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Animated Activity Questionnaire (AAQ)

Background

The Animated Activity Questionnaire (AAQ) was developed as a new method to assess activity limitations in patients with hip or knee osteoarthritis, for use in research and clinical practice. [1] The AAQ uses videos in which an animation of a basic daily activity is shown, performed with different levels of difficulty. Patients are asked to choose the animation that best matches their own performance.

Common methods to assess activity limitations are self-reported questionnaires, and performance-based tests. Both methods have advantages, but also disadvantages. Self-reported questionnaires are considered easy to implement, inexpensive and harmless for the patient. But they are also highly dependent on the perception and the reference frame of the patient. They also require reading ability in the language at issue. Moreover, self-reported questionnaires scores are influenced by a large number of personal factors (e.g. body mass, depression, self-efficacy, fatigue and pain). Performance-based tests, on the other hand, quantify the capacity of the patient on how well he or she is able to perform specific tasks. But these tests may be considered cumbersome and require physical presence of the patient. It is also stated that tests administered in the clinic, do not represent a real-life situation and only capture a snapshot of reality.

The AAQ combines the advantages of self-report questionnaires and performance-based test. The AAQ is easy to implement, inexpensive, harmless for patients, and in addition no comprehensive language understanding, except for directions and internet navigating is required, which makes the AAQ accessible for people with low literacy and non-native speakers. The AAQ showed good content validity, construct validity and reliability. [1-3] There is also some evidence that the AAQ is responsive to measuring changes in physical functioning. [4] Moreover, the AAQ appeared to measure activity limitations closely mimicking real life situations. [5] In comparison with other languages the AAQ showed good cross cultural validity, meaning that AAQ scores of persons with hip and/or knee osteoarthritis with the same functional limitations are comparable. [6-7]

Publications

  1. Peter WF, Loos M, de Vet HC, Boers M, Harlaar J, Roorda LD, Poolman RW, Scholtes VA, Boogaard J, Buitelaar H, Steultjens M, Roos EM, Guillemin F, Rat AC, Benedetti MG, Escobar A, Østerås N, Terwee CB. Development and preliminary testing of a computerized animated activity questionnaire in patients with hip and knee osteoarthritis. Arthritis Care Res (Hoboken). 2015 Jan;67(1):32-9. doi: 10.1002/acr.22386.
  2. Peter WF, Dagfinrud HS, Østerås N, Terwee CB. Animated Activity Questionnaire (AAQ), a new method of self-reporting activity limitations in patients with hip and knee osteoarthritis: Comparisons with observation by spouses for construct validity. Musculoskeletal Care. 2017 Sep;15(3):263-271. doi: 10.1002/msc.1172. Epub 2016 Dec 7.
  3. Peter WF, de Vet HCW, Terwee CB. Reliability of the Animated Activity Questionnaire for assessing activity limitations of patients with hip and knee osteoarthritis. Musculoskeletal Care. 2018 Sep;16(3):363-369. doi: 10.1002/msc.1349.
  4. Peter WF, Poolman RW, Scholtes VAB, de Vet HCW, Terwee CB. Responsiveness and interpretability of the Animated Activity Questionnaire for assessing activity limitations of patients with hip or knee osteoarthritis. Musculoskeletal Care. 2019 Dec;17(4):327-334. doi: 10.1002/msc.1418.
  5. Peter WF, Dagfinrud HS, Østerås N, Terwee CB. Animated Activity Questionnaire (AAQ), a new method of self-reporting activity limitations in patients with hip and knee osteoarthritis: Comparisons with observation by spouses for construct validity. Musculoskeletal Care. 2017 Sep;15(3):263-271. doi: 10.1002/msc.1172.
  6. Peter WF, de Vet HCW, Boers M, Harlaar J, Roorda LD, Poolman RW, Scholtes VAB, Steultjens M, Hendry GJ, Roos EM, Guillemin F, Benedetti MG, Cavazzuti L, Escobar A, Dagfinrud H, Terwee CB. Cross-Cultural and Construct Validity of the Animated Activity Questionnaire. Arthritis Care Res (Hoboken). 2017 Sep;69(9):1349-1359. doi: 10.1002/acr.23127.
  7. Nascimento CD, Peter WF, Ribeiro IM, Moreira BS, Lima VP, Kirkwood RN, Bastone AC. Cross-cultural validity of the Animated Activity Questionnaire for patients with hip and knee osteoarthritis: a comparison between the Netherlands and Brazil. Braz J Phys Ther. 2021 Jul 1:S1413-3555(21)00057-5. doi: 10.1016/j.bjpt.2021.06.002.