ORIGINAL ENGLISH VERSION

ARTICLE

Validation and reliability of the Baecke questionnaire for

the evaluation of habitual physical activity in adult men*
Alex Antonio Florindo1 and Maria do Rosario Dias de Oliveira Latorre1

ABSTRACT reliable to measure habitual physical activity in Brazilian

adult men.
The aim of this study was to verify validity and reliabil-
ity of the scores for physical exercise in leisure (PEL), lei- Key words: Habitual physical activity. Evaluation. Questionnaire.
sure and locomotion activities (LLA), and total score (TS) Men.
of the Baecke habitual physical activity questionnaire in
adult males. Twenty-one students of Physical Education
were evaluated. For validation, the maximum oxygen up- INTRODUCTION
take (VO2max) and the decrease of the heart rate in percen-
There are different methods to assess habitual physical
tile (%DHR) were measured through the Cooper’s 12-minute
activity (HPA), being the questionnaires the most accessi-
walk or run test, and an annual index of physical exercise
ble for epidemiologic studies1. Different questionnaires
(IPE), and a week index of locomotion activities (ILA). The
presented in the literature were summarized in a 1997 sup-
reliability was verified through test-retest with interval of
plement2. However, for the Brazilian population, there are
45 days. The Pearson correlation coefficient, and partial
few validated instruments. Another problem is related to
correlation adjusted for age and body mass index were used
the validation standards. There is not yet a golden standard
for validation. The intraclass correlation and paired t-test
to measure physical activity or fitness against HPA ques-
were used for reliability. The results indicated that %DHR
tionnaires. Methods such as energy exertion measured by
was correlated with LLA and TS (r = 0.47 and p = 0.030; r =
doubly labelled water, or motion sensors such as acceler-
0.48 and p = 0.027, respectively). IPE was correlated with
ometers are being used in validation studies. The first meth-
PEL and TS (r = 0.56 and p = 0.008; r = 0.46 and p = 0.036,
od, however, is quite expensive and difficult to apply. The
respectively). ILA was correlated with LLA and TS (r = 0.64
second is more feasible in terms of costs, but its applica-
and p = 0.002 and r = 0.51 and p = 0.017, respectively).
tion and control of participants are difficult to do, particu-
There was no significant difference in PEL, LLA and TS
larly in developing countries, such as Brazil, as they de-
means in test-retest. The intraclass correlations were r =
mand high compliance level from participants in using,
0.69; r = 0.80 and r = 0.77, respectively for PEL, LLA and
handling and giving the devices back. Inquiries on energy
TS. In conclusion, the Baecke questionnaire is valid and
exertion have been an alternative for measuring physical
activity, as the subjects need to record their physical activ-
* Apoio através de bolsa de doutorado da Fapesp para Alex Antonio Flo- ities over a pre-defined period of time only. Also as alter-
rindo. natives, physical fitness measures have been used, as they
1. Departamento de Epidemiologia da Faculdade de Saúde Pública da Uni- require only attendance of the subject at the lab or field to
versidade de São Paulo. carry out the test. Baecke’s questionnaire for HPA3 is a re-
Received in 6/12/02 cording tool for the past 12 months, easy to understand
2nd version received in 16/2/03 and apply, and measures qualitative and quantitative indi-
Accepted in 20/4/03 ces, addressing dimensions such as occupational physical
activity, physical exercises in leisure, and leisure and loco-
Correspondance address:
Alex Antonio Florindo motion activities. This instrument has been used in an epi-
Departamento de Epidemiologia, Faculdade de Saúde Pública, demiologic study of the Brazilian population4. The pur-
Universidade de São Paulo pose of this study was to investigate validity and reliability
Av. Dr. Arnaldo, 715
of the scores from physical exercises in leisure, and leisure
01246-904 – São Paulo, SP
Tel.: +55(11) 3066-7744, fax: +55(11) 3082-2920 and locomotion activities assessed by Baecke’s habitual
E-mail: aflorind@usp.br physical activity questionnaire for Brazilian adult males.
Rev Bras Med Esporte _ Vol. 9, Nº 3 – Mai/Jun, 2003 129
METHODS correlation coefficients of studies relating total Baecke’s
Subjects HPA scores with maximum oxygen uptake5-7, employing a
type I (α) error of 5%, and a type II (β) error of 20%, in
The studied population included male students attend-
accordance with Browner et al. (2001)8. This study was
ing the sixth semester of the Physical Education School of
part of a broad Ph.D. program research approved by the
the Escola da Polícia Militar do Estado de São Paulo
Ethics Committee of the Public Health School from the
(EEFPMSP), and data collection was carried out between
Universidade de São Paulo.
August and September, 2001. From a total of 26 students
enrolled, two were excluded for impossibility of physical Habitual physical activity questionnaire
activity assessment, and three for not completing all the Baecke’s questionnaire includes 16 questions compre-
tests, remaining 21 students to be evaluated. hending three HPA scores from the past 12 months: 1) oc-
The calculation of the size of the sample was carried out cupational physical activities score (8 questions); 2) phys-
assuming a 0.50 correlation as the average result of the ical exercises in leisure (PEL) score (4 questions); 3) leisure

