). Assessment of physical activity, fitness and performance in 76-year-olds. Scandinavian Journal of Medicine & Science in Sports, 4, 41-46. We had excellent results with this instrument when comparing it to accelerometer data.

Beste regards,

Thanks for all the suggestions. I will check the literature, check feasibilty etc. and then keep you posted.

We are conducting a pilot evaluating the feasibility and accessibility of yoga for arthritis patients. Although our sample is not all older adultss we have found that pairing our patient reported outcomes with physical assessment metrics from our rehabilitation colleagues has brought us a more full picture of our participants functional capacity. I am adding a paper that describes the measures in detail in cse that might be of assistance.

Gwen

Thanks a lot Gwenyth!

I agree with others that a mix of objective & subjective measures works best. I've successfully used the 6-min walk test in combo w/the sit-to-stand test and find these 2 objective measures to work well. However if you don't have the time or space for the 6-min walk, try the timed 10-meter walk test. It's got good reliability, validity, etc...

Thanks a lot Karen. I am now doing exactly this. So far my focus is more on behavioral outcomes and not so much on performance or functional ones. However, I am not yet 100% done with the design.

Karen, could you send me a reference for the 10-meter walk test? THANKS

Andre,

I don't have the *original* reference any longer but it can probably be found in one of these papers. All are in English. I've also attached a quick PubMed search. Best of luck w/your research!

Spinal Cord. 2014 Jan 21. doi: 10.1038/sc.2013.171. [Epub ahead of print]

Concurrent validity of the 10-meter walk test as compared with the 6-minute walk test in patients with spinal cord injury at various levels of ability.

Amatachaya S1, Naewla S2, Srisim K1, Arrayawichanon P3, Siritaratiwat W1.

Author information

Abstract

Study design:Cross-sectional design.Objectives:To evaluate the concurrent validity of the 10-meter walk test (10MWT) as compared with the 6-minute walk test (6MinWT) in patients with spinal cord injury (SCI) at various levels of walking ability, as determined using the criteria from the functional independence measure locomotor (FIM-L) scores.Setting:A major tertiary referral hospital in Thailand.Methods:Ninety-four independent ambulatory subjects with SCI (FIM-L scores 5-7) were assessed for their functional abilities using the 10MWT and 6MinWT.Results:The data of the 10MWT and the 6MinWT had excellent correlation in subjects with FIM-L 7 (r=0.83, P

Oooppps - here's the ref list. :-)

Thanks a lot Karen, I will check it out. Need to see how feasible it is since we are talking about Malaysia, a country that is very hot and humid. That's usually a bit of a problem for the elderly. However, if I can set it up properly this might work. All the best from the heat!

Just briefly Andre, IPAQ from my experience has poor criterion validity when compared to maximal oxygen uptake values in postmenopausal women. Accelerometers, such as actigraphs, would be my choice.

Hi Ian,

I have indeed revamped the whole thing. However, all depends also on resources but things should go well.

PA measures will now be only secondary because I am looking at a specific programme. However, I would still like to include some phys. fitness measures. Do you have any good idea of something simple, time and cost effective. I want to do it in the participant's home. Something for upper trunk (arms, shoulder, chest) would be great. If you know of anything (with reference) please share it!! THANKS!

Hi,

sorry for my english.

We have used this one in a pupil work: “Comparative judgement of physical activity”, Bailis, Chipperfield, Perry, Newall y Haynes (2008). Is a subjective measure but easy to fullfil and only 4 ítems. Is related with sense of coherence, subjetive well-being and perceived health.

They are others measure simple and cost effective described in this two papers: Lohne-Seiler, H., Anderssen, Blazevich, Torstveit. Reliability and validity of chair-stand and box-lift test in elderly subjects,

Maryer, T. G. Barnes, D. Kishino, N.D, Nichols, G. Gatchel, R.J., Mayer, H., and Mooney, V. Progressive isoinertial fifting evaluation I. A standardized protocol land normative database.

This imply to sit and stand chair with a box at the head.

Good chance!

Thanks

Dear Andre, i would suggest to use objective measurement of physical activity instead of questionnaires. Becaus of some specific restriction regarding the meaurement of PA in elder people, it would be important to use a measurement device wich is able to assess raw data (acceleration signals) and output results based on a standardized unit (e.g. mg or MET) instead of manufacturer dependent outcomes as e.g. counts. We user the move II sensor (movisens GmbH, Karlsruhe, Germany) in several projects.

Hallo Stefan..Danke..yeah..we are now shifting our research focus anyway in another direction because we encountered some practical problems. We will asses using diaries. However, we will link it with some physical fitness measures and also subjective measures of overall PA. Well, designs keep on changing while in the real world.

