Feasibility, Validity, and Responsiveness of Self‐Report and Objective Measures of Physical Activity in Patients With Chronic Pain

AbstractPurposeThis study evaluates the clinical usefulness of patient-rated and objective measures to identify physically-oriented functional changes after an intensive chronic pain program in a pediatric setting. Past studies have demonstrated the importance of adolescents’ perception of their abilities and measurement tools used for rehabilitation outcomes within physical and occupational therapy; however, these tools used are not often easily utilized or have not been examined with a pediatric chronic pain population. In chronic pain rehabilitation, it is important to have a primary focus on functional improvement not on pain reduction as a leading outcome. This study examines how both self-report and objective physical activity measures can be meaningful constructs and can be used as reliable outcome measures. It was hypothesized that adolescents completing an interdisciplinary pain rehabilitation program would report functional gains from admission to discharge, and that perceived gains in physical ability would be associated with objective physical activities. Further, it was hypothesized that gains in functioning would be associated with mild pain reduction.MethodsData from 78 children and adolescents with chronic pain that participated in an intensive multidisciplinary treatment program completed self-report measures including the Lower Extremity Functional Scale (LEFS), Upper Extremity Functional Index (UEFI). In addition, adolescents were objectively monitored for repetitions of selected physical activities for 1 min intervals.ResultsData demonstrated significant gains in all measures of functioning during the program. Correlations between self-report and objective outcomes suggest they are measuring similar yet distinct factors.ConclusionsThe LEFS, UEFI, and objective exercises provide a meaningful way to track progress in pediatric chronic pain rehabilitation. Despite similarities, they appear to track separate but related aspects of rehabilitation and capture important short-term response to rehabilitation. Both measures appear distinct from pain as an outcome. These findings increase our understanding of rehabilitation practices provide opportunities to promote clinical improvement in pediatric pain.ImplicationsThe use of self-report measures along with objective measures can help therapists gain understanding in regards to a patient’s insight and how that may impact their overall outcome compared to the use of a single outcome measure. Viewing these rated measures at any point in the rehabilitation process can be useful to facilitate discussion about challenges they can identify and how therapies can facilitate improvement and functional gains.

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What they say and what they do: comparing physical activity across the USA, England and the Netherlands

Journal of Epidemiology & Community Health ◽

10.1136/jech-2017-209703 ◽

2018 ◽

Vol 72 (6) ◽

pp. 471-476 ◽

Cited By ~ 26

Author(s):

Arie Kapteyn ◽

James Banks ◽

Mark Hamer ◽

James P Smith ◽

Andrew Steptoe ◽

...

Keyword(s):

Physical Activity ◽

The Netherlands ◽

Age Groups ◽

The Self ◽

Self Report ◽

Objective Measures ◽

Accelerometer Data ◽

Physically Active ◽

Self Reports ◽

The Usa

BackgroundPhysical activity (PA) is important for maintaining health, but there are fundamental unanswered questions on how best it should be measured.MethodsWe measured PA in the Netherlands (n=748), the USA (n=540) and England (n=254), both by a 7 day wrist-worn accelerometer and by self-reports. The self-reports included a global self-report on PA and a report on the frequency of vigorous, moderate and mild activity.ResultsThe self-reported data showed only minor differences across countries and across groups within countries (such as different age groups or working vs non-working respondents). The accelerometer data, however, showed large differences; the Dutch and English appeared to be much more physically active than Americans h (For instance, among respondents aged 50 years or older 38% of Americans are in the lowest activity quintile of the Dutch distribution). In addition, accelerometer data showed a sharp decline of PA with age, while no such pattern was observed in self-reports. The differences between objective measures and self-reports occurred for both types of self-reports.ConclusionIt is clear that self-reports and objective measures tell vastly different stories, suggesting that across countries people use different response scales when answering questions about how physically active they are.

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(257) Evaluating Self Report and Objective Measures for Adolescents’ Change in Functional Abilities after Completion of an Intensive Chronic Pain Rehabilitation Program

Journal of Pain ◽

10.1016/j.jpain.2017.02.149 ◽

2017 ◽

Vol 18 (4) ◽

pp. S40

Author(s):

H. Kempert ◽

E. Benore

Keyword(s):

Chronic Pain ◽

Rehabilitation Program ◽

Self Report ◽

Objective Measures ◽

Functional Abilities

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Periodic Change in Sufficient Physical Activity: A 2-Year Study of a Multi-Ethnic Cohort

Journal of Physical Activity and Health ◽

10.1123/jpah.2014-0373 ◽

2015 ◽

Vol 12 (10) ◽

pp. 1369-1377

Author(s):