FIGURE 1
Habitual physical activity questionnaire

Please, make a circle around the appropriate answer for each question, considering the past
12 months:
1. Do you or did you practice sports or physical exercise within the past 12 months:
yes/no
Which sport or physical exercise do you or did you practice more often?

– how many hours a week?

– how many months a year?

If you practice or practiced a second modality of sport or physical activity, what is it?:

– how many hours a week?

– how many months a year?

2. When compared to others of my age, I think my physical activity during leisure hours is: 5 4 3 2 1
much more/more/the same/less/much less

3. During leisure hours, I sweat: 5 4 3 2 1

very often/often/sometimes/seldom/never

4. During leisure hours, I practice sports or physical exercises: 1 2 3 4 5

never/seldom/sometimes/often/very often

5. During leisure time, I watch TV: 1 2 3 4 5

never/seldom/sometimes/often/very often

6. During leisure hours, I walk: 1 2 3 4 5

never/seldom/sometimes/often/very often

7. During leisure hours I ride a bike: 1 2 3 4 5

never/seldom/sometimes/often/very often

8. For how many minutes a day do you walk or ride a bike going back and forth from work,
school or shopping? 1 2 3 4 5
< 5/5-15/16-30/31-45/> 45
Total in minutes

130 Rev Bras Med Esporte _ Vol. 9, Nº 3 – Mai/Jun, 2003

and locomotion physical activities (LLA) score (4 ques- ing their seats. The average response time for the HPA ques-
tions). In this investigation, as the subjects were students, tionnaire was 5 minutes. Once all students completed the
the PEL and LLA scores were used, the total score being the questionnaire, they were taken to the athletic track for phys-
sum of these (TS = PEL + LLA). The questionnaire with PEL ical assessment.
and LLA scores, and their calculation formulas are in fig-
ures 1 and 2, respectively. Criteria validity
To check cardiorespiratory capacity, Cooper’s 12-minute
Methodology walk or run test was used9. The test was carried out in EEF-
The sixth semester class of the course was selected, be- PMSP’s official athletic track. Based on the total distance
cause of the facility in applying the assessment tests, as attained, maximum oxygen intake (VO2max) was measured,
they were taking practical, field classes. The first approach in milliliter per kilo of body weight per minute (ml/kg/
was done in the classroom. First, the person responsible min), in accordance with the formula proposed by Cooper
for the investigation explained the purposes of the study, and described by Leite10:
and all those who agreed to take part signed the informed
consent form. After this step, two questionnaires were hand- VO2máx (ml/kg/min) = (distance attained in meters – 504)/45
ed out, one on demographics and the HPA questionnaire.
The students were asked to call the person in charge of the Final heart rate (HRfinal) was assessed immediately after
investigation if they had any questions to ask, without leav- the test, and recovery heart rate (HRrecovery) was assessed

