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@article{Wang:2026:10.1183/23120541.01496-2025,
author = {Wang, L and Ntotsis, K and Manifield, J and Tziannou, K and Plekhanova, T and Rowlands, A and Edwardson, CL and Baldwin, M and Bishop, NC and Bolton, C and Chalmers, JD and Daynes, E and Docherty, A and Efstathiou, C and Elneima, O and Gardiner, L and Greenhalf, W and Greening, N and Guillen-Guio, B and Harris, V and Harrison, E and Ho, L-P and Horsley, A and Houchen-Wolloff, L and Jacob, J and Leavy, O and Lone, N and Lozano-Rojas, D and Marks, M and McAuley, H and McNarry, M and Nolan, C and Quint, JK and Raman, B and Richardson, M and Sargeant, J and Saunders, RM and Sereno, M and Shikotra, A and Singapuri, A and Stensel, DJ and Taquet, M and Thorpe, M and Vogiatzis, I and Man, W and Wain, LV and Stewart, I and Singh, S and Brightling, CE and Lawson, C and Yates, T and Evans, RA},
doi = {10.1183/23120541.01496-2025},
journal = {ERJ Open Res},
title = {Validation of the General Practice Physical Activity Questionnaire after severe COVID-19.},
url = {http://dx.doi.org/10.1183/23120541.01496-2025},
volume = {12},
year = {2026}
}
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TY  - JOUR
AB  - BACKGROUND: Physical inactivity is a risk factor for severe COVID-19 and often worsens after hospitalisation. Clinicians need quick, accurate assessments to target interventions. We aimed to assess the validity of the General Practice Physical Activity Questionnaire (GPPAQ) in adults recovering 1 year after COVID-19 hospitalisation. METHODS: Post-hospitalisation for COVID-19, adults attended a 1-year-visit and completed the GPPAQ Physical Activity Index (PAI-4 active), 14-day wrist-worn accelerometry (moderate-vigorous physical activity (MVPA) active) and other health outcomes. Validity was examined via 1) internal consistency (factor analysis); 2) measurement invariance across sex, age and ethnicity using differential item functioning (DIF); 3) convergent validity (GPPAQ sensitivity/specificity versus accelerometry); and 4) construct validity (correlations with health outcomes). RESULTS: 752 participants had GPPAQ and accelerometry (265 female, mean±sd age 60.9±11.6years), MVPA 18.75min·day-1 (interquartile range 7.55-36.11), PAI-1 46.8%, PAI-2 15.6%, PAI-3 19.4% and PAI-4 18.2%. Factor analyses supported good internal consistency with two factors (daily activities and physical exercise). Comparative factor index (CFI) showed an excellent fit (CFI 0.965). DIF indicated moderate variability by sex and age. GPPAQ-PAI showed limited sensitivity (26.3%) for correctly classifying physically active individuals, but higher specificity (88.4%) for classifying physical inactivity, and weak-to-moderate correlations with health outcomes. CONCLUSIONS: GPPAQ demonstrates internal consistency, with construct and convergent validity in adults 1year after COVID-19 hospitalisation. GPPAQ effectively identifies inactive individuals to support clinical care; however, its sensitivity suggests under-estimation of activity relative to accelerometry. Future pathways should combine GPPAQ with device-based assessment to optimise evaluation of physical activity to gu
AU  - Wang,L
AU  - Ntotsis,K
AU  - Manifield,J
AU  - Tziannou,K
AU  - Plekhanova,T
AU  - Rowlands,A
AU  - Edwardson,CL
AU  - Baldwin,M
AU  - Bishop,NC
AU  - Bolton,C
AU  - Chalmers,JD
AU  - Daynes,E
AU  - Docherty,A
AU  - Efstathiou,C
AU  - Elneima,O
AU  - Gardiner,L
AU  - Greenhalf,W
AU  - Greening,N
AU  - Guillen-Guio,B
AU  - Harris,V
AU  - Harrison,E
AU  - Ho,L-P
AU  - Horsley,A
AU  - Houchen-Wolloff,L
AU  - Jacob,J
AU  - Leavy,O
AU  - Lone,N
AU  - Lozano-Rojas,D
AU  - Marks,M
AU  - McAuley,H
AU  - McNarry,M
AU  - Nolan,C
AU  - Quint,JK
AU  - Raman,B
AU  - Richardson,M
AU  - Sargeant,J
AU  - Saunders,RM
AU  - Sereno,M
AU  - Shikotra,A
AU  - Singapuri,A
AU  - Stensel,DJ
AU  - Taquet,M
AU  - Thorpe,M
AU  - Vogiatzis,I
AU  - Man,W
AU  - Wain,LV
AU  - Stewart,I
AU  - Singh,S
AU  - Brightling,CE
AU  - Lawson,C
AU  - Yates,T
AU  - Evans,RA
DO  - 10.1183/23120541.01496-2025
PY  - 2026///
SN  - 2312-0541
TI  - Validation of the General Practice Physical Activity Questionnaire after severe COVID-19.
T2  - ERJ Open Res
UR  - http://dx.doi.org/10.1183/23120541.01496-2025
UR  - https://www.ncbi.nlm.nih.gov/pubmed/42769819
VL  - 12
ER  -
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