Physical Activity Questionnaire for Older Children and Adolescents
Title: Physical Activity Questionnaire for Older Children and Adolescents
Category: Predictive
Most recent research article: Physical Activity and Sedentary Behavior in Children With Congenital Heart Disease
Summary of article:
Purpose of article: The purpose of this article was to describe both objectively measured physical activity and sedentary behavior by congenital heart disease severity as well as qualitatively describe physical activity and sports participation and their association with objectively measured physical activity.
Study population: 90 children (13.6 years +/- 2.7 years, 54% male) who had CHD or pediatric heart transplant enrolled from British Columbia Children’s Hospital or traveling clinics across British Columbia and Yukon, Canada.
Methods: Participants were grouped by cardiac diagnosis: (1) 26 mild, (2) 26 moderate, (3) 29 severe CHD and (4) 9 cardiac transplant recipients. Physical activity restrictions were obtained from the treating cardiologist. Each participant wore an accelerometer over the right hip for 7 days in order to track physical activity and sedentary time. They were only removed for water-based activities (including showering and swimming) and during sleep. Accelerometry days were valid if the accelerometer was worn for > or = 600 min/day permitting 60 minutes of < or = 2 min of zeros to avoid discarding reasonable sedentary bouts of non-wear. Overall accelerometer data was considered valid if there were 3 or more valid days.
Outcome measures: Depending on participant age, either the Physical Activity Questionnaire for Children (PAQ-C) (</= 11 years old) or the Physical Activity Questionnaire for Adolescents (PAQ-A) (>/= 12 years old). This is a self-administered, 7 day recall questionnaire that assesses participant physical activity levels both at school and outside of school. Each question is scored between 1 (low physical activity) and 5 (high physical activity) with the average of all responses being determined for the overall score.
Interventions: No interventions were administered as the purpose was to obtain objective measures of physical activity in children with CHD.
Results: Group median moderate – vigorous physical activity (MVPA) was ~ 43 min/day and the skewed group MVPA was no different from national data (~49 min/day versus ~50 min/day). 8% of participants met physical activity guidelines defined as ~60 min/day MVPA for 6-7 days. 4% of girls and 11% of boys adhered to guidelines and was very similar to national estimates (4% of girls and 9% of boys). There were no significant differences were found in daily MVPA and CHD severity. Boys were found to be significantly more active and less sedentary than girls with both sexes seeing a decrease in activity levels and increase in sedentary time with age. Median score of the PAQ was 2.6/5 and were somewhat lower than that of healthy children aged 10 (~3.1) and 15 (~2.7) who are from the same area of British Columbia, Canada.
Major strengths and limitations: Strengths: Objective measures were used to determine physical activity and sedentary levels in children with varying severity of CHD. Use of the PAQ-C and PAQ-A provided supplementary data on physical activity levels to provide context for the information gathered. During the ~500 accelerometer days, detailed weather reports for each individual’s location were determined in order to rule out if inclement weather played a role in the activity levels of the participants. Limitations: While assigning participants into study groups based on CHD severity, it was noted that 2 participants with atrial septal defects were grouped in the moderate CHD category. However, when these participants were grouped in the mild CHD group, there were no significant differences found in the results. The authors also did not input missing physical activity data when the accelerometers were not worn (swimming, bathing, etc.). This may have slightly underestimated physical activity levels in some of the participants. Also, physiological measures were not considered such as ventricular function or exercise capacity that could have potentially played a role in the results.
Overall conclusion: Physical activity and sedentary levels measured objectively were not significantly different by CHD severity. However, they did follow age-sex expected norms which could suggest that sociocultural factors are likely important to consider and could also help determine levels of physical activity in children with CHD.
Reference:
Voss, C., Duncombe, S. L., Dean, P. H., Souza, A. M., & Harris, K. C. (2017). Physical Activity and Sedentary Behavior in Children With Congenital Heart Disease. Journal of the American Heart Association,6(3). doi:10.1161/jaha.116.004665
2 responses to “Physical Activity Questionnaire for Older Children and Adolescents”
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Nate, well organized summary. It’s interesting to see that activity levels were not significantly different based on severity of CHD. The thing that stood out to me the most was the difference in percentage of boys to girls that adhered to guidelines (11% and 4% respectively). Admittedly, I was unaware of the national averages. I know that these differences were attributed to “sociocultural factors,” and I was wondering if you would be willing to expand on that a little more.
According to the authors of the article, “In healthy children, the determinants of physical activity are multifactorial and include factors that are intrapersonal (attitudes, motivation, self‐efficacy), sociocultural (encouragement, support, social norms), and environmental (access to opportunities and facilities).” It seems to point to the fact that each child grows up in different environments with different parental situations, various worldviews and viewpoints, and different cultural norms that could potentially effect their levels of physical activity on a daily basis. Bullying in school can also effect many things with children, including physical activity. Overall, varying levels of physical activity levels in children is determined by a mulitfactorial approach that warrants further study due to the fact that so many things can impact physical activity.