FIGURE 2
Formulas to calculate scores for Baecke’s HPA questionnaire

Physical exercises in leisure (PEL)

Calculating the first question related to the practice of sports/physical exercises:

• Intensity (type of modality) = 0.76 for modalities of mild energy exertion, or 1.26 for modalities of moderate energy
exertion, or 1.76 for modalities of strenuous energy exertion (as determined from the answer as to the type of
modality: energy exertion should be checked in Ainsworth’s compendium of physical activities13)
• Time (hours per week) = 0.5 for less than one hour a week, or 1.5 from more than one hour and less than two hours
a week, or 2.5 for more than two hours a week and less than three hours a week, or 3.5 for more than three and up
to four hours a week, or 4.5 for more than four hours a week (as determined from the answer as to number of
hours per week of physical activities practice)
• Proportion (months a year) = 0.04 for less than one month, or 0.17 for between one and three months, or 0.42 for
between four and six months, or 0.67 for between seven and nine months, or 0.92 for more than nine months (as
determined for the answer as to the number of months a year one of physical activities practice)
To calculate the score of this question, the values should be multiplied and added:
Modality 1 = (Intensity*Time*Proportion) + Modality 2 = (Intensity*Time*Proportion)
For the final amount, a score will be found according to values from the formula:
0 (no physical exercise) = 1/between 0.01 up to < 4 = 2/between 4 up to < 8 = 3/between 8 up to < 12 = 4/≥ 12,00 = 5

Scores for questions two to four will be calculated in accordance with Likert’s scales responses.
Final PEL score should be calculated according to the formula below:

question 1 + question 2 + question 3 + question 4 + question 3 + question 4

PEL score =
4

Leisure and locomotion activities (LLA)

Scores for questions five to eight are calculated in accordance with Likert’s scales responses.
Final PEL score should be calculated according to the formula below:

(6 – question 5) + question 6 + question 7 + question 8

ALL score =
ALL score = 4
Total score (TS) = PEL + LLA

Rev Bras Med Esporte _ Vol. 9, Nº 3 – Mai/Jun, 2003 131

one minute after the test, through Polar ® monitors models DURATION (hours/week)*INTENSITY (mets hours/week)*WEIGHT (kg)
Beat and Favor. The percentile for decrease of heart rate
(%DHR) was calculated through the formula adapted from ↓
Oliveira et al.11 and used by Florindo12:
INDEX OF LOCOMOTION ACTIVITIES
%DHR = (HRfinal-HRrecovery)*100/HRfinal (use of energy in kcal/week)

Concurrent validity
Reliability
To assess concurrent validity, a record of physical exer-
After 45 days, the measurement was repeated (retest)
cise over the past 12 months was used. Detailed questions
according to the criteria used in the first measurement.
on the practice of physical exercise in terms of frequency
in months per year, and duration in hours per week were Statistical analysis
asked for the two main modalities. The intensity of the
Validation analysis used the Pearson correlation coeffi-
modalities in mets was determined in accordance with
cient, and age- and body mass index (BMI) adjusted coeffi-
Ainsworth et al.’s compendium of physical activities13. A
cient between HPA and VO2max, IPE and ILA scores, after
total index of physical exercises (IPE) was calculated for
checking that data had normal distribution through the
the previous 12 months in kilocalories per year (kcal/year)
Kolmogorov-Smirnov test.
according to a model proposed by Kriska2:
For reliability analysis, the intraclass correlation test and
FREQUENCY (months/year)*DURATION (hours/month)* t-paired test were used.
INTENSITY (mets hours/year)*WEIGHT (kg) For all analyses, a significance level of p < 0.05 was
used. All calculations were done with the software Statisti-
↓ cal Package for the Social Sciences (SPSS) version 10.0.
INDEX OF PHYSICAL EXERCISES (use of energy in kcal/year)
RESULTS
The question about locomotion activities from the ques-
tionnaire (the last question) was transformed in the index Table 1 presents the features of the sample. Age ranged
of locomotion activities (ILA), measured in kcal, by multi- from 27 to 37 years, mean of 32.6 years (sd = 3.2 years).
plying the total number of hours per week walking or riding Weight ranged from normal to overweight with no obese
a bike to go to and come back from work, school, shop- student. VO2max had a high average rate, showing the good
ping by the average mets of these two activities as deter- cardiorespiratory capacity of the subjects. It was noted that
mined in the compendium of physical activities13 and the average annual energy exertion on physical exercises
weight: within the sample was high, however, with significant vari-

