The use of the Godin-Shephard Leisure-Time Physical Activity Questionnaire in oncology research: a systematic review

BMC Medical Research Methodology

Catherine M. Sabiston²  Jason Lacombe²  Gaston Godin¹  Steve Amireault³ 

[1] Faculty of Nursing, Université Laval, Quebec City G1V 0A4, QC, Canada;Department of Health and Kinesiology, Purdue University, Lambert Fieldhouse, 800 W. Stadium Ave. Room 311A, West Lafayette, IN, USA;Department of Psychology, Faculty of Arts and Science, Concordia University, Montreal, QC, Canada

关键词: Reproducibility of results;    Questionnaires;    Oncology;    Neoplasm;    Exercise;    Cancer;   

Others  :  1222422
DOI  :  10.1186/s12874-015-0045-7

 received in 2014-10-30, accepted in 2015-07-06,  发布年份 2015

【 摘 要 】

Background

The Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ) is one of the most often used questionnaires in oncology research, yet modifications to the scale are done with little evidence of psychometric testing. This study aimed to (i) document the frequency of use of the questionnaire for ranking (i.e., level of activity) and classification (i.e., active versus insufficiently active) purposes, (ii) summarize how the GSLTPAQ is used in terms of item content and scoring, and (iii) evaluate the extent to which validity evidence supports the use of the scale among cancer survivors.

Methods

A systematic review was conducted with evidence drawn from English-written articles published between January 1 ^st1985 (year the GSLTPAQ was published) and December 31, 2014. A search of six databases, a scan of reference list of included articles, and a cited reference search identified articles that reported using the GSLTPAQ among cancer survivors.

Results

A total of 212 articles were retrieved. The GSLTPAQ was used for classifying cancer survivors into active and insufficiently active categories in 51 % of the articles. Moreover, a modified version of the questionnaire was used in 81 % of the research studies. Three studies reported validity evidence based on the relationship between the scores on the GSLTPAQ (i.e., leisure score index, LSI) and accelerometer or pedometer-derived activity data. Validity evidence supporting the use of the GSLTPAQ for assessing changes in LSI was computed from six randomized trials.

Conclusions

The use of the GSLTPAQ for classification purpose in oncology research is common. Standardization in the use and interpretation of the GSLTPAQ in oncology research is warranted. Although limited, there is support for using the original form of the GSLTPAQ and interpreting the LSI for ranking cancer survivors from the lowest to highest levels of leisure-time physical activity.

【 授权许可】

   
2015 Amireault et al.

【 图 表 】

Fig. 1.

Fig. 2.

