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Tradução e validação do questionário global de atividade física (GPAQ) para a população adulta portuguesa
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Introdução: A atividade física (AF) é um eixo fundamental de um estilo de vida saudável, desempenhando um papel importante de carácter preventivo e protetor da doença. Métodos subjetivos, como os questionários, são dos instrumentos mais utilizados para a avaliação do padrão de AF na área da Epidemiologia. O Questionário Global de Atividade Física (GPAQ), desenvolvido pela Organização Mundial de Saúde (OMS), tem sido amplamente utilizado na avaliação da AF da população adulta em diversos países, no âmbito da vigilância de fatores de risco para as doenças crónicas não transmissíveis. Porém, ainda não foi validada a sua versão em português europeu. Objetivo: Este estudo tem como objetivo validar o Questionário Global de Atividade Física, versão 2, (GPAQv2), por autoadministração, para a população adulta portuguesa, por comparação a um método subjetivo (International Physical Activity Questionnaire-Long Form (IPAQ-LF)) e a um método objetivo (acelerometria). Métodos: Este trabalho consistiu num estudo transversal, observacional e prospetivo que incluiu duas fases: qualitativa e quantitativa. A primeira contemplou os processos de tradução (do questionário original, em inglês, para português europeu) e adaptação cultural do GPAQv2. A segunda englobou a avaliação das suas propriedades psicométricas (fiabilidade e validade). Foram recrutados 118 participantes, com o intuito de avaliar o seu padrão de AF e comportamento sedentário (CS) através do GPAQv2, por autoadministração. O processo de validação foi efetuado por comparação das variáveis avaliadas pelo IPAQ-LF (validade concorrente) e utilização do acelerómetro ActiGraph wGT3X-BT (validade de critério). A AF e o CS foram avaliados em dois momentos (M1 e M2), no início do estudo e após sete dias consecutivos. Inicialmente, procedeu-se a uma Análise Exploratória dos Dados. Posteriormente, a técnica Teste-Reteste foi utilizada para a análise da fiabilidade do GPAQv2, através do teste de Kappa (k) e do Coeficiente de Correlação Intraclasse (CCI). A validade foi aferida pelo Coeficiente de Correlação de Spearman (rho) e a concordância entre os métodos – GPAQv2 versus acelerómetro -, pela análise gráfica Bland-Altman. A AF foi avaliada em minutos/semana (min/sem) e o CS adicionalmente em horas/dia (h/d). Resultados: O estudo incluiu 108 participantes adultos (38.94 ± 11.45 anos; 50.9% do sexo masculino) que completaram todas as avaliações. A fiabilidade variou de forte a quase perfeita (k: 0.864-0.976, p < 0.001) e de moderada a excelente (CCI: 0.562-0.994, p < 0.001), para variáveis categóricas e variáveis contínuas do GPAQv2, respetivamente. Verificou-se uma correlação moderada a substancial entre IPAQ-LF e GPAQv2 (rho: 0.471-0.680, p < 0.001) e uma validade de critério de razoável a substancial (rho: 0.226-0.672, p < 0.05) entre os resultados do acelerómetro e do GPAQv2. Os gráficos de Bland-Altman mostraram que o GPAQv2 superestimou a atividade física vigorosa (AFV) em 109.67 9 min/sem (-204.14 a 423.48) e a atividade física moderada a vigorosa (AFVM) em 93.62 min/sem (-347.18 a 534.42); e subestimou a AFM em 16.05 min/sem (-327.91 a 295.80). A maior diferença encontrada, 172.67 min/sem (2.88 h/d), incidiu sobre o CS, uma vez que GPAQv2 subestimou o tempo despendido nesta atividade de baixo dispêndio energético. Conclusões: O GPAQv2, por autoadministração, apresenta fiabilidade e validade aceitáveis para a avaliação do padrão de AF e CS da população adulta portuguesa. Contudo, embora tenha sido obtida uma validade de critério de razoável a substancial, deve ter-se em consideração que os níveis de AF reportados pelo GPAQv2 foram superiores aos avaliados pela acelerometria, nomeadamente para a AFV e AFVM, e inferiores para a AFM e CS.
