Nanna Kurtze

Reliability and validity of the international physical activity questionnaire in the Nord-Trondelag health study (HUNT) population of men.

BackgroundThere is no standardized method for the assessment of physical activity (PA). Therefore it is important to investigate the validity and comparability of different measures. The International Physical Activity Questionnaire (IPAQ) has been developed as an instrument for cross-national assessment of PA and has been validated in 12 countries. These instruments have acceptable measurement properties for monitoring population levels of PA among 18–65 year-old adults in diverse settings. However, there are some concerns that IPAQ may over-report PA.The purpose of this study is to evaluate the reliability and validity of IPAQ, short version, last 7-days in the Nord-Trøndelag Health Study (HUNT) population of men.MethodsThe questionnaire was administered twice to a random sample of 108 men aged 20–39 and validity by comparing results with VO2max and ActiReg, an instrument that measures PA and energy expenditure (EE). ActiReg discriminates between the body positions: stand, sit, bend forward and lie and also registers if there is motion or not in each of them or both.ResultsOur results for reliability of the IPAQ short version were good for vigorous and fair for moderate activities. Intraclass correlations ranged from a low of 0.30 for moderate activity hours, to a high of 0.80 for sitting hours. Concerning validity, our results suggest that total IPAQ vigorous PA was a moderately good measure of vigorous activity, having moderately strong, significant correlations with VO2max, r = 0.41 (p ≤ 0.01), but correlated not with metabolic equivalent (METs) values of 6 or more measured with ActiReg. Only total IPAQ walking was fair correlated with METs 1–3 and METs 3–6, respectively r = -0.27 and 0.26 (p ≤ 0.05). The index for IPAQ sitting hours per week was moderate correlated with METs values of 1–3 and negatively correlated with METs values of 3–6. Classification of PA in three levels (low, moderate and high) correlated also most strongly with VO2max (0.31 p ≤ 0.01) and METs 3–6 and METs 1–3 from ActiReg (r = 0.32 and -0.31, p ≤ 0.01). Classification of BMI in three levels (normal, overweight and obese) correlated most strongly negative with VO2max (-0.42 p ≤ 0.01) and MJ from ActiReg (r = 0.31 p ≤ 0.01).ConclusionOur results indicate that IPAQ short version for men has acceptable reliability and criterion validity for vigorous activity and sitting. Walking has moderate reliability. Only the IPAQ for walking had a fair correlation with METs 6+. The questions about moderate activity had fair reproducibility and correlated poorly with most comparison measures.

Fatigue and patterns of pain in fibromyalgia: Correlations with anxiety, depression and co‐morbidity in a female county sample

This study explored the prevalence of fibromyalgia, the relationship of anxiety and depression with two major symptoms (pain and fatigue), and the role of co-morbidity. Participants were recruited from the Nord-Trøndelag Health Study (The HUNT Study) in Norway (N = 92,936). They were females given the diagnosis of fibromyalgia by their doctor (N = 1,816), divided into one sample without (N = 977) and another with (N = 839) co-morbidity. Owing to colinearity between anxiety and depression, extreme groups were defined according to high vs. low anxiety and depression scores. About four-fifths of the initial sample were excluded by this approach, which permitted a two x two factorial split-plot ANCOVA for the assessment of the relations of anxiety and depression with pain and fatigue. The overall prevalence was 3.2%, which obscured a highly biased sex difference with 5.2% for females and .9% for males. Results from the sample without co-morbidity (N = 977) supported the idea of independent partial correlations of anxiety and depression with pain and fatigue. A different trend was indicated in the co-morbidity sample (N = 839) where fatigue was only significantly associated with depression, whereas pain was associated with anxiety. The idea of widespread pain was supported consistently only in participants without co-morbidity who scored low on anxiety. Age, incident pain and depression contributed to a discriminant function reflecting the status of co-morbidity.

Quality of life, functional disability and lifestyle among subgroups of fibromyalgia patients: The significance of anxiety and depression

This study explored the significance of anxiety and depression in quality of life, functional disability and lifestyle among fibromyalgia patients. Functional disability was defined by subjective work ability and activity-related discomfort. Lifestyle reflected habits of physical activity, regularity of meals, smoking and patterns of drinking coffee and alcohol. Members of two county divisions of fibromyalgia patients (N = 322) were investigated. Owing to colinearity between anxiety and depression scores, extreme groups were defined according to high vs. low anxiety and depression scores. Two-thirds of the initial sample were excluded by this approach which permitted a 2 x 2 factorial split-plot MANCOVA for the assessment of main effects and interaction of anxiety and depression upon quality of life, functional disability and lifestyle. Main effects of anxiety and depression were significant for index scores on activity-related discomforts, subjective work ability and quality of life, whereas depression was also significantly associated with regularity of meals. Anxiety and depression interacted to yield relatively high consumption of coffee and cigarettes among the anxious and depressed subgroup, and this effect emerged only after the elimination of confounding effects of age and duration of the fibromyalgia disease.

The Impact of Perceived Physical Dysfunction, Health-Related Habits, and Affective Symptoms on Employment Status Among Fibromyalgia Support Group Members

Objective: This study was designed to evaluate the impact of perceived physical limitation, affective symptoms, pain, and lifestyle habits on employment status among members of a fibromyalgia support association. Methods: Three hundred and twenty-two female members of the Fibromyalgia Association in two Norwegian counties were surveyed. Perceived limitations of physical function, habits of daily living, affective symptoms, and current work status were assessed by brief validated instruments. The dependent variable, employment status, was dichotomized as employed or unemployed. When testing the effects of perceived physical function limitations on employment status, structured hierarchical regression analyses were executed blockwise to eliminate confounding effects from lifestyle habits and affective symptoms such as anxiety and depression. Results: The subjects perceived physical limitation was the best measure at predicting employment status. Affective symptoms contributed significantly, but weakly, to employment status. There was no apparent contribution from lifestyle habits or perceived pain. Conclusion: The results of this study of people who belong to a fibromyalgia support organization highlight the importance of perceived physical limitations in their ability to maintain employment. It is somewhat surprising that the data failed to support a role for lifestyle habits or pain.

A County Population of Males Given the Diagnosis of Fibromyalgia Syndrome–Comparison with Fibromyalgia Syndrome Females Regarding Pain, Fatigue, Anxiety, and Depression: The Nord-Trøndelag Health Study [The HUNT Study]

Objectives: For reasons that remain poorly understood, the fibromyalgia syndrome [FMS] affects women more frequently than men. As a result of this strong female preponderance, the research in FMS mainly has involved females, and studies addressing sex differences are limited. This study explored the prevalence and the relationship of anxiety and depression with pain and fatigue in males given the diagnosis of FMS, and investigated differences between males and females with FMS in an unselected adult county population. Methods: Participants were recruited from the Nord-Trøndelag Health Study [The HUNT Study] in Norway [N = 92,936]. A total of 2,093 participants were included. All reported being given the diagnosis of FMS by their doctor [277 males, 1,816 females]. Results: Significant partial correlations were found in males of anxiety and depression with fatigue, and extremity pain was associated with anxiety. The odds of being female increased by 120 percent when a participant reported pain last year, and by 112 percent with anxiety, whereas it dropped to 85 percent with depression. Conclusion: The role of anxiety and depression in FMS appeared related to gender and should be further investigated.