Physical Activity and Sedentary Time in Chronic Stroke: An Agreement Study Between the IPAQ-SF and ActiGraph Measures

BackgroundThe International Physical Activity Questionnaire - Short Form (IPAQ-SF) and ActiGraph accelerometers are widely used and internationally recommended to assess physical activity (PA) and sedentary time (ST). However, their agreement in individuals with chronic stroke remains unclear.ObjectivesTo quantify the magnitude of agreement between IPAQ-SF and ActiGraph-derived weekly moderate-to-vigorous PA (MVPA), total PA, and ST in chronic stroke survivors.MethodsFifty community-dwelling adults with chronic stroke who walked independently were enrolled in this cross-sectional study. Participants wore an accelerometer (ActiGraph GT3X+) on the non-paretic side of the waist for seven consecutive days. The IPAQ-SF was completed via interview on the following day.ResultsIPAQ-SF and ActiGraph-derived estimates showed substantial individual-level discrepancies, with wide limits of agreement (LoA) across outcomes. For MVPA, the mean ratio was 1.02 (95%CI: 0.49 to 2.11; ratio LoA: 0.01 to 154.62). For total PA, the median ratio was 0.08 (95% CI: 0.06 to 0.14; non-parametric ratio LoA: 0.00 to 1.33). For ST, the mean ratio was 0.85 (95%CI: 0.78 to 0.92; ratio LoA: 0.47 to 1.53).ConclusionFindings indicate poor individual-level agreement between the IPAQ-SF and ActiGraph-derived estimates, with wide LoA and evidence of heteroscedasticity. At the group level, the IPAQ-SF underestimated total PA and ST, whereas MVPA showed no evidence of fixed bias. Although the IPAQ-SF may provide a broad descriptive assessment of PA and ST at the group level, it should not be used interchangeably with ActiGraph for individual-level estimation in individuals with chronic stroke.