Validation of the General Practice Physical Activity Questionnaire after severe COVID-19.

IF 4.4 3区医学 Q1 RESPIRATORY SYSTEM

ERJ Open Research Pub Date : 2026-09-21 eCollection Date: 2026-09-01 DOI:10.1183/23120541.01496-2025

Lin Wang, Kimon Ntotsis, James Manifield, Katerina Tziannou, Tatiana Plekhanova, Alex Rowlands, Charlotte L Edwardson, Molly Baldwin, Nicolette C Bishop, Charlotte Bolton, James D Chalmers, Enya Daynes, Annemarie Docherty, Claudia Efstathiou, Omer Elneima, Lucy Gardiner, William Greenhalf, Neil Greening, Beatriz Guillen-Guio, Victoria Harris, Ewen Harrison, Ling-Pei Ho, Alexander Horsley, Linzy Houchen-Wolloff, Joseph Jacob, Olivia Leavy, Nazir Lone, Daniel Lozano-Rojas, Michael Marks, Hamish McAuley, Melitta McNarry, Claire Nolan, Jennifer K Quint, Betty Raman, Matthew Richardson, Jack Sargeant, Ruth M Saunders, Marco Sereno, Aarti Shikotra, Amisha Singapuri, David J Stensel, Maxime Taquet, Mathew Thorpe, Ioannis Vogiatzis, William Man, Louise V Wain, Iain Stewart, Sally Singh, Christopher E Brightling, Claire Lawson, Tom Yates, Rachael A Evans

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引用次数: 0

Abstract

Background: Physical inactivity is a risk factor for severe COVID-19 and often worsens after hospitalisation. Clinicians need quick, accurate assessments to target interventions. We aimed to assess the validity of the General Practice Physical Activity Questionnaire (GPPAQ) in adults recovering 1 year after COVID-19 hospitalisation.

Methods: Post-hospitalisation for COVID-19, adults attended a 1-year-visit and completed the GPPAQ Physical Activity Index (PAI-4 active), 14-day wrist-worn accelerometry (moderate-vigorous physical activity (MVPA) active) and other health outcomes. Validity was examined via 1) internal consistency (factor analysis); 2) measurement invariance across sex, age and ethnicity using differential item functioning (DIF); 3) convergent validity (GPPAQ sensitivity/specificity versus accelerometry); and 4) construct validity (correlations with health outcomes).

Results: 752 participants had GPPAQ and accelerometry (265 female, mean±sd age 60.9±11.6 years), MVPA 18.75 min·day^-1 (interquartile range 7.55-36.11), PAI-1 46.8%, PAI-2 15.6%, PAI-3 19.4% and PAI-4 18.2%. Factor analyses supported good internal consistency with two factors (daily activities and physical exercise). Comparative factor index (CFI) showed an excellent fit (CFI 0.965). DIF indicated moderate variability by sex and age. GPPAQ-PAI showed limited sensitivity (26.3%) for correctly classifying physically active individuals, but higher specificity (88.4%) for classifying physical inactivity, and weak-to-moderate correlations with health outcomes.

Conclusions: GPPAQ demonstrates internal consistency, with construct and convergent validity in adults 1 year after COVID-19 hospitalisation. GPPAQ effectively identifies inactive individuals to support clinical care; however, its sensitivity suggests under-estimation of activity relative to accelerometry. Future pathways should combine GPPAQ with device-based assessment to optimise evaluation of physical activity to guide pulmonary rehabilitation and targeted interventions.

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重症COVID-19后全科医生身体活动问卷的验证。

背景：缺乏身体活动是严重COVID-19的一个危险因素，住院后往往会恶化。临床医生需要快速、准确的评估来确定干预措施的目标。我们的目的是评估在COVID-19住院1年后康复的成年人中全科医生体育活动问卷（GPPAQ）的有效性。方法：因COVID-19住院后，成年人参加了为期1年的随访，并完成了GPPAQ体力活动指数（PAI-4活动）、14天腕带加速度计（中度剧烈体力活动（MVPA）活动）和其他健康结果。通过1)内部一致性（因子分析）检验效度；2)使用差异项目功能（DIF）测量跨性别、年龄和种族的不变性；3)收敛效度（GPPAQ灵敏度/特异度与加速度计）；4)建构效度（与健康结果的相关性）。结果：752名受试者具有GPPAQ和加速度测量（女性265名，平均±sd年龄60.9±11.6岁），MVPA 18.75 min·day-1（四分位数间距7.55-36.11），PAI-1 46.8%, PAI-2 15.6%, PAI-3 19.4%和PAI-4 18.2%。因子分析支持两个因素（日常活动和体育锻炼）的良好内部一致性。比较因子指数（CFI）拟合良好（CFI 0.965）。DIF显示性别和年龄的中度差异。GPPAQ-PAI对正确分类体力活动个体的敏感性有限（26.3%），但对分类体力不活动个体的特异性较高（88.4%），与健康结局的相关性为弱至中度。结论：GPPAQ在COVID-19住院1年后的成人中具有内部一致性，具有构建效度和收敛效度。GPPAQ有效地识别不活跃的个体以支持临床护理；然而，它的灵敏度表明相对于加速度计，对活动的估计不足。未来的路径应该将GPPAQ与基于设备的评估相结合，以优化身体活动评估，指导肺部康复和有针对性的干预。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ERJ Open Research Medicine-Pulmonary and Respiratory Medicine

CiteScore

6.20

自引率

4.30%

发文量

273

审稿时长

8 weeks

期刊介绍： ERJ Open Research is a fully open access original research journal, published online by the European Respiratory Society. The journal aims to publish high-quality work in all fields of respiratory science and medicine, covering basic science, clinical translational science and clinical medicine. The journal was created to help fulfil the ERS objective to disseminate scientific and educational material to its members and to the medical community, but also to provide researchers with an affordable open access specialty journal in which to publish their work.