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Svege et al. BMC Musculoskeletal Disorders 2012, 13:26


Open Access

Reliability and validity of the Physical Activity Scale for the Elderly (PASE) in patients with hip osteoarthritis
Ida Svege1*†, Elin Kolle2† and May Arna Risberg1,2†
Background: Physical activity (PA) is beneficial in reducing pain and improvingfunction in lower limb osteoarthritis (OA), and is recommended as a first line treatment. Self-administered questionnaires are used to assess PA, but knowledge about reliability and validity of these PA questionnaires are limited, in particular for patients with OA. The purpose of this study was to evaluate the reliability and validity of the Physical Activity Scale for the Elderly (PASE) inpatients with hip OA. Methods: Forty patients with hip OA (20 men and 20 women, mean age 61.3 ± 10 years) were included. For testretest reliability PASE was administered twice with a mean time between tests of 9 ± 4 days. Intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimal detectable change (MDC) were calculated for the total score and for the particular itemsassessing different PA intensity levels. In addition a Bland-Altman analysis for the total PASE score was performed. Construct validity was evaluated by comparing the PASE results with the Actigraph GT1M accelerometer and the International Physical Activity Questionnaire (IPAQ), using the Spearman rank correlation coefficient. Results: ICC for the total PASE score was 0.78, with relatively large errorof measurement; SEM = 31 and MDC = 87. ICC for the intensity items was 0.20 for moderate PA intensity, 0.46 for light PA intensity and to 0.68 for vigorous PA intensity. The Spearman rank correlation coefficient between the Actigraph GT1M total counts per minute and the total PASE score was 0.30 (p = 0.089), and ranging from 0.20-0.38 for the different PA intensity categories. The Spearman rankcorrelation between IPAQ and PASE was 0.61 (p = 0.001) for the total scores. Conclusions: In patients with hip OA the test-retest reliability of the total PASE score was moderate, with acceptable ICC, but with large measurement errors. The construct validity of the PASE was poor when compared to the Actigraph GT1M accelerometer. Test-retest reliability and construct validity revealed that the PASEwas unable to assess PA intensity levels. PASE is not recommended as a valid tool to examine PA level for patients with hip OA.

Background Physical inactivity is considered to be a risk factor for many life-threatening diseases and regarded as a major burden on general public health, therefore international and national guidelines recommend that all adults engage in moderate to vigorous physicalactivity
* Correspondence: † Contributed equally 1 Norwegian Research Center for Active Rehabilitation, Department of Orthopedics, Oslo University Hospital, Ullevaal and Hjelp 24 NIMI, Oslo, Norway Full list of author information is available at the end of the article

(MVPA) for at least 30 minutes per day[1-3]. Patients with OA are found to be less physically active thanthe general adult population, and fewer fulfill the recommendations of 30 minutes MVPA per day[4,5]. Being physically active according to the recommended guidelines is beneficial in preserving function and reduce symptoms[6], and PA is recommended as a first line treatment that should be offered to all individuals with hip or knee OA[7,8]. The efficacy and importance of PA and exercise forpatients with OA of the lower limbs have been emphasized in several studies[9-12].

© 2012 Svege et al; licensee Chemistry Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly...
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