【 参考文献 】

• [1]Caspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985; 100:126-31.
• [2]Bouchard C, Blair SN, Haskell WL. Why Study Physical Activity and Health? In: Physical activity and health. 1st ed. Bouchard C, Blair SN, Haskell WL, editors. Human Kinetics, Inc, Champaign, IL, USA; 2007: p.3-20.
• [3]Church TS, Thomas DM, Tudor-Locke C, Katzmarzyk PT, Earnest CP, Rodarte RQ, et al. Trends over 5 decades in U.S. occupation-related physical activity and their associations with obesity. PLoS One. 2011;6:e19657.
• [4]Troiano RP, Pettee Gabriel KK, Welk GJ, Owen N, Sternfeld B. Reported physical activity and sedentary behavior: why do you ask? J Phys Act Health. 2012; 9 Suppl 1:S68-75.
• [5]Jacobs DR, Ainsworth BE, Hartman TJ, Leon AS. A simultaneous evaluation of 10 commonly used physical activity questionnaires. Med Sci Sports Exerc. 1993; 25:81-91.
• [6]Mishra SI, Scherer RW, Geigle PM, Berlanstein DR, Topaloglu O, Gotay CC, et al. Exercise interventions on health-related quality of life for cancer survivors. The Cochrane Database Syst Rev. 2012;8, CD007566.
• [7]Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012;62:243–74.
• [8]Sabiston CM, Brunet J. Reviewing the benefits of physical activity during cancer survivorship. Am J Lifestyle Med. 2012; 6:167-77.
• [9]Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvao DA, Pinto BM, et al. American college of sports medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2010;42:1409–26.
• [10]Fong DY, Ho JW, Hui BP, Lee AM, Macfarlane DJ, Leung SS, et al. Physical activity for cancer survivors: meta-analysis of randomised controlled trials. BMJ. 2012;344, e70.
• [11]Godin G, Shephard RJ. A simple method to assess exercise behavior in the community. Can J Appl Sport Sci. 1985; 10:141-6.
• [12]Godin G. The Godin-Shephard Leisure-Time Physical Activity Questionnaire. Health Fit J Can. 2011;4:18–22.
• [13]Godin G, Shephard RJ. Godin leisure-time exercise questionnaire. Med Sci Sports Exerc. 1997;26 Suppl 6:S36–8.
• [14]Liu RD, Buffart LM, Kersten MJ, Spiering M, Brug J, van Mechelen W, et al. Psychometric properties of two physical activity questionnaires, the AQuAA and the PASE, in cancer patients. BMC Med Res Methodol. 2011;11:30.
• [15]Su CC, Lee KD, Yeh CH, Kao CC, Lin CC. Measurement of physical activity in cancer survivors: a validity study. J Cancer Surviv. 2014; 8:205-12.
• [16]Masse LC, de Niet JE. Sources of validity evidence needed with self-report measures of physical activity. J Phys Act Health. 2012; 9 Suppl 1:S44-55.
• [17]Canadian Society for Exercise Physiology: Canadian Physical Activity Guidelines for Adults- 18–64 years. http://www. csep.ca/english/view.asp?x=804 webcite
• [18]Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, et al. American College of Sports Medicine position stand. quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43:1334–59.
• [19]Physical activity and health: a report of the surgeon general. In: Book physical activity and health: a report of the surgeon general. Centers for disease control and prevention, national center for chronic disease prevention and health promotion, Atlanta, GA; 1996: p.278.
• [20]Division of cancer epidemiology & genetics research program of the national cancer institute: Godin Exercise Leisure-time Questionnaire. http://dceg. cancer.gov/tools/design/questionnaires/physical-activity/godin-exercise-and-leisure-time webcite
• [21]Division of cancer epidemiology & genetics research program of the national cancer institute: questionnaire development resources. questionnaires and questionnnaire segments for use in a variety of epidemiological studies. http://dceg. cancer.gov/tools/design/questionnaires webcite
• [22]Godin G, Jobin J, Bouillon J. Assessment of leisure time exercise behavior by self-report: a concurrent validity study. Can J Public Health. 1986; 77:359-62.
• [23]Miller DJ, Freedson PS, Kline GM. Comparison of activity levels using the caltrac accelerometer and five questionnaires. Med Sci Sports Exerc. 1994; 26:376-82.
• [24]Motl RW, McAuley E, DiStefano C. Is social desirability associated with self-reported physical activity? Prev Med. 2005; 40:735-9.
• [25]Hyde AL, Elavsky S, Doerksen SE, Conroy DE. Habit strength moderates the strength of within-person relations between weekly self-reported and objectively-assessed physical activity. Psychol Sport Exerc. 2012; 13:558-61.
• [26]Shephard RJ. Limits to the measurement of habitual physical activity by questionnaires. Br J Sports Med. 2003; 37:197-206.
• [27]Terwee CB, Mokkink LB, van Poppel MN, Chinapaw MJ, van Mechelen W, de Vet HC. Qualitative attributes and measurement properties of physical activity questionnaires: a checklist. Sports Med. 2010; 40:525-37.
