Physical activity assessment questionnaire for pregnant women: a literature review
DOI:
https://doi.org/10.36557/2674-8169.2026v8n3p1885-1914Keywords:
Atividade física, gestantes, revisão de literatura, questionáriosAbstract
This study aims to analyze the literature concerning Physical Activity questionnaires used to assess physical activity among pregnant women. A literature review was conducted structured in two databases, PubMed and Embase, following their respective search guidelines. Studies conducted with healthy, adult pregnant women were considered, which measured their physical activities in different contexts and evaluated at least one psychometric property (content, criterion, transcultural, or reliability validation). Twenty-two articles were considered eligible, and the quality of evidence was analyzed in validity and reliability studies for three measures of vigorous, light, and moderate physical activity. Among the questionnaires identified in this review, the Pregnancy Physical Activity Questionnaire (PPAQ) prevailed, and its versions were adapted to other languages. The results of this study showed that the psychometric properties of most of the included questionnaires were based on evidence ranging from very low to moderate, except for the Portuguese and English versions for the reliability measurement, which were classified with high-quality evidence. Regarding criterion validation, the results were insufficient for the three measures assessed (vigorous, light, and moderate physical activity) and were based on low-quality evidence. Content validation studies were considered adequate in terms of methodological quality, and transcultural validation studies met all the criteria established by this study.
Downloads
References
Freitas IGCD, Lima CDA, Santos VM, Silva FT, Rocha JSB, Dias OV. Nível de atividade física e fatores associados entre gestantes: estudo epidemiológico de base populacional. Cien Saúde Colet. 2022;27(11):4315-28.
Physical Activity and Exercise During Pregnancy and the Postpartum Period: ACOG Committee Opinion, Number 804. Obstet Gynecol. 2020;135(4):e178-88.
Gjestland K, Bø K, Owe KM, Eberhard-Gran M. Do pregnant women follow exercise guidelines? Prevalence data among 3482 women, and prediction of low-back pain, pelvic girdle pain and depression. Br J Sports Med. 2013;47(8):515-20.
Harrod CS, Chasan-Taber L, Reynolds RM, Fingerlin TE, Glueck DH, Brinton JT, et al. Physical activity in pregnancy and neonatal body composition: the Healthy Start study. Obstetrics and gynecology. 2014; 124(201): 257.
Ko Y L, Chen, CP, Lin PC. Physical activities during pregnancy and type of delivery in nulliparae. European journal of sport Science.2016; 16(3):374-80.
Mourady D, Richa S, Karam R, Papazian T, Hajj Moussa F, El Osta N, et al. Associations between quality of life, physical activity, worry, depression and insomnia: A cross-sectional designed study in healthy pregnant women. PloS one. 2017; 12(5), e0178181.
Smith KM, Campbell CG. Physical activity during pregnancy: Impact of applying different physical activity guidelines. Journal of Pregnancy, 2013;165617.
Suliga E, Sobaś K, Król G. Validation of the Pregnancy Physical Activity Questionnaire (PPAQ). Med Stud. 2017; 33(1): 40-45
Barakat R, Refoyo I, Coteron J, Franco E. Exercise during pregnancy has a preventative effect on excessive maternal weight gain and gestational diabetes. A randomized controlled trial. Braz J Phys Ther. 2019;23(2):148-55.
Santos PC, Maciel LYS, Abreu S, Mesquita AR, Mesquita CC, Lopes S, et al. Cultural adaptation and validation of the "Pregnancy Physical Activity Questionnaire" for the Portuguese population. PLoS One. 2023; 18(1):e0279124.
World Health Organization, T. (2010). Global recommendations on physical activity for health. World Health Organization.
ACSM AC. SM. Impact of Physical Activity during Pregnancy and Postpartum on Chronic Disease Risk. Medicine & Science in Sports & Exercise. 2006;38(5), 989–1006
Çırak Y, Yılmaz GD, Demir YP, Dalkılınç M, Yaman S. Pregnancy physical activity questionnaire (PPAQ): reliability and validity of Turkish version. J Phys Ther Sci.2015; 27(12): 3703-09.
Chasan-Taber L, Park S, Marcotte RT, Staudenmayer J, Strath S, Freedson P. Update and Novel Validation of a Pregnancy Physical Activity Questionnaire. Am J Epidemiol. 2023;192(10):1743-53.
Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. (2003). International physical activity questionnaire: 12-country reliability and validity. Medicine & science in sports & exercise.2003;35(8), 1381-95.
Schmidt MD, Freedson PS, Pekow P, Roberts D, Sternfeld B, Chasan-Taber L. Validação do Kaiser Physical Activity Survey em mulheres grávidas. Medicina e Ciência no Esporte e Exercício. 2006;38(1), 42–50.
Armstrong T, Bull F. Development of the world health organization global physical activity questionnaire (GPAQ). Journal of Public Health.2006; 14, 66-70.
Fjeldsoe BS, Marshall AL, Miller YD. Measurement properties of the Australian Women's Activity Survey. Med Sci Sports Exerc. 2009;41(5):1020-33.
Haakstad LA, Voldner N, Henriksen T, Bø K. Physical activity level and weight gain in a cohort of pregnant Norwegian women. Acta Obstet Gynecol Scand. 2007;86(5):559-64.
Chasan-Taber L, Schmidt MD, Roberts DE, Hosmer D, Markenson G, Freedson PS. Development and validation of a Pregnancy Physical Activity Questionnaire. Med Sci Sports Exerc. 2004;36(10):1750-60.
Sattler MC, Jaunig J, Watson ED, van Poppel MNM, Mokkink LB, Terwee CB, et al. Physical Activity Questionnaires for Pregnancy: A Systematic Review of Measurement Properties. Sports Med. 2018;48(10):2317-46.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. Int J Surg. 2021;88:105906.
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(7):525-37.
Mokkink LB, Terwee CB, Knol DL, Stratford PW, Alonso J, Patrick DL, Bouter LM, de Vet HC. Protocol of the COSMIN study: COnsensus-based Standards for the selection of health Measurement Instruments. BMC Med Res Methodol. 2006;6(2):1-7.
Guyatt GH, Oxman AD, Schünemann HJ, Tugwell P, Knottnerus A. GRADE guidelines: a new series of articles in the Journal of Clinical Epidemiology. J Clin Epidemiol. 2011;64(4):380-2.
Ota E, Haruna M, Yanai H, Suzuki M, Anh DD, Matsuzaki M, et al. Reliability and validity of the Vietnamese version of the Pregnancy Physical Activity Questionnaire (PPAQ). Southeast Asian J Trop Med Public Health. 2008;39(3):562-70.
Matsuzaki M, Haruna M, Nakayama K, Shiraishi M, Ota E, Murayama R, et al. Adapting the Pregnancy Physical Activity Questionnaire for Japanese pregnant women. J Obstet Gynecol Neonatal Nurs. 2014;43(1):107-16.
Matsuzaki M, Haruna M, Ota E, Yeo S, Murayama R, Murashima S. Translation and cross-cultural adaptation of the Pregnancy Physical Activity Questionnaire (PPAQ) to Japanese. Biosci Trends. 2010; 4(4):170-7.
Silva FT, Araujo Júnior E, Santana EF, Lima JW, Cecchino GN, Silva Costa FD. Translation and cross-cultural adaptation of the Pregnancy Physical Activity Questionnaire (PPAQ) to the Brazilian population. Ceska Gynekol. 2015; 80(4):290-8.
Xiang M, Konishi M, Hu H, Takahashi M, Fan W, Nishimaki M, et al. Reliability and Validity of a Chinese-Translated Version of a Pregnancy Physical Activity Questionnaire. Matern Child Health J. 2016; 20(9):1940-7.
Krzepota J, Sadowska D, Sempolska K, Pelczar M. Measuring physical activity during pregnancy - Cultural adaptation of the Pregnancy Physical Activity Questionnaire (PPAQ) and assessment of its reliability in Polish conditions. Ann Agric Environ Med. 2017; 24(4): 640-43.
Oviedo-Caro MÁ, Bueno-Antequera J, Munguía-Izquierdo D. Transcultural adaptation and psychometric properties of Spanish version of Pregnancy Physical Activity Questionnaire: the PregnActive project. Gac Sanit. 2019;33(4):369-76.
Schmidt JT, Nielsen J, Riis A, Larsen BT. Translation and cultural adaptation of the Pregnancy Physical Activity Questionnaire into Danish using the dual-panel approach: comparison with outcomes from an alternative translation approach. BMC Res Notes. 2021;14(1):225.
