Limits to the measurement of habitual physical activity by questionnaires

Shephard, R J

doi:10.1136/bjsm.37.3.197

Cited by 1,694Physical Activity and HealthCardiovascular and exercise physiologySports and Physical Education Studies

Limits to the measurement of habitual physical activity by questionnaires

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Shephard, R J·2003·British Journal of Sports Medicine

DOI 10.1136/bjsm.37.3.197PMC PMC1724653

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Abstract

Despite extensive use over 40 years, physical activity questionnaires still show limited reliability and validity. Measurements have value in indicating conditions where an increase in physical activity would be beneficial and in monitoring changes in population activity. However, attempts at detailed interpretation in terms of exercise dosage and the extent of resulting health benefits seem premature. Such usage may become possible through the development of standardised instruments that will record the low intensity activities typical of sedentary societies, and will ascribe consistent biological meaning to terms such as light, moderate, and heavy exercise.

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The evidence used to inform current guidelines has exclusively relied on self-reported measurements, which are largely susceptible to both recall and social desirability biases.
“The evidence used to inform current guidelines has exclusively relied on self-reported measurements, which are largely susceptible to both recall and social desirability biases.18,19”
From Accelerometer-measured physical activity, sedentary behavior, and incidence of macrovascular and microvascular events in individuals with type 2 diabetes mellitus and prediabetes (2025) · cites this paper as [18]
The Basic issues section says questionnaire responses can be influenced by social desirability, and the Reliability section identifies shortcomings of human memory as a problem for recall. The paper describes questionnaires as a feasible way to assess large populations, but does not establish that evidence informing current guidelines relied exclusively on self-reported measurements. (LLM, conf=0.87)
Experimental — accuracy not yet measured
Self-reported questionnaires are subject to recall and social desirability biases and are prone to underestimate physical activity, especially intermittent moderate-to-vigorous physical activity or light-intensity physical activity.
“self-reported questionnaires are subject to recall and social desirability biases; therefore, they are prone to underestimate PA, especially intermittent MVPA or LPA.18”
From Accelerometer-measured physical activity, sedentary behavior, and incidence of macrovascular and microvascular events in individuals with type 2 diabetes mellitus and prediabetes (2025) · cites this paper as [18]
The Basic issues section describes memory-related limits on recall, and Types of activity and Duration explain that questionnaires can miss low-intensity activity and brief bouts. But the claim's general direction of bias is overstated: Basic issues says social desirability generally leads people to overreport physical activity, not underestimate it. No page numbers are available in our copy. (LLM, conf=0.89)
Experimental — accuracy not yet measured
The MAQ was not designed to measure light-intensity activity because of concerns regarding the accuracy of recall of light-intensity activity.
“Although light-intensity activity comprises the largest percentage of the average adults' day, the MAQ was not designed to measure activities that comprise that level of intensity because of concerns regarding the accuracy of recall of light-intensity activity.”
From The impact of physical activity on the prevention of type 2 diabetes: Evidence and lessons learned from the Diabetes Prevention Program, a long-standing clinical trial incorporating subjective and objective activity measures (2021) · cites this paper as [9]
The Reliability section says recall problems are particularly acute when activity intensity is low, and Types of activity says some questionnaires omit low-intensity activities. Neither passage identifies the MAQ or says why it was designed to omit them; the paper’s general concern does not establish that specific design rationale. Page numbers are unavailable in our copy. (LLM, conf=0.82)
Experimental — accuracy not yet measured
Only objective measures, such as the accelerometer, can validly measure activities of light intensity.
“Only objective measures, such as the accelerometer, can validly measure activities of light intensity (9,10).”
From The impact of physical activity on the prevention of type 2 diabetes: Evidence and lessons learned from the Diabetes Prevention Program, a long-standing clinical trial incorporating subjective and objective activity measures (2021) · cites this paper as [9]
The “Types of activity” section says many questionnaires have floor effects and may omit activities less intense than brisk walking. The “Sensitivity” section says accelerometers are generally more sensitive than questionnaires, but the paper does not establish that only objective measures can validly measure light-intensity activity; its “Reliability” section also describes limitations of motion sensors. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Self-reports poorly capture light-intensity physical activity, which is often scattered throughout the day, and underestimate sedentary behavior.
“Another major limitation of self-reports is that they poorly capture LPA, which is often scattered throughout the day, and underestimate SB.18”
From Accelerometer-measured physical activity, sedentary behavior, and incidence of macrovascular and microvascular events in individuals with type 2 diabetes mellitus and prediabetes (2025) · cites this paper as [18]

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Authors: Shephard, R. J.
Corresponding author: Shephard, R J
ORCID: Shephard, R J
Venue: British Journal of Sports Medicine
Publisher: BMJ
Published: 2003-06
Volume: 37
Issue: 3
Pages: 197-206
ISSN: 0306-3674 (ISSN-L)
1473-0480
DOI: 10.1136/bjsm.37.3.197
PMC: PMC1724653
OpenAlex: W2141063224
Cited by: 1,694
References: 171
Citations by year: 2026: 35 · 2025: 48 · 2024: 38 · 2023: 66 · 2022: 71 · 2021: 90 · 2020: 107 · 2019: 99 · 2018: 107 · 2017: 107 · 2016: 89 · 2015: 120 · 2014: 119 · 2013: 116 · 2012: 112
FWCI: 1.88
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: British Journal of Sports Medicine (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Physiology › Physical Activity and Health
Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
Social Sciences › Life-span and Life-course Studies › Sports and Physical Education Studies
Keywords: physical activity measurement, physical activity questionnaire, questionnaire reliability, questionnaire validity, exercise dose, sedentary behavior, light physical activity, exercise intensity classification, health benefits of physical activity
MeSH terms: Energy Metabolism, Environment, Humans, Surveys and Questionnaires, Risk Factors, Sensitivity and Specificity, Time Factors, Reproducibility of Results, Exercise

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