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Aim: In Japan, there are no valid and reliable physical activity questionnaires for elderly people. In this study, we translated the Physical Activity Scale for the Elderly (PASE) into Japanese and assessed its validity and reliability.
Physical Activity Scale For The Elderly Questionnaire Download
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Methods: Three hundred and twenty-five healthy and elderly subjects over 65 years were enrolled. Concurrent validity was evaluated by Spearman's rank correlation coefficient between PASE scores and an accelerometer (waking steps and energy expenditure), a physical activity questionnaire for adults in general (the Japan Arteriosclerosis Longitudinal Study Physical Activity Questionnaire, JALSPAQ), grip strength, mid-thigh muscle area per bodyweight, static valance and bodyfat percentage. Reliability was evaluated by the test-retest method over a period of 3-4 weeks.
Old age is associated with reduced physical ability. It is necessary to measure and evaluate the physical activity of older people. Implementing appropriate requires a valid and reliable tool. Physical Activity Scale for the Elderly (PASE) is the frequently used self-reported physical activity assessment for older adults. Therefore, this study aimed to determine the translation validity and reliability of the Persian version of the Physical Activity Scale for the Elderly.
The Persian or Farsi version of PASE was shown to have acceptable validity and reliability. This tool is suitable for measuring the physical activity level in the Persian elderly language special in clinical environments and therapeutic interventions.
Ageing is one of the most important anthropological phenomena of the century [1]. The life expectancy of older people is rising around the world [2]. In Iran, in the next decade, an increase in the population of the elderly will be significant, that the population of people over 60 will reach 8.5 million [3]. Ageing is accompanied by a reduction in physical abilities in all countries [4]. Also, the rate of motor disability in the Iranian elderly is significant [5].
There are several tools for measuring daily activity in adult populations, which are also used for the elderly. Some of them are Functional Independence Measure (FMI), Barthel index and Katz Activities of Daily Living (ADL) [19, 20]. Although these tools, have been good metrics proprieties and are widely used to assess functional decline [19] some of them, such as the Katz Index used to assess the level of independence in older adults [20]. Specifically, most activity questionnaires do assess moderate-to-vigorous physical activity and not involved in less strenuous activities such as light housework [21, 22]. Also, little is known about the patterns of physical activity among older people [23, 24]. This is due, in part, to a lack of reliable and valid measures of physical activity among the aged [21]. One of the tools for measuring the level of physical activity in the elderly, currently used globally, is the Physical Activity Scale for the Elderly (PASE). PASE was first designed in 1993 by Washburn et al. [25]. The PASE is a self-report/interview-based measure designed to capture and assess occupational, household, and leisure activities typically performed by older adults; that is, those who are 65 year. of age and older [21]. The results indicated that PASE can be considered as an appropriate tool for measuring the physical activity of the elderly [25]. The advantages of The PASE compared to the others are the short practice period, the easy scoring process, and self-report/interview-based measures that applicability via letters or phone [21]. Separately, it consists of three subheadings of leisure time, household, and work-related activities [25]. which makes it easier to compare subheadings with others and to evaluate the physical activities of individuals among themselves in more detail [26, 27]. To investigate the broad characteristics of physical activity of the Persian population, the translation and validation of scale are important. Therefore, the aims of the study were to translate the PASE scale into Persian, to culturally adapt the instrument, and to evaluate its validity and reliability.
The PASE originally developed in the United Kingdom in 1993. The PASE measures the level of self-reported physical activity in individuals aged 65 years or older for the purpose of assessing the components of physical activities involving leisure time, work-related activities, and the household during the previous 7-day period [21]. The PASE evaluates the frequency, duration, and intensity of physical activities related to walking; light, moderate, and strenuous sports and entertainment activities; muscle strengthening and endurance exercises; work-related activities including walking and standing up; lawn and garden care; care for another individual; house repairs; and heavy and light household activities. The questions are scored differently. The total PASE score is computed by multiplying either the time spent in each activity (hours per week) or participation (i.e., yes/no) in an activity, by empirically derived item weights and then summing overall activities. The overall PASE score ranges from 0 to 400 or more and high scores show better physical activity levels [26, 27]. The English version of PASE is available at the following web address: -pedia.com/Physical_Activity_Scale_for_the_Elderly_(PASE). The PASE administration and Scoring Instruction Manual is available at the following web address: -content/uploads/instrumenten/PASE-handl.pdf.