Background: Physical activity (PA) is a fundamental component of a healthy lifestyle, playing an important preventive and protective role against disease. Subjective methods, such as questionnaires, are among the most used instruments for assessing the pattern of PA in epidemiological studies. The Global Physical Activity Questionnaire (GPAQ), developed by the World Health Organization (WHO), has been widely used in the assessment of PA in the adult population in several countries, within the scope of surveillance of risk factors for chronic noncommunicable diseases. However, the European Portuguese version has not yet been validated. Purpose: This study aims to validate the Global Physical Activity Questionnaire, version 2, (GPAQv2), by self-administration, for the Portuguese adult population, by comparison with a subjective method (International Physical Activity Questionnaire-Long Form (IPAQ-LF)) and an objective method (accelerometry). Methods: This work consisted of a cross-sectional, observational and prospective study that included two phases: qualitative and quantitative. The first included the translation process (from the original questionnaire, in English, to European Portuguese) and cultural adaptation of the GPAQv2. The second included the assessment of psychometric properties (reliability and validity). A total of 118 participants were recruited in order to assess their PA pattern and sedentary behavior (SB) through the GPAQv2, by self-administration. The validation process was carried out by comparing the variables evaluated by the IPAQ-LF (concurrent validity) and using the ActiGraph wGT3X-BT accelerometer (criterion validity). PA and SB were evaluated in two moments (M1 and M2), at baseline and after seven consecutive days. Initially, an Exploratory Analysis of the data was carried out. Subsequently, the Test-Retest technique was used to analyze the reliability of the GPAQv2, through the Kappa test (k) and the Intraclass Correlation Coefficient (ICC). Validity was assessed by Spearman's Correlation Coefficient (rho). The agreement between GPAQv2 versus accelerometer was evaluated by Bland-Altman graphical analysis. PA was evaluated in minutes/week (min/week) and SB in hours/day (h/d) additionally. Results: The study included 108 adult participants (38.94 ± 11.45 years; 50.9% male) that completed all assessments. Reliability ranged from strong to almost perfect (k: 0.864-0.976, p < 0.001) and from moderate to excellent (ICC: 0.562-0.994, p < 0.001), for GPAQv2’s categorical and continuous variables, respectively. There was a moderate to substantial correlation between IPAQ-LF and GPAQv2 (rho: 0.471-0.680, p < 0.001) and a fair to substantial criterion validity (rho: 0.226-0.672, p < 0.05) between the accelerometer and GPAQv2. Bland-Altman plots showed that GPAQv2 overestimates vigorous physical activity (VPA) by 109.67 min/week (-204.14 to 423.48) and moderate to vigorous physical activity (MVPA) by 93.62 min/week (-347.18 to 534.42); and underestimated the moderate 11 physical activity (MPA) by 16.05 min/w (-327.91 to 295.80). The highest difference found was related to SB, 172.67 min/week (2.88 h/d), since GPAQv2 underestimated the sitting time. Conclusions: The GPAQv2, by self-administration, has an acceptable validity and reliability for assessing the pattern of PA and SB in the Portuguese adult population. However, despite the fair to substantial criterion validity obtained, it should be taken into account that the levels of PA reported by GPAQv2 were higher than those assessed by accelerometry, namely for VPA and MVPA, and lower for MPA and SB.
Background: Physical activity (PA) is a fundamental component of a healthy lifestyle, playing an important preventive and protective role against disease. Subjective methods, such as questionnaires, are among the most used instruments for assessing the pattern of PA in epidemiological studies. The Global Physical Activity Questionnaire (GPAQ), developed by the World Health Organization (WHO), has been widely used in the assessment of PA in the adult population in several countries, within the scope of surveillance of risk factors for chronic noncommunicable diseases. However, the European Portuguese version has not yet been validated. Purpose: This study aims to validate the Global Physical Activity Questionnaire, version 2, (GPAQv2), by self-administration, for the Portuguese adult population, by comparison with a subjective method (International Physical Activity Questionnaire-Long Form (IPAQ-LF)) and an objective method (accelerometry). Methods: This work consisted of a cross-sectional, observational and prospective study that included two phases: qualitative and quantitative. The first included the translation process (from the original questionnaire, in English, to European Portuguese) and cultural adaptation of the GPAQv2. The second included the assessment of psychometric properties (reliability and validity). A total of 118 participants were recruited in order to assess their PA pattern and sedentary behavior (SB) through the GPAQv2, by self-administration. The validation process was carried out by comparing the variables evaluated by the IPAQ-LF (concurrent validity) and using the ActiGraph wGT3X-BT accelerometer (criterion validity). PA and SB were evaluated in two moments (M1 and M2), at baseline and after seven consecutive days. Initially, an Exploratory Analysis of the data was carried out. Subsequently, the Test-Retest technique was used to analyze the reliability of the GPAQv2, through the Kappa test (k) and the Intraclass Correlation Coefficient (ICC). Validity was assessed by Spearman's Correlation Coefficient (rho). The agreement between GPAQv2 versus accelerometer was evaluated by Bland-Altman graphical analysis. PA was evaluated in minutes/week (min/week) and SB in hours/day (h/d) additionally. Results: The study included 108 adult participants (38.94 ± 11.45 years; 50.9% male) that completed all assessments. Reliability ranged from strong to almost perfect (k: 0.864-0.976, p < 0.001) and from moderate to excellent (ICC: 0.562-0.994, p < 0.001), for GPAQv2’s categorical and continuous variables, respectively. There was a moderate to substantial correlation between IPAQ-LF and GPAQv2 (rho: 0.471-0.680, p < 0.001) and a fair to substantial criterion validity (rho: 0.226-0.672, p < 0.05) between the accelerometer and GPAQv2. Bland-Altman plots showed that GPAQv2 overestimates vigorous physical activity (VPA) by 109.67 min/week (-204.14 to 423.48) and moderate to vigorous physical activity (MVPA) by 93.62 min/week (-347.18 to 534.42); and underestimated the moderate 11 physical activity (MPA) by 16.05 min/w (-327.91 to 295.80). The highest difference found was related to SB, 172.67 min/week (2.88 h/d), since GPAQv2 underestimated the sitting time. Conclusions: The GPAQv2, by self-administration, has an acceptable validity and reliability for assessing the pattern of PA and SB in the Portuguese adult population. However, despite the fair to substantial criterion validity obtained, it should be taken into account that the levels of PA reported by GPAQv2 were higher than those assessed by accelerometry, namely for VPA and MVPA, and lower for MPA and SB.
Descrição
Tese de mestrado, Reabilitação Cardiovascular, Universidade de Lisboa, Faculdade de Medicina, 2023
Palavras-chave
Atividade física Questionários Acelerómetro Validade Comparação de métodos Teses de mestrado - 2023