- 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
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.
ICF Domain
Participation
Administration
- Completed by self-report or by an 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
Number of Items
39
Equipment
None
Scoring
A participation score (range: 30-155) and a problem score (0-16) are produced by summing items in each scale.
Languages
English and Thai
Training Required
Does not require advanced training
Availability
The Impact on Participation and Autonomy Questionnaire worksheet can be found here.
The above file contains the IPAQ rating system and scale items in the format of a ready-to-use worksheet for data collection.
# of studies reporting psychometric properties: 6
Interpretability
- Higher scores in participation domain = lower participation
- Higher scores in problem experience domain = more problem
- Typical values: Mean (SD) Subscale Scores:
- Autonomy Indoors = 0.55 (0.77)
- Family Role = 0.99 (0.97)
- Autonomy Outdoors = 1.14 (1.14)
- Social Life & Relationships = 0.62 (0.70)
- Work & Education = 0.99 (1.12)
(Noonan et al. 2010a; n=545; 145 with SCI, 79 males; ASIA A-D; n=187 spinal column fracture; n=213 spinal degenerative disease)
MCID: not established in SCI
SEM:
Autonomy Indoors: 0.25
Family Role: 0.30
Autonomy Outdoors: 0.42
Social life and relationships: 0.28
Work and Education: 0.35
(Noonan et al. 2010a; n=545; 145 with SCI, 79 males; ASIA A-D; n=187 spinal column fracture; n=213 spinal degenerative disease)
MDC:
Autonomy Indoors: 0.70
Family Role: 0.83
Autonomy Outdoors: 1.18
Social life and relationships: 0.76
Work and Education: 0.96
(Noonan et al. 2010a; n=545; 145 with SCI, 79 males; ASIA A-D; n=187 spinal column fracture; n=213 spinal degenerative disease)
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).
(Noonan et al. 2010b: n=545; 145 with SCI, 79 males; ASIA A-D; n=187 spinal column fracture; n=213 spinal degenerative disease)
(Cardol et al. 1999: n=100, n=3 with SCI)
(Cardol et al. 2001: n=126, n=21 with SCI
(Sibley et al. 2006: n=213, n=42 with SCI)
Validity
- Moderate to High correlation between IPAQ Autonomy Indoors and:
London Handicap Scale: r = -0.31 to -0.68
Functional Limitations Profile: r = 0.43 to 0.63
SF-36: r= -0.43 to -0.57 - Moderate to High correlation between IPAQ Family Role and:
London Handicap Scale: r = -0.37 to -0.70
Functional Limitations Profile: r = 0.50 to 0.68
SF-36: r = -0.42 to -0.68 - Moderate correlation between IPAQ Social Life and Relationships and:
London Handicap Scale: r = -0.32 to -0.58
Functional Limitations Profile: r = 0.45 to 0.53
SF-36: r = -0.43 to -0.46 - Low to High correlation between IPAQ Autonomy Outdoors and:
London Handicap Scale: r = -0.29 to -0.74
Functional Limitations Profile: r = 0.45 to 0.66
SF-36: r = -0.45 to -0.65 - Low to Moderate correlation between IPAQ Work and Education and:
London Handicap Scale: r = -0.19 to -0.51
Functional Limitations Profile: r = 0.42 to 0.50
SF-36: r = -0.40 to -0.49
(Sibley et al. 2006; n=213 (42 SCI); 89 males, outpatient)
Responsiveness
The Standard Response Mean (SRM) of the IPAQ Participation Domains has not been established in SCI. However, for patients with various neurological diagnoses 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: n=49; 13 males; mixed diagnoses; median duration of disease = 2 years)
Floor/Ceiling Effect
There are significant ceiling effects (>20% have best possible score) in all the IPAQ subscales.
(Lund et al. 2007: n=161, 101 males, 60 females; mean age = 52 years; 100 paraplegia, 61 tetraplegia)
Reviewers
Dr. Carlos L. Cano-Herrera, Tyra Chu
Date Last Updated
31 December 2024
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
