André Vinicius Santana1, Andrea Daiane Fontana1, Rafaela Cristina de Almeida1, Leandro Cruz Mantoani1, Carlos Augusto Camillo1,2, Karina Couto Furlanetto1,2, Fátima Rodrigues3,4, Joana Cruz5, Alda Marques6, Cristina Jácome7,8, Heleen Demeyer9, Fabienne Dobbels10, Judith Garcia-Aymerich11,12,13, Thierry Troosters9, Nidia Aparecida Hernandes1, Fabio Pitta1
J Bras Pneumol.2023;49(4):e20220372
Objective: To adapt the PROactive Physical Activity in COPD-clinical visit (C-PPAC) instrument to the cultural setting in Brazil and to determine the criterion validity, test-retest reliability agreement, and internal consistency of this version. Methods: A protocol for cultural adaptation and validation was provided by the authors of the original instrument and, together with another guideline, was applied in a Portuguese-language version developed by a partner research group from Portugal. The adapted Brazilian Portuguese version was then cross-sectionally administered twice within a seven-day interval to 30 individuals with COPD (57% were men; mean age was 69 ± 6 years; and mean FEV1 was 53 ± 18% of predicted) to evaluate internal consistency and test-retest reliability. Participants also completed the International Physical Activity Questionnaire (IPAQ), the modified Medical Research Council scale, the COPD Assessment Test, and Saint George's Respiratory Questionnaire to evaluate criterion validity. Results: The C-PPAC instrument showed good internal consistency and excellent test-retest reliability: "amount" domain = 0.87 (95% CI, 0.73-0.94) and "difficulty" domain = 0.90 (95% CI, 0.76-0.96). Bland & Altman plots, together with high Lin's concordance correlation coefficients, reinforced that agreement. Criterion validity showed moderate-to-strong correlations of the C-PPAC with all of the other instruments evaluated, especially with the IPAQ (rho = -0.63). Conclusions: The Brazilian Portuguese version of the C-PPAC is a reliable and valid instrument for evaluating the experience of Brazilian individuals with COPD with their physical activity in daily life.
Keywords: Pulmonary disease, chronic obstructive; Validation study; Activities of daily living; Psychometrics.