• [28]Broderick JM, Ryan J, O'Donnell DM, Hussey J. A guide to assessing physical activity using accelerometry in cancer patients. Support Care Cancer. 2014; 22:1121-30.
• [29]Matthews CE, Moore SC, George SM, Sampson J, Bowles HR. Improving self-reports of active and sedentary behaviors in large epidemiologic studies. Exerc Sport Sci Rev. 2012; 40:118-26.
• [30]Kriska AM, Caspersen CJ. Introduction to a collection of physical activity questionnaires. Med Sci Sports Exerc. 1997; 29 Suppl 6:S5-9.
• [31]Schatzkin A, Subar AF, Moore S, Park Y, Potischman N, Thompson FE, et al. Observational epidemiologic studies of nutrition and cancer: the next generation (with better observation). Cancer Epidemiol Biomarkers Prev. 2009;18(4):1026–32.
• [32]Messick S. Validity of psychological assessment. Am Psychol. 1995; 50:741-9.
• [33]Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6: Article ID e1000097
• [34]National cancer institute: dictionary of cancer terms. http://www. cancer.gov/dictionary?cdrid=445089 webcite
• [35]Lagerros YT, Lagiou P. Assessment of physical activity and energy expenditure in epidemiological research of chronic diseases. Eur J Epidemiol. 2007; 22:353-62.
• [36]Sternfeld B, Goldman-Rosas L. A systematic approach to selecting an appropriate measure of self-reported physical activity or sedentary behavior. J Phys Act Health. 2012; 9 Suppl 1:S19-28.
• [37]van Poppel MN, Chinapaw MJ, Mokkink LB, van Mechelen W, Terwee CB. Physical activity questionnaires for adults: a systematic review of measurement properties. Sports Med. 2010; 40:565-600.
• [38]Stratford PW, Binkley JM, Riddle DL. Health status measures: strategies and analytic methods for assessing change scores. Phys Ther. 1996; 76:1109-23.
• [39]Mendoza JL, Stafford KL, Stauffer JM. Large-sample confidence intervals for validity and reliability coefficients. Psychol Methods. 2000; 5:356-69.
• [40]Cohen J. A power primer. Psychol Bull. 1992;112:155-9
• [41]Culos-Reed SN, Carlson LE, Daroux LM, Hately-Aldous S. A pilot study of yoga for breast cancer survivors: physical and psychological benefits. Psychooncology. 2006; 15:891-7.
• [42]Serdà BC, Monreal P, Del Valle A. Physical exercise as complementary treatment in prostate cancer. Apunts Med Esport. 2010; 45:81-93.
• [43]Maddocks M, Armstrong S, Wilcock A. Exercise as a supportive therapy in incurable cancer: exploring patient preferences. Psychooncology. 2011; 20:173-8.
• [44]Courneya KS, Friedenreich CM. Relationship between exercise pattern across the cancer experience and current quality of life in colorectal cancer survivors. J Altern Complem Med. 1997; 3:215-26.
• [45]Keats MR, Courneya KS, Danielsen S, Whitsett SF. Leisure-time physical activity and psychosocial well-being in adolescents after cancer diagnosis. J Pediatr Oncol Nurs. 1999; 16:180-8.
• [46]Keats MR, Nicole Culos-Reed S, Courneya KS, McBride M. An examination of physical activity behaviors in a sample of adolescent cancer survivors. J Pediatr Oncol Nurs. 2006; 23:135-42.
• [47]Grimmett C, Bridgewater J, Steptoe A, Wardle J. Lifestyle and quality of life in colorectal cancer survivors. Qual Life Res. 2011; 20:1237-45.
• [48]Stephenson LE, Bebb DG, Reimer RA, Culos-Reed SN. Physical activity and diet behaviour in colorectal cancer patients receiving chemotherapy: associations with quality of life. BMC Gastroenterol. 2009;9.
• [49]Grossman P, Deuring G, Garland SN, Campbell TS, Carlson LE. Patterns of objective physical functioning and perception of mood and fatigue in posttreatment breast cancer patients and healthy controls: an ambulatory psychophysiological investigation. Psychosom Med. 2008; 70:819-28.
• [50]Tillmann V, Darlington AS, Eiser C, Bishop NJ, Davies HA. Male sex and low physical activity are associated with reduced spine bone mineral density in survivors of childhood acute lymphoblastic leukemia. J Bone Miner Res. 2002; 17:1073-80.
• [51]Perna FM, Craft L, Freund KM, Skrinar G, Stone M, Kachnic L, et al. The effect of a cognitive behavioral exercise intervention on clinical depression in a multiethnic sample of women with breast cancer: a randomized controlled trial. Int J Sport Exerc Psychol. 2010;8:36–47.
• [52]Bourke L, Doll H, Crank H, Daley A, Rosario D, Saxton JM. Lifestyle intervention in men with advanced prostate cancer receiving androgen suppression therapy: a feasibility study. Cancer Epidemiol Biomarkers Prev. 2011; 20:647-57.
• [53]Bourke L, Thompson G, Gibson DJ, Daley A, Crank H, Adam I, et al. Pragmatic lifestyle intervention in patients recovering from colon cancer: a randomized controlled pilot study. Arch Phys Med Rehabil. 2011;92:749–55.
