Physical Activity Recall Assessment for People with Spinal Cord injury (PARA-SCI)

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Tool Description

  • Designed to capture information on the type, frequency, duration and intensity of physical activity carried out by people with SCI using a wheelchair as their primary mode of mobility. Individuals are asked about their activity over the previous 3 days, starting with the prior day.
  • Activity is broken down into 8 periods:
    1. Morning routine (subdivided into transferring, bowel and bladder management, bathing, personal hygiene, dressing)
    2. Breakfast
    3. Morning
    4. Lunch
    5. Afternoon
    6. Dinner
    7. Evening
    8. Evening Routine (subdivided into transferring, bowel and bladder management, bathing, personal hygiene, dressing)

ICF Domain:

Participation

Number of Items:

n/a

Brief Instructions for Administration & Scoring

Administration:

  • Data are reported as an average number of minutes of activity per day (mild, moderate, heavy, total) for the two dimensions (Leisure-time physical activity or lifestyle activity) and a cumulative index.
  • On average, the interview can be completed within 20-30 minutes.

Interview protocol: An interview format was developed to capture activities performed over the last 3 days which are divided into 8 periods from morning routine to evening routine. The 2 routine periods are subdivided to capture activity related to daily living (transfer, bowel and bladder management, dressing, etc.).  The interviewer asks the respondent about general activities performed during each period.  The number of minutes spent on each specific activity is recorded and the activity is coded into 2 dimensions: Leisure-time physical activity or lifestyle activity.

Intensity Classification system: This system was developed from empirical data collected during maximal exercise testing (VO2max and 1RM muscle workload for chest press and bicep curl). From a list of adjectives, participants of the experiment identified words that described how they felt during exercise. Based on their responses, definitions were created for mild, moderate and heavy intensity exercise.

Equipment:

  • Only equipment patients use in their everyday physical activities.

Scoring:

  • Average daily LTPA and lifestyle activity scores are calculated by averaging the number of minutes of mild, moderate, and heavy activity reported for these activity categories across the three recalled days.
  • Average daily cumulative physical activity is calculated by averaging the sum of LTPA and leisure activity across the three recalled days.
  • As well, for each activity category (i.e., LTPA, lifestyle, cumulative), separate scores are calculated for mild, moderate, and heavy intensity levels.

Interpretability

MCID: not established for SCI
SEM and MDC: (both calculated from data in Martin-Ginis et al. 2005):

PARA-SCI measure and Intensity Level

SEM (min)

MDC (min)

Cumulative - Total

64.7

179.4

Cumulative - Mild

63.5

176.1

Cumulative - Moderate

36.3

100.6

Cumulative - Heavy

13.6

37.8

Leisure Time Activity - Total

31.7

87.9

Leisure Time Activity - Mild

15.3

42.3

Leisure Time Activity - Moderate

24.8

68.7

Leisure Time Activity - Heavy

8.5

23.5

Lifestyle Activity - Total

65.0

180.1

Lifestyle Activity - Mild

54.3

150.6

Lifestyle Activity - Moderate

29.5

81.7

Lifestyle Activity - Heavy

9.8

27.2

  • No cut-points or normative data have been established for the SCI population
  • Published data for the SCI population is available for comparison (see Interpretability section of Study Details sheet)

Languages:

n/a

Training Required:

None.

Availability:

Can be purchased from: http://www.flintbox.com/public/project/1902/. The telephone interview script can be found in the Appendix of Martin-Ginis et al. 2005 (http://www.ncbi.nlm.nih.gov/pubmed/16015125).

Clinical Considerations

  • PARA-SCI is a promising instrument that provides information on the intensity-based type of physical activities. It has to be used more extensively before a final assessment is completed.
  • This assessment was specifically developed for the SCI population.  It provides a quantitative measure of physical activity (including the intensity of exercise), taking into account ADLs – which are often physically taxing for individuals with SCI.

Measurement Property Summary

# of studies reporting psychometric properties: 3

Reliability:

  • Test-retest reliability is Moderate to High for the PARA-SCI measures of physical activity:
    • Cumulative activity (ICC=0.70-0.85)
    • Leisure time physical activity (LTPA) (ICC=0.6-0.8)
    • Lifestyle activity (ICC=0.68-0.84)

[Martin-Ginis et al. 2005]

Validity:

  • High correlations were found between indirect calorimetry measurement and PARA-SCI cumulative activity levels - moderate (Pearson’s r=0.63), heavy (Pearson’s r=0.88), total (Pearson’s r=0.79).
  • All correlations between the PARA-SCI and the Leisure Time Physical Activity Questionnaire – SCI measures of leisure time physical activity were positive and statistically significant.

[Martin-Ginis et al. 2005, Latimer et al. 2006, Martin-Ginis et al. 2012]

Responsiveness:

No values were reported for the responsiveness of the PARA-SCI for the SCI population at this time.

Floor/ceiling effect:

  • Minimum between-subject variability may have caused floor effects in heavy intensity lifestyle activity for reliability scores.

[Martin-Ginis et al. 2005]

Reviewer

Dr. Ben Mortenson, John Zhu

Date Last Updated:

Mar 16, 2017

Download the measure

Download Worksheet:
Can be purchased from: http://www.flintbox.com/public/project/1902/. The telephone interview script can be found in the Appendix of Martin-Ginis et al. 2005 (http://www.ncbi.nlm.nih.gov/pubmed/16015125).

Video

n/a

Scoring

n/a

Equipment Needed

PARA-SCI:

Latimer A, Martin Ginis K, Craven B, Hicks A. The Physical Activity Recall Assessment for People with Spinal Cord Injury: Validity. Med  Sci Sports Exerc 2006;38:208-216.
http://www.ncbi.nlm.nih.gov/pubmed/16531886

Martin Ginis K, Latimer A, Hicks A, Craven B. development and Assessment of an Activity Measure for People with Spinal Cord Injury. Med  Sci Sports Exerc 2005;37:1099-1111.
http://www.ncbi.nlm.nih.gov/pubmed/16015125

Martin Ginis KA, Phang SH, Latimer AE, Arbour-Nicitopoulos KP. Reliability and validity tests of the leisure time Physical Activity Questionnaire for People with Spinal Cord Injury. Arch Phys Med Rehabil, 2012; 93: 677-82.
http://www.ncbi.nlm.nih.gov/pubmed/22336103