TABLE 1
Descriptive statistics of the study’ subjects variables

Variables Males (N = 21)

Minimum-maximum Average (sd)

Age (years) 27-37 32.6 (3.1)

Body mass index (kg/m2) 19.7-27.7 23.5 (2.2)
Leisure physical exercises score 2,750-4,500 4,002 (0.464)
Leisure and locomotion activities 2,250-4,250 3,417 (0.526)
Total score 5,000-8,750 7,429 (0.881)
Maximum oxygen intake (ml/kg/min) 45.5-62.1 55.4 (4.1)
Distance completed in Cooper’s test (meters) 2,550-3,300 2,999.0 (185.8)
Physical exercises rate (kcal/annual) 35,280.0-430,080.0 196,016.4 (115,023.6)
Locomotion activities rate (kcal/weekly) 96.0-5,085.0 1,386.4 (1,139.4)
Final heart rate (bpm) 154-198 181 (11)
Recovery heart rate (bpm) 122-177 150 (15)
Percentage of heart rate decrease 7.0-30.0 16.9 (6.0)

132 Rev Bras Med Esporte _ Vol. 9, Nº 3 – Mai/Jun, 2003

ations among the subjects. The weekly energy exertion in DISCUSSION
locomotion activities was relatively low, but also showed
In this study, physical activity (IPE and ILA) and physi-
important variations.
cal fitness (VO2max and %DHR) standards were compared
It has been noted that PEL and TS scores were correlated to Baecke’s HPA questionnaire scores.
to IPE, and correlation improved after adjusted for age and VO2max is related to energy exertion, and is chiefly in-
BMI (table 2). LLA and TS scores were correlated to ILA, fluenced by age14 and physical fitness level. In this study,
and correlation improved for LLA after age and BMI adjust- no HPA score was significantly correlated with VO2max. Sig-
ments, and maintained on TS evaluation. There was no sig- nificant results were found in the correlation of physical
nificant correlation among the PEL, LLA and TS scores with exercises score with peak VO2 (r = 0.47) among Belgian
VO2max. As for %DHR, a significant correlation with LLA adult males5, and with VO2max (r = 0.52) in American male
and TS was noted, which improved for LLA after age and and female adults7. In the analysis of modified Baecke’s
BMI adjustments, and was maintained for TS. questionnaire, correlation values of 0.45 for American fe-
In regard to reliability measures (table 3), it was noted males and 0.67 for American males were obtained15. It is
that intraclass correlation coefficients were significant for believed that significant correlation values were not ob-
all HPA scores, being the highest values found, respective- tained in this study due to the homogeneity of VO2max val-
ly, in TS, LLA and PEL scores. There were no significant ues (sample of EEFPMSP Physical Education students), as
differences between the average of the first and second mea- the average value from the group was high, with little vari-
surements for all HPA scores. ation, which impaired the analysis.

TABLE 2
Pearson correlation coefficient and adjusted coefficients between
HPA scores and physical fitness and physical activity standards

Measurements PEL LLA TS

r(p) r(p) r(p)

Simple correlation
VO2máx (ml/kg/min) 0.04 (0.867) 0.24 (0.285) 0.17 (0.470)
%DHR 0.38 (0.091) 0.47 (0.030)* 0.48 (0.027)*
IPE (kcal/year) 0.56 (0.008)* 0.28 (0.224) 0.46 (0.036)*
ILA (kcal/week) 0.25 (0.264) 0.64 (0.002)* 0.51 (0.017)*
Age and BMI adjusted correlation
VO2max (ml/kg/min) 0.15 (0.539) 0.42 (0.069) 0.33 (0.169)
%DHR 0.32 (0.172) 0.51 (0.026)* 0.47 (0.043)*
IPE (kcal/annual) 0.61 (0.005)* 0.25 (0.292) 0.47 (0.043)*
ILA (kcal/weekly) 0.22 (0.355) 0.69 (0.001)* 0.52 (0.022)*

* p < 0,05; PEL (physical exercises in leisure score); LLA (leisure and locomotion activities); TS (total score); %DHR (percent-
age of heart rate decrease); IPE (physical exercises index); ILA (index of locomotion activities).