Rod K. Dishman ◽

Claudio Nigg

Keyword(s):

Physical Activity ◽

Latent Transition Analysis ◽

Outcome Studies ◽

Point Prevalence ◽

Self Report ◽

Periodic Change ◽

Objective Measures ◽

Transition Analysis ◽

Total Cohort ◽

Multiethnic Sample

Background:Measuring the way people vary across time in meeting recommended levels of physical activity is a prerequisite to quantifying exposure in outcome studies or identifying determinants of sufficient physical activity. The study determined whether distinct patterns of change in sufficient physical activity could be identified in a population.Methods:A cohort (N = 497) from a random, multiethnic sample of adults living in Hawaii was assessed every 6 months for 2 years beginning spring 2004. Latent transition analysis classified people as sufficiently or insufficiently active each time.Results:In the total cohort, odds that people would move from insufficient to sufficient activity (45% to 59%) at each 6-month transition were higher than odds they would move from sufficient to insufficient activity (8% to 13%). However, those odds, as well as types and amounts of physical activity, differed widely among and within 3 of 4 transition classes that represented 21% of the cohort.Conclusions:Point-prevalence of sufficient physical activity in the total cohort was similar to contemporary U.S. estimates. However, physical activity varied between and within subgroups of the cohort. Further research is needed using self-report and objective measures to determine patterns of change in sufficient physical activity in other representative cohorts.

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Pre- to Postoperative Physical Activity Changes in Bariatric Surgery Patients: Self Report vs. Objective Measures

Obesity ◽

10.1038/oby.2010.88 ◽

2010 ◽

Vol 18 (12) ◽

pp. 2395-2397 ◽

Cited By ~ 121

Author(s):

Dale S. Bond ◽

John M. Jakicic ◽

Jessica L. Unick ◽

Sivamainthan Vithiananthan ◽

Dieter Pohl ◽

...

Keyword(s):

Physical Activity ◽

Bariatric Surgery ◽

Self Report ◽

Objective Measures

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Physical Activity and Body Composition Among Ambulatory Individuals With Multiple Sclerosis

International Journal of MS Care ◽

10.7224/1537-2073-7.4.137 ◽

2005 ◽

Vol 7 (4) ◽

pp. 137-142 ◽

Cited By ~ 11

Author(s):

Erin M. Snook ◽

Mina C. Mojtahedi ◽

Ellen M. Evans ◽

Edward McAuley ◽

Robert W. Motl

Keyword(s):

Physical Activity ◽

Multiple Sclerosis ◽

Body Composition ◽

Self Report ◽

Objective Measures ◽

Activity Levels ◽

Body Fatness ◽

X Ray ◽

The Relationship ◽

Report Measure

Individuals with multiple sclerosis (MS) engage in less physical activity than the general population. This level of inactivity may increase a person's risk of being overweight and obese. The relationship between physical activity and body composition is examined among 34 ambulatory adults with a definite diagnosis of MS. Participants wore pedometers and accelerometers, objective measures of physical activity, for 7 days; completed a self-report measure of physical activity; and underwent various measurements of body composition, including body mass index (BMI), waist circumference, and relative body fat by dual energy X-ray absorptiometry (DXA). Statistically significant negative correlations were found between physical activity levels and measures of body fatness, and the correlations were strong between the objective measures of physical activity and DXA measures of body composition. The correlations were moderate between the self-report measure of physical activity and less precise measures of body composition. Our findings suggest that inactivity plays an important role in body fatness among people with MS, and subjective measures of physical activity and less precise measures of body fatness, such as BMI, may underestimate the strength of the relationship between physical activity and risk for obesity in the MS population.

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Difference Between Self-Reported and Accelerometer Measured Moderate-to-Vigorous Physical Activity in Youth

Pediatric Exercise Science ◽

10.1123/pes.22.4.523 ◽

2010 ◽

Vol 22 (4) ◽

pp. 523-534 ◽

Cited By ~ 36

Author(s):

Allana G.W. LeBlanc ◽

Ian Janssen

Keyword(s):

Physical Activity ◽

Vigorous Physical Activity ◽

Systematic Difference ◽

Self Report ◽

Objective Measures ◽

The Difference

We examined differences between objective (accelerometer) and subjective (self-report) measures of moderate-to-vigorous physical activity (MVPA) in youth. Participants included 2761 youth aged 12–19 years. Within each sex and race group, objective and self-reported measures of MVPA were poorly correlated (R2 = .01–.10). Self-reported MVPA values were higher than objective values (median: 42.4 vs. 15.0 min/d). 65.4% of participants over-reported their MVPA by 35 min/d. The difference between self-reported and objective measures was not influenced by sex, age, or race. There was, however, a systematic difference such that inactive participants over-reported their MVPA to the greatest extent.

