The PROactive instruments to measure physical activity in patients with chronic obstructive pulmonary disease

Elena Gimeno-Santos, Yogini Raste, Heleen Demeyer, Zafeiris Louvaris, Corina De Jong, Roberto A. Rabinovich, Nicholas S. Hopkinson, Michael I. Polkey, Ioannis Vogiatzis, Maggie Tabberer, Fabienne Dobbels, Nathalie Ivanoff, Willem I. De Boer, Thys Van Der Molen, Karoly Kulich, Ignasi Serra, Xavier Basagaña, Thierry Troosters, Milo A. Puhan, Niklas KarlssonJudith Garcia-Aymerich, Solange Corriol-Rohou, Ian Jarrod, Damijen Erzen, Caterina Brindicci, Tim Higenbottam, Mario Scuri, Paul McBride, Nadia Kamel, Pim De Boer, Alastair Glendenning, Katja Rudell, Frederick J. Wilson, Enkeleida Nikai, Bill MacNee, Anja Frei

Research output: Indexed journal article Articlepeer-review

102 Citations (Scopus)


No current patient-centred instrument captures all dimensions of physical activity in chronic obstructive pulmonary disease (COPD). Our objective was item reduction and initial validation of two instruments to measure physical activity in COPD. Physical activity was assessed in a 6-week, randomised, two-way cross-over, multicentre study using PROactive draft questionnaires (daily and clinical visit versions) and two activity monitors. Item reduction followed an iterative process including classical and Rasch model analyses, and input from patients and clinical experts. 236 COPD patients from five European centres were included. Results indicated the concept of physical activity in COPD had two domains, labelled "amount" and "difficulty". After item reduction, the daily PROactive instrument comprised nine items and the clinical visit contained 14. Both demonstrated good model fit (person separation index >0.7). Confirmatory factor analysis supported the bidimensional structure. Both instruments had good internal consistency (Cronbach's α>0.8), test-retest reliability (intraclass correlation coefficient ≥0.9) and exhibited moderate-to-high correlations (r>0.6) with related constructs and very low correlations (r<0.3) with unrelated constructs, providing evidence for construct validity. Daily and clinical visit "PROactive physical activity in COPD" instruments are hybrid tools combining a short patient-reported outcome questionnaire and two activity monitor variables which provide simple, valid and reliable measures of physical activity in COPD patients.

Original languageEnglish
Pages (from-to)988-1000
Number of pages13
JournalEuropean Respiratory Journal
Issue number4
Publication statusPublished - 1 Oct 2015


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