Younis AS, Alyousefi NA, Al-Habib DM, Al-Omran AT. The validation and cross-cultural adaptation of the Arabic version of the pregnancy physical activity questionnaire. Saudi Med J. 2021;42(5): 499.
Rovcanin M, Jankovic S, Mikovic Z, Sipetic Grujicic S, Ersk IRB, Lackovic M, et al. The Translation and Cross-Cultural Adaptation of the Pregnancy Physical Activity Questionnaire: Validity and Reliability of a Serbian Version (PPAQ-SRB). Healthcare (Basel). 2022;10(8):1482.
Papazian T, El Osta N, Hout H, Chammas DE, El Helou N, Younes H, et al. Pregnancy physical activity questionnaire (PPAQ): Translation and cross-cultural adaption of an Arabic version. PLoS One. 2020;15(3):e0230420.
Santos PC, Maciel LYS, Abreu S, Mesquita AR, Mesquita CC, Lopes S, et al. Cultural adaptation and validation of the "Pregnancy Physical Activity Questionnaire" for the Portuguese population. PLoS One. 2023; 18(1): e0279124.
Tosun OC, Solmaz U, Ekin A, Tosun G, Mutlu EK, Okyay E, et al. The Turkish version of the pregnancy physical activity questionnaire: cross-cultural adaptation, reliability, and validity. Rev Pesqui Fisioter. 2015: 27(10): 3215-21.
Coll-Risco I, Camiletti-Moirón D, Acosta-Manzano P, Aparicio VA. Translation and cross-cultural adaptation of the Pregnancy Physical Activity Questionnaire (PPAQ) into Spanish. J Matern Fetal Neonatal Med. 2019;32(23):3954-61.
Krøner FH, Knudsen SP, Roland CB, Alomairah SA, Molsted S. Validity and reliability of the Danish version of the pregnancy physical activity questionnaire to assess levels of physical activity during pregnancy. J Matern Fetal Neonatal Med. 2022;35(23):4566-72.
Han JW, Kang JS, Lee H. Validity and reliability of the Korean version of the pregnancy physical activity questionnaire. J. Environ. Health.2020; 17(16): 5873.
Kazemi AF, Hajian S, Sharifi N. The psychometric properties of the Persian version of the pregnancy physical activity questionnaire. Int J Women's Health Reprod.2019; 7(1): 54-60.
Mitrogiannis I, Chatzakis C, Skentou C, Koutalia N, Makrydimas S, Efthymiou A, et al. Pregnancy physical activity questionnaire: Translation and cross-cultural adaptation of a Greek version. Eur J Obstet Gynecol Reprod Biol. 2023;291:156-61.
Chandonnet N, Saey D, Alméras N, Marc I. French Pregnancy Physical Activity Questionnaire compared with an accelerometer cut point to classify physical activity among pregnant obese women. PLoS One. 2012;7(6):e38818.
Bernardo D, Carvalho C, Leirós-Rodríguez R, Mota J, Santos PC. Comparison of the Portuguese Version of the Pregnancy Physical Activity Questionnaire (PPAQ) with Accelerometry for Classifying Physical Activity among Pregnant Women with Obesity. Int J Environ Res Public Health. 2023;20(2):929.
Adanaş Aydın G, Taşan HA, Tarhan N, Çakar E, Şenol Güler N, Ankaralı H, et al. Reliability and validity of Turkish version of pregnancy physical activity questionnaire (PPAQ) in patients with gestational diabetes mellitus. J Obstet Gynaecol. 2020;40(2):176-81.
Cohen TR, Plourde H, Koski KG. Use of the Pregnancy Physical Activity Questionnaire (PPAQ) to identify behaviours associated with appropriate gestational weight gain during pregnancy. J Phys Act Health. 2013;10(7):1000-7.
Watson ED, Micklesfield LK, van Poppel MNM, Norris SA, Sattler MC, Dietz P. Validity and responsiveness of the Global Physical Activity Questionnaire (GPAQ) in assessing physical activity during pregnancy. PLoS One. 2017;12(5):e0177996.
Aittasalo M, Pasanen M, Fogelholm M, Ojala K. Validity and repeatability of a short pregnancy leisure time physical activity questionnaire. J Phys Act Health. 2010;7(1):109-18.
Chasan-Taber L, Schmidt MD. Pregnancy Physical Activity Questionnaire. Can J Public Health. 2016;106(8):e563.
