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Psychometric Properties of a Questionnaire to Assess Exercise-Related Musculoskeletal Injuries in Older Adults

The objective of present study was to develop and evaluate the psychometric properties of a questionnaire to measure exercise-related injury in older adults participating in supervised multimodal exercise programs.

Liza Stathokostas, Clinical Epidemiology & Biostatistics, McMaster University; Olga Theou, Health and Rehabilitation Sciences, University of Western Ontario, Canada; Anthony Vandervoort, School of Physical Therapy, University of Western Ontario, Canada; Clara Fitzgerald, Shannon Belfry, Canadian Centre for Activity and Aging, University of Western Ontario, Canada; Connie Lebrun, Glen Sather Sports Medicine Clinic, University of Alberta, Canada; Parminder Raina, Clinical Epidemiology & Biostatistics, McMaster University, Canada

There currently is no reliable or validated tool for the assessment of exercise-related injuries in older adults. The objective of present study was to develop and evaluate the psychometric properties of a questionnaire to measure exercise-related injury in older adults participating in supervised multimodal exercise programs.

Purpose: To conduct test-retest reliability and assess the construct validity of the developed questionnaire. Our hypothesis for the construct validity component of the study was that self-reported exercise-related injury in the older adult population would be correlated with health-care-provider diagnosis and injury incidence report forms collected at the study site.

Methods: A literature review of exercise-related injury questionnaires generated potential items and questions relevant to the topic. An expert panel reduced the list of items by a consensus process to a list deemed relevant for assessing exercise-related injuries in older adults, and pilot testing of the new questionnaire was conducted. Test-retest reliability of the self-administered written questionnaire was determined at two time points, one week apart, at the Canadian Centre for Activity and Aging, a community-based older adult exercise facility. One week was determined to be of sufficient duration whereby participants were unlikely to recall their previous responses and there was a low risk of additional injury occurrence. The questionnaire asked participants about exercise-related injuries incurred at the facility in the 12 months previous, where injury was defined as a self-reported muscle, tendon, bone, ligament, or joint injury. Items included the mechanism of injury, cause of the injury, anatomical site of the injury, and treatment sought. Covariables (age, sex, body mass index, fitness, and attendance records) were obtained from available facility databases. The minimum requirement for reliability was set at .80. The kappa coefficient was used to determine repeatability for categorical variables. To validate the data obtained from the questionnaire, participants who reported having an injury were asked to provide contact information for the health care provider who treated the injury. The sample size for the validity study included all participating older adults reporting an injury. A correlation of >.4 was chosen to assess the hypothesis that with respect to the questionnaire, self-reported exercise-related injury would be correlated with health care provider diagnosis.

Preliminary Results: The questionnaire was administered to 110 community-dwelling older adults (45 males, mean age 75 ± 8 y; 65 females, mean age 71 ± 8 y). Of the 110 volunteers, 16% (n = 18) reported having an injury in the 12 months previous. Test-retest reliability ranged from .76 to 1.00, with all but one variable (type of injury, .76) having kappa coefficients greater than .80. The lower extremities were the most common site of exercise-related injury. Overexertion or strenuous movements were the most common cause of injury occurring during strength training exercises. The final reporting of this study will include results regarding the validation of the questionnaire.

Conclusions: The present questionnaire assessing the 12-month recall in older adults is a reliable measure of exercise-related injuries in older adults.

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