Hallo Andre, do you want to use electronic diaries or paper pencil methods?

so far we are planing to use paper-pencil as our old people feel more comfortable with this..however, if you can suggest a good electronic method I would have a look at it.

we are using movisens XS platform (https://xs.movisens.com/), a web based tool that alows you to build elecronic questionnaires in an easy way without having expoerience in programming.

hi Stefan,

I have checked it out and am now playing a bit around with it. Looks very promising.

One assessment to use with older people is the Senior Fitness test. This includes a battery of fitness tests that are sensitive to change on intervention.

Ho Gareth..thanks for that..I found this as well. I will include 2 to 3 of the tests..

Andre,

The Physical Activity Scale for the Elderly (PASE, Washburn et al. 1993), which intends to evaluate physical activity level of the 65 years or older, may be another option. Several studies have looked into its reliability and validity as well as applicability/sensitivity on patients with chronic diseases. Paper-pencil questionnaires are still a more practical tool for large sample, limited budget, and/or older population who tends to be gadget phobia. However, they may have recall problem or difficulty in understanding the questions that we suggest to cross-examine the answers in doubt with dialogue immediately after administration. Interviewing may be the best method when surveying older people, but additional trained investigators are required.

Adding fitness or functional ability test is a good approach because activity record and actual physical performance can verify of each other. You may also want to consider the Short Physical Performance Battery (SPPB) for the 65 years or older (Guralnik et al. 1994). This test has been reviewed (see Evans et al., J Gerontol A Biol Sci Med Sci. 63(2): 160–164, 2008) and is less demanding and less time-consuming comparing to the Functional Fitness test (Jones and Rikli, 2002).

Hi Jackson,

thanks for your response. I have indeed checked all questionnaire options available and found PASE to be a good alternative. I agree that paper-pencil approaches are the best way to go. But, as you pointed out you still face problems with understanding. Hence, the researcher (me or colleague) will administer the questionnaire (interview form) to get it right. Since my study focus had to be adjusted the overall PA variable will be a secondary measure (however, an interesting one). Yepp, the fitness test is good for 2 reasons. I can sort of verify what people did and whether the intervention worked (also on this level). Further, it can be helpful to do something more exciting in order to reduce possible drop-out. I have taken only 2 tests for the physical fitness part because it is not a major thing in the study. I am aware that there are many "cool" things I could do...but I also need to keep the focus.

I have experience using SenseWear and Actigraph activity monitors in survivors of intensive care, together with HRQL SF36 assessment and the Clinical Frailty Scale Score (McDermid et al 2011, Crit Care. 2011;15(1):301). These methods were highly correlated (McNelly AS, et al. Thorax 2013; 68(SIII): A69), so your choice depends on what data you would like to gather. Certainly individuals from 17-84 years old coped well with using activity monitors, and it enables analysis of variation in activitiy which may be as informative as activity level per se.

Dear Andre,

according to my knowledge there are either studies that suggest a high relyability and validity of paper and pencil questionnaires that assess physical activity and objective measures to do so. However, there is also evidence that self-reports overestimate physical activity. Have you considered the godin leisure time exercise questionnaire?

Kind regards,

Julian

Miller D. J., Freedson P. S., & Kline G. M. (1994). Comparison of activity levels using the Caltrac accelerometer and five questionnaires. Medicine and Science in Sports and Exercise, 26, 376–382.

Gillison, F. B., Standage, M., & Skevington, S.M. (2006). Relationship among adolescents’ weight perceptions, exercise goals, exercise motivation, quality of life and leisure-time exercise behaviour: A self-determination theory approach. Health Education Research, 21, 836-847.

Godin, G. & Shephard, R. J. (1985). A simple method to assess exercise behavior in the community. Canadian Journal of Applied Sport Science, 10(3), 141-146

http://www.ncbi.nlm.nih.gov/pubmed/8183104

http://her.oxfordjournals.org/content/21/6/836.short

http://www.ncbi.nlm.nih.gov/pubmed/4053261

Thanks Angela and Julian. I had to change my study focus a bit so that the PA measurement is now "just" a secondary measure. However, I do agree that objective measure are the way forward. I appreciate the studies you shared (Julian). I have indeed read a number of articles on this issue and I have learned that the papers give different answers in terms of validity of data from traditional questionnaires. It was kind of important to get an instrument that works for the age group (validated if possible), is short and gives me an idea about PA levels. And it should also work in the context I am in (Malaysia). So, the dilemma never ends..

I also had that dilema... but for me it is best to use Short Physical Performance Battery and PASE. That way you can also see corelation between tests. Maybe it is complicate but science need time...

Thanks for this. I have already finished everything using IPAQ short. It was just a secondary outcome and IPAQ did ok.