• [54]Bourke L, Gilbert S, Hooper R, Steed LA, Joshi M, Catto JWF, et al. Lifestyle changes for improving disease-specific qualityof life in sedentary men on long-term androgen-deprivation therapy for advanced prostate cancer: a randomised controlled trial. Eur Urol. 2014;65:865–72.
• [55]Broderick JM, Guinan E, Kennedy MJ, Hollywood D,Courneya KS, Culos-Reed SN, et al. Feasibility and efficacy of a supervised exercise intervention in de-conditioned cancer survivors during the early survivorship phase: the PEACH trial. J Cancer Surviv. 2013;7:551–62.
• [56]Guinan E, Hussey J, Broderick JM, Lithander FE, O'Donnell D, Kennedy MJ, et al. The effect of aerobic exercise on metabolic and inflammatory markers in breast cancer survivors - A pilot study. Support Care Cancer. 2013;21:1983–92.
• [57]Cormie P, Newton RU, Spry N, Joseph D, Taaffe DR, Galvao DA. Safety and efficacy of resistance exercise in prostate cancer patients with bone metastases. Prostate Cancer Prostatic Dis. 2013; 16:328-335.
• [58]Altman DG, Royston P. The cost of dichotomising continuous variables. BMJ. 2006;332:1080.
• [59]Greenland S. Dose–response and trend analysis in epidemiology: alternatives to categorical analysis. Epidemiol. 1995; 6:356-365.
• [60]Network SBR. Letter to the Editor: Standardized use of the terms "sedentary" and "sedentary behaviours". Appl Physiol Nutr Metab. 2012;37:540–2.
• [61]Owen N, Healy GN, Matthews CE, Dunstan DW. Too much sitting: the population health science of sedentary behavior. Exerc Sport Sci Rev. 2010;38:105–13.
• [62]Lamonte MJ, Ainsworth BE. Quantifying energy expenditure and physical activity in the context of dose response. Med Sci Sports Exerc. 2001;33 Suppl 6:S370–8.
• [63]Amireault S, Godin G. The Godin-Shephard Leisure-Time Physical Activity Questionnaire: validity evidence supporting its use for classifying healthy adults into active and insufficiently active categories. Percept Motor Skill. 2015;120:605–22.
• [64]Amireault S, Godin G, Lacombe J, Sabiston CM. Validation of the Godin-Shephard Leisure-Time Physical Activity Questionnaire classification coding system using accelerometer assessment among breast cancer survivors. J Cancer Surviv,in press.
• [65]Andrykowski MA, Beacham AO, Jacobsen PB. Prospective, longitudinal study of leisure-time exercise in women with early-stage breast cancer. Cancer Epidemiol Biomarkers Prev. 2007;16:430–8.
• [66]Bélanger LJ, Plotnikoff RC, Clark A, Courneya KS. Physical activity and health-related quality of life in young adult cancer survivors: a Canadian provincial survey. J Cancer Surviv. 2011;5:44–53.
• [67]Courneya KS, Segal RJ, Mackey JR, Gelmon K, Reid RD, Friedenreich CM, et al. Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: a multicenter randomized controlled trial. J Clin Oncol. 2007;25:4396–404.
• [68]Santa Mina D, Guglietti CL, Alibhai SM, Matthew AG, Kalnin R, Ahmad N, et al. The effect of meeting physical activity guidelines for cancer survivors on quality of life following radical prostatectomy for prostate cancer. J Cancer Surviv. 2014;8:190–8.
• [69]Trinh L, Plotnikoff RC, Rhodes RE, North S, Courneya KS. Associations between physical activity and quality of life in a population-based sample of kidney cancer survivors. Cancer Epidemiol Biomarkers Prev. 2011;20:859–68.
• [70]Boyle T, Lynch BM, Courneya KS, Vallance JK. Agreement between accelerometer-assessed and self-reported physical activity and sedentary time in colon cancer survivors. Support Care Cancer. 2015;23:1121–6.
• [71]Helmerhorst HJ, Brage S, Warren J, Besson H, Ekelund U. A systematic review of reliability and objective criterionrelated validity of physical activity questionnaires. Int J Behav Nutr Phys Act. 2012;9:103.
• [72]Prince SA, Adamo KB, Hamel ME, Hardt J, Gorber SC, Tremblay M. A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review. Int J Behav Nutr Phys Act. 2008;5:56.
• [73]Tudor-Locke C, Williams JE, Reis JP, Pluto D. Utility of pedometers for assessing physical activity: convergent validity. Sports Med. 2002;32:795–808.
• [74]Higgins JP, Greene S. Cochrane Handbook for systematic reviews of interventions: 8.14 Selective outcome reporting. http://www. cochrane-handbook.org/ webcite
• [75]Ouellette JA, Wood W. Habit and intention in everyday life: the multiple processes by which past behavior predicts future behavior. Psychol Bull. 1998;124:54–74.
• [76]Courneya KS, Jones LW, Rhodes RE, Blanchard CM. Effects of different combinations of Iintensity categories on selfreported exercise. Res Q Exerc Sport. 2004;75:429–33.