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Gender Differences in the Prevalence of Chronic Pain and Leisure Time Physical Activity Among US Adults: A NHANES Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16060988 ◽

2019 ◽

Vol 16 (6) ◽

pp. 988 ◽

Cited By ~ 3

Author(s):

Masataka Umeda ◽

Youngdeok Kim

Keyword(s):

Physical Activity ◽

Gender Differences ◽

Chronic Pain ◽

Leisure Time ◽

Leisure Time Physical Activity ◽

Gender Disparities ◽

Self Report ◽

Men And Women ◽

Nationally Representative ◽

Primary Type

Gender disparities in chronic pain are well documented in the literature. However, little is known regarding the relationship between physical activity (PA) and gender disparities in chronic pain. This study described gender differences in prevalence of chronic pain and PA, and identified a type of leisure time PA that individuals frequently chose in a nationally representative sample of US adults (N = 14,449). Data from the National Health Nutrition Examination Survey 1999–2004 were analyzed. Individuals were categorized into no chronic pain (NCP), localized chronic pain (LCP), and widespread chronic pain (WCP) groups based on responses to a pain questionnaire. A self-report PA questionnaire was used to estimate the time spent in different types of PA. Women showed higher prevalence of LCP and WCP compared to men. Men spent more hours per week for leisure time PA compared to women, but men and women showed similar prevalence of sufficient PA to meet a PA recommendation (≥150 min/week of moderate-to-vigorous intensity PA) across chronic pain categories. However, the prevalence of sufficient PA was substantially higher among men and women with NCP compared to men and women with LCP and WCP. Additionally, both men and women chose walking as the primary type of leisure time PA. Together, gender disparities exist in the prevalence of chronic pain and hours spent for leisure time PA. More research is needed to explore the role of increasing leisure time PA, such as walking, in reducing gender disparities in chronic pain.

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Sex and Ethnic Differences in Children’s Physical Activity: Discrepancies between Self-Report and Objective Measures

Pediatric Exercise Science ◽

10.1123/pes.10.3.277 ◽

1998 ◽

Vol 10 (3) ◽

pp. 277-284 ◽

Cited By ~ 26

Author(s):

James F. Sallis ◽

Thomas L. McKenzie ◽

John P. Elder ◽

Patricia L. Hoy ◽

Todd Galati ◽

...

Keyword(s):

Physical Activity ◽

Ethnic Differences ◽

Mexican American ◽

Self Report ◽

Objective Measures ◽

Accelerometer Data ◽

Recall Data ◽

Anglo American ◽

American Children ◽

Children’S Physical Activity

Previous studies have not used both self-report and objective measures to assess sex and ethnic differences in children’s physical activity. In the present study, 187 Mexican American and Anglo American children, aged 11 to 12 years, were assessed by two 7-day physical activity recall interviews and up to 8 days of accelerometer (Caltrac) monitoring over a 6-month period. Compared to Anglo American boys, accelerometer data showed Mexican American boys, Anglo American girls, and Mexican American girls to be 95,81, and 75% as active, respectively. Activity recall data showed that, compared to Anglo American boys, Mexican American boys, Anglo American girls, and Mexican American girls were 95,95, and 90% as active, respectively. The extent of sex and ethnic differences in children’s physical activity depend on the measure used.

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State of the Art Reviews: Measurement of Physical Activity in Children and Adolescents

American Journal of Lifestyle Medicine ◽

10.1177/1559827607301686 ◽

2007 ◽

Vol 1 (4) ◽

pp. 299-314 ◽

Cited By ~ 200

Author(s):

Stewart G. Trost

Keyword(s):

Physical Activity ◽

Children And Adolescents ◽

State Of The Art ◽

Self Report ◽

Objective Measures ◽

Doubly Labeled Water ◽

Heart Rate Monitoring ◽

New Developments ◽

Wide Range ◽

Measurement Approach

To date, a wide range of methods has been used to measure physical activity in children and adolescents. These include self-report methods such as questionnaires, activity logs, and diaries as well as objective measures of physical activity such as direct observation, doubly labeled water, heart rate monitoring, accelerometers, and pedometers. The purpose of this review is to overview the methods currently being used to measure physical activity in children and adolescents. For each measurement approach, new developments and/or innovations are identified and discussed. Particular attention is given to the use of accelerometers and the calibration of accelerometer output to units of energy expenditure to developing children.

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