Impact on Participation and Autonomy Questionnaire (IPAQ)

Download Clinical Summary PDF

Tool Description

  • Self-administered questionnaire developed using the ICF model of human functioning and disability.
  • Developed using input from experienced clinicians and individuals attending an out-patient rehabilitation unit (e.g. stroke, SCI, rheumatoid arthritis, and neuromuscular conditions)
  • Assesses autonomy and participation as perceived by the individual.
  • Measures two different aspects of participation: perceived participation and the experience of problems for each aspect of participation.

The participation domains include:
1) autonomy outdoors (e.g. visiting friends, leisure time)
2) autonomy indoors (e.g. self-care)
3) family role (e.g. housework)
4) social relations
5) paid work and education.

ICF Domain:

Participation.

Number of Items:

39

Brief Instructions for Administration & Scoring

Administration:

  • Completed by self-report or by interviewer.
  • The perceived participation scale consists of 31 items which are assessed using a 5 point rating scale (1=very good and 5=very poor) and the problem scale contains 8 items which are assessed using a 3 point rating scale (0=no problem and 2=severe problem).
  • Administration requires approximately 20 minutes.

Equipment:None.

Scoring:

  • A participation score (range: 30-155) and a problem score (0-16) are produced by summing items in each scale.

Interpretability

MCID: not established in SCI
SEM: [Noonan et al. 2010a]
Autonomy Indoors: 0.25
Family Role: 0.30
Autonomy Outdoors: 0.42
Social life and relationships: 0.28
Work and Education: 0.35

MDC: [Noonan et al. 2010a]
Autonomy Indoors: 0.70
Family Role: 0.83
Autonomy Outdoors: 1.18
Social life and relationships: 0.76
Work and Education: 0.96

  • Higher scores in participation domain = lower participation
  • Higher scores in problem experience domain = more problem
  • No normative data has been established for the SCI population
  • Published data is available to compare results for individuals with SCI (see interpretability section of Study Details sheet).

Languages:

English only.

Training Required:

None.

Availability:

See the ‘How-to use’ page of this tool.

Clinical Considerations

  • Items should be acceptable and relevant to individuals with SCI as the IPAQ was developed using input from experienced clinicians and individuals attending an out-patient rehabilitation unit

Measurement Property Summary

# of studies reporting psychometric properties: 6

Reliability:

  • Internal consistency is High for all the IPAQ subscales:
    • Social relationships (Cronbach’s a=0.86-0.90)
    • Autonomy Indoors (Cronbach’s a=0.84-0.94)
    • Family Role (Cronbach’s a=0.84-0.95)
    • Autonomy outdoors (Cronbach’s a=0.81-0.95)
    • Work and Education (Cronbach’s a=0.86-0.96).
  • Test-retest reliability is High for all IPAQ subscales:
    • Social relationships (ICC=0.83-0.94)
    • Autonomy Indoors (ICC=0.87-0.95)
    • Family Role (ICC=0.83-0.97)
    • Autonomy outdoors (ICC=0.91-0.97)
    • Work and Education (ICC=0.91).

[Cardol et al. 1999, Cardol et al. 2001, Sibley et al. 2006]

Validity:

  • Correlations between IPAQ subscales (Autonomy indoors, Family role and Autonomy outdoors) and the Short Form -36 Physical Domain are Moderate (Pearson’s r=-0.43 to -0.51).

[Cardol et al. 1999, Cardol et al. 2001, Sibley et al. 2006, Lund et al. 2005, Lund et al. 2007]

Responsiveness:

  • The Standard Response Mean (SRM) of the IPAQ Participation Domains are as follows:
    • Autonomy Indoors (0.4)
    • Family Role (0.8)
    • Autonomy Outdoors (1.2)
    • Social Relations (0.1)
    • Work and Education (1.3).

[Cardol et al. 2002]

Floor/ceiling effect:

  • There are significant ceiling effects (>20% have best possible score) in all the IPAQ subscales.

[Lund et al. 2007]

Reviewer

Dr. Ben Mortenson, Jeff Tan/Brodie Sakakibara, John Zhu, Jeremy Mak, Kyle Diab

Date Last Updated:

Mar 23, 2017

Download the measure

Download Worksheet:

Worksheet Document

Video

n/a

Scoring

2 scores are calculated for the IPAQ:

- the Participation domains score

- the Problem experience score

See the worksheet for the scale items that are summed for each score.

Equipment Needed

IPAQ:

Cardol M, Beelen A, van den Bos GA, de Jong BA, de Groot IJ, de Haan RJ. Responsiveness of the Impact on Participation and Autonomy Questionnaire. Arch Phys Med Rehabil 2002; 83:1524-1529.
http://www.ncbi.nlm.nih.gov/pubmed/12422319

Cardol M, de Haan RJ, van den Bos GA, de Jong BA, de Groot IJ. The development of a handicap assessment questionnaire: the Impact on Participation and Autonomy (IPA). Clin Rehabil 1999;13:411-419.
http://www.ncbi.nlm.nih.gov/pubmed/10498348

Cardol M, de Haan RJ, de Jong BA, van den Bos GA, de Groot IJ. Psychometric properties of the Impact on Participation and Autonomy Questionnaire. Arch Phys Med Rehabil 2001; 82:210-216.
http://www.ncbi.nlm.nih.gov/pubmed/11239312

Cardol M, de Jong BA, van den Bos GA, Beelem A, de Groot IJ, de Haan RJ. Beyond disability: perceived participation in people with a chronic disabling condition. Clin Rehabil 2002;16:27-35.
http://www.ncbi.nlm.nih.gov/pubmed/11841066

Lund ML, Nordlund A, Nygard L, Lexell J, Bernspang B. Perceptions of participation and predictors of perceived problems with participation in persons with spinal cord injury. J Rehabil Med, 2005; 37(1): 3-8.
http://www.ncbi.nlm.nih.gov/pubmed/15788326

Lund ML, Nordlund A, Bernspang B, Lexell J. Perceived participation and problems in participation are determinants in life satisfaction in people with spinal cord injury. Disability & Rehabilitation, 2007; 29(18): 1417-22.
http://www.ncbi.nlm.nih.gov/pubmed/17729088

Noonan VK, Kopec JA, Noreau L, Singer J, Masse LC, Dvorak MF. Comparing the reliability of five participation instruments in persons with spinal conditions. J Rehabil Med, 2010; 42: 735-43.
http://www.ncbi.nlm.nih.gov/pubmed/20809055

Noonan VK, Kopec JA, Noreau L, Singer J, Masse LC, Dvorak MF. Comparing the validity of five participation instruments in persons with spinal conditions. J Rehabil Med, 2010; 42: 724-34.
http://www.ncbi.nlm.nih.gov/pubmed/20809054

Sibley A, Kersten P, Ward CD, White B, Mehta R, George S. Measuring autonomy in disabled people: validation of a new scale in a UK population. Clin Rehabil, 2006; 20:793-803.
http://www.ncbi.nlm.nih.gov/pubmed/17005503

Suttiwong J, Vongsirinavarat M, Vachalathiti R, Chaiyawat P. Impact on participation and autonomy questionnaire: psychometric properties of the thai version. J Phys Ther Sci. 2013;25(7):769-74.
http://www.ncbi.nlm.nih.gov/pubmed/24259849