• 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)

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.

ICF Domain

Participation

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.

Number of Items

N/A

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.

Languages

N/A

Training Required

Does not require advanced training

Availability

The interview script and scoring sheet can be found here.

# of studies reporting psychometric properties: 3

  • 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)

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

Reliability

  • Moderate to High Test-retest Reliability:
    Cumulative: ICC = 0.79
    LTPA: ICC = 0.72
    Lifestyle Activity: ICC = 0.78

(Martin Ginis et al. 2005: N = 102, 72% male, mixed injury types, mean (SD) time since injury = 12.5 (11.2) years for paraplegics (n = 50), 11.2 (8.5) years for tetraplegics (n = 52))

  • Moderate Test-retest Reliability:
    Non-ambulatory participants: ρ (95%CI) = 0.68 (0.53-0.79)
    Ambulatory participants: ρ (95%CI) = 0.53 (0.24-0.73)

(Zbogar et al. 2016: N = 106; Non-ambulatory patients (n = 70), 49M, 21F, Mean age (SD) = 48.9 (18.3), 49% Paraplegic, 51% Tetraplegic; Ambulatory patients  (n = 36), 26M, 9F, Mean age (SD) = 51.8 (15.4), 63% Paraplegic, 37% Tetraplegic)

Validity

  • Moderate correlation between Leisure Time Physical Activity Questionnaire for People with Spinal Cord Injury and PARA-SCI LTPA subscale:
    r = 0.46

(Martin Ginis et al. 2012: N = 103, 75% male, mixed injury types, general community, mean (SD) time since injury = 17.9 (11.9) years)

  • Moderate correlation with Step Counts: r (95%CI) = 0.35 (0.01-0.61)
  • Low correlation with Wrist accelerometry: r (95%CI) = -0.04 (-0.27-0.20)
  • Low correlation with SCIM III mobility score: r (95%CI) = -0.14 (-0.37-0.11)

(Zbogar et al. 2016: N = 106; Non-ambulatory patients (n = 70), 49M, 21F, Mean age (SD) = 48.9 (18.3), 49% Paraplegic, 51% Tetraplegic; Ambulatory patients  (n = 36), 26M, 9F, Mean age (SD) = 51.8 (15.4), 63% Paraplegic, 37% Tetraplegic)

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)

Reviewers

Dr. Ben Mortenson, John Zhu, Gita Manhas

Date Last Updated

22 July 2020

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

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