The participants of the study had to be aged 65 years and older, based on previous validations of the PASE [29]. Three hundred elder people were selected from the retirement community or the City Pensioners Association by convenience sampling in Yazd province, Iran. The inclusion criteria for older people were able to perform daily activities independently and were mobile and willingness to cooperate. Exclusion criterion was amputation in the upper and lower limbs, having some diseases or progressive illness (such as rheumatoid arthritis, cancer, serious osteoporosis, stroke, and severe cardiovascular disease), neurological or general diseases, and mental illness with medical treatment that could have negatively influenced the daily life activity. Inclusion and exclusion criteria were assessed by reviewing the file and asking questions of the participants.
The first phase was related to the translation and cultural adaptation of scale. In this phase, the scale was translated based on the process of translation and adaptation of scale recommended by the World Health Organization. The purpose of this process is to achieve different language versions of the English tool that are conceptually equivalent in each of the target nations/cultures. The tool, while simple and practically acceptable perform in the same way, should be equally natural and acceptable. The focus in this method was on cross-cultural and conceptual nature, rather than on linguistic meanings or literal equivalence. A well-established process to achieve this goal is to use forward-translations and back-translations. The implementation of this method includes the four steps included forward translation, expert panel back-translation, pre-testing and cognitive interviewing, and final version. In this study, first, the scale was translated into Persian by two expert translators (health professionals, familiar with the terminology of the area and English-speaking culture). Then was established an expert panel with two English experts, two geriatric experts, and two physical activity experts. They were asked to study the scale carefully and compare it to the original version in terms of it being equivalent in meaning. Thus it was produced a complete translated version of the scale. After this stage, the translated scale was translated into English by two experts in English without access to the original scale. The pre-test and cognitive interview respondents were ten older people. Then the final edition scale for the rest of the study was confirmed.
The third phase related to the validation of the scale that included face (qualitative and quantitative) and content validity. Purposive sampling was also used in relation to the determination of face and content validity as well as the selection of experts in the field of geriatric and the selection of older people (10 people).
In this study to determining qualitative face validity, the opinions of a 6-person specialist panel including two professional health, two sports, and two geriatric experts, were considered. The level of difficulty, ambiguity, and vague expressions, or any difficulty with comprehension and understanding of the concepts was checked. The corrective comments of this stage were examined and reviewed in a panel consisting of members of the research team and other invited experts.
In order to assess the qualitative content validity of the translated scale, five experts (geriatric, physical activity, and community health nurse) were asked to study the tool carefully and provide written corrective comments on grammar, vocabulary, and the use of proper words, the importance of questions, proper order of questions, and the time to complete the questionnaire. The corrective comments of this stage were examined and reviewed in a panel consisting of members of the research team and other invited experts.
Content validity is defined as the degree to which items of a tool are relevant to and representative of the targeted concept for a specific evaluation purpose [37]. In the current study, quantitative content validity was assessed two different methods were used to check the content validity of the scale: Content Validity Ratio (CVR) and Content Validity Index (CVI).
The Confirmatory Factor Analysis (CFA) was carried out to determine the factor structures of the Persian version of PASE. The models were compared with each other according to the obtained dispersion indices including the ratio of Chi Square to its degrees of freedom (2/df), Comparative Fit Index (CFI), Goodness Of Fit Index (GFI), Adjusted Goodness Of Fit Index (AGFI), Root Mean Square Residual (RMR), and Root Mean Square Error of Approximation (RMSEA) [43]. 152ee80cbc
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