Wojtyła C, Ciebiera M, Wojtyła-Buciora P, Janaszczyk A, Brzęcka P, Wojtyła A. Physical activity patterns in third trimester of pregnancy - use of pregnancy physical activity questionnaire in Poland. Ann Agric Environ Med. 2020;27(3):388-93.
Brett KE, Wilson S, Ferraro ZM, Adamo KB. Self-report Pregnancy Physical Activity Questionnaire overestimates physical activity. Can J Public Health. 2015;106(5):e297-302.
Siyad S, Mustafa N, Banu SS, Buharoon MA, Al Mulla MA, Ankarali H, Carrick FR, Abdulrahman M. Pregnant women's perceptions of physical activity: Adaptation of the pregnancy physical activity questionnaire in Dubai, a multicultural society. J Public Health Res. 2021;11(1):2261.
Antosiak-Cyrak KZ, Demuth A. A study of physical activity levels of pregnant women using the Polish version of Pregnancy Physical Activity Questionnaire (PPAQ-Pl). Ginekol Pol. 2019;90(5):250-55.
Conway MR, Marshall MR, Schlaff RA, Talge NM, Pfeiffer KA, Pivarnik JM. Validity of the pregnancy physical activity questionnaire for maternal recall. Measurement in Physical Education and Exercise Science. 2020;24(4), 264-72.
Chandonnet N, Saey D, Dufresne A, Robitaille J, Marc I. Assessment of physical activity in pregnant obese women using the pregnancy physical activity questionnaire (PPAQ) and accelerometer. Canadian Journal of Diabetes. 2011;35(2), 148.
Cunha CM, Almeida Neto OP, Stackfleth R. Principais métodos de avaliação psicométrica da validade de instrumentos de medida. Revista de Atenção à Saúde. 2016;14(47), 75-83.
IBGE 2022
Takito MY, Neri LDCL, Benício MHA. Avaliação da reprodutibilidade e validade de questionário de atividade física para gestantes. Revista Brasileira de Medicina do Esporte. 2008;14(2), 132-38.
Silva CM, Sartorelli DS, Machado DRL, Perdoná GDSC. Padrão de atividade física em gestantes usuárias do Sistema Público de Saúde. Conexões. 2021; 19, e021003-e021003.
Galvão MCB, Ricarte ILM. Revisão sistemática da literatura: conceituação, produção e publicação. Logeion: Filosofia da informação. 2019; 6(1), 57-73.
Saglam M, Arikan H, Savci S, Inal-Ince D, Bosnak-Guclu M, Karabulut E, et al. International physical activity questionnaire: reliability and validity of the Turkish version. Percept Mot Skills. 2010 ;111(1):278-84.
Hendelman D, Miller K, Baggett C, Debold E, Freedson P. Validity of accelerometry for the assessment of moderate intensity physical activity in the field. Med Sci Sports Exerc. 2000;32(9 Suppl):S442-9.
Swartz AM, Strath SJ, Bassett DR Jr, O'Brien WL, King GA, Ainsworth BE. Estimation of energy expenditure using CSA accelerometers at hip and wrist sites. Med Sci Sports Exerc. 2000;32(9 Suppl):S450-6.
Freedson PS, Melanson E, Sirard J. Calibration of the Computer Science and Applications, Inc. accelerometer. Med Sci Sports Exerc. 1998;30(5):777-81.
Schneider PL, Crouter S, Bassett DR. Pedometer measures of free-living physical activity: comparison of 13 models. Med Sci Sports Exerc. 2004;36(2):331-5.
Kumahara H, Schutz Y, Ayabe M, Yoshioka M, Yoshitake Y, Shindo M, et al. The use of uniaxial accelerometry for the assessment of physical-activity-related energy expenditure: a validation study against whole-body indirect calorimetry. Br J Nutr. 2004;91(2):235-43.
Hildebrand M, Van Hees VT, Hansen BH, et al. Age group comparability of raw accelerometer output from wrist-and hip-worn monitors. Med Sci Sports Exerc. 2014;46(9): 1816-24.
Montoye AHK, Clevenger KA, Pfeiffer KA, et al. Development of cut-points for determining activity intensity from a wrist-worn ActiGraph accelerometer in free-living adults. J Sports Sci. 2020;38(22):2569-78.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Carla Micheli da Silva, Gleici da Silva Castro Perdona
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors are copyright holders under a CCBY 4.0 license.