TABLE 3
Paired t-test and intraclass correlation coefficients
significance values for repeated measurements

Scores Measurement 1 Measurement 2 t test Intraclass correlation

average (sd) average (sd) P r (IC)

PEL 4,011 (0.464) 3,952 (0.640) 0.542 0.69 (0.40-0.86)*

LLA 3,417 (0.526) 3,440 (0.713) 0.797 0.80 (0.57-0.91)*
TS 7,429 (0.881) 7,393 (1.286) 0.832 0.77 (0.52-0.90)*

* p < 0,05; PEL (physical exercises in leisure score); LLA (leisure and locomotion activities); TS (total score).

Rev Bras Med Esporte _ Vol. 9, Nº 3 – Mai/Jun, 2003 133

 It is to be stressed the magnitude of correlation values Belgian adult males19. In this population a physical activi-
obtained from each score. One believes that, being a phys- ty index was calculated based on energy exertion divided
ical fitness measurement, VO2max better differentiates phys- by metabolic rate in hours of sleep, and a correlation of r =
ical exercises from other physical activities. However, ac- 0.55 was obtained from the physical exercises score19.
cording to the results of this study, higher values were A significant correlation between ILA-measured energy
obtained in comparing leisure and locomotion activities. exertion and leisure and locomotion physical activities score
Other investigations have found lower correlation between was found. Also significant correlations between the daily
leisure and locomotion activities score and VO2max5,7. energy exertion and the leisure and locomotion activities
Baecke’s questionnaire includes comparison and self- were also found for American females (r = 0.42) and males
assessment questions. There can be some difficulties for (r = 0.37)15, and with the total score for Dutch females (r =
answering the questions16. Due to the importance of ques- 0.52)6. In comparing with the accelerometer, a correlation
tions addressing sweating or perspiration for HPA assess- of r = 0.285 with the leisure and locomotion activities score
ment16,17, correlation between the gross value from self- in Belgian adult males was found; and with doubly labeled
assessment on sweating with VO2max was tested. There was water, the correlation was r = 0.5019.
positive correlation after age and BMI adjustment (r = 0.51; A number of studies have shown good reliability indices
p = 0.027) (data not shown). These results are similar to for Baecke’s HPA questionnaire. The values for physical
those found in the analysis of the perspiration report by exercises score were of r = 0.92 and r = 0.88 respectively,
correlating Paffenbarger’s questionnaire total score with for American females and males15, and r = 0.93 for Belgian
VO2max (r = 0.54) in adult and elder American males16. adult males20. The total score follows the other indices,
Heart rate and its recovery processes are considered phys- reaching correlation values of r = 0.93 for adult American
ical fitness indicators11. The %DHR index is correlated to males and females7, and r = 0.86 for Belgian adult males20.
VO2max12. In this study, once more an interesting result has Values assessed with a 15-day interval did not present ma-
been found, with significant correlation between %DHR and jor changes, as shown in Belgian adult males, being of r =
HPA scores, underlining the highest magnitude obtained 0.79 for physical exercises19. In the analysis of leisure and
with leisure and locomotion activities. Using the workload locomotion physical activities score, with a 30-day inter-
from a maximum treadmill test as an indicator, Jacobs et val, high correlation values were obtained from American
al. (1993)7 showed significant correlation with physical females and males (r = 0.87 and r = 0.86, respectively)15,
exercises score (r = 0.57) and total score (r = 0.51), and and from Belgian adult males (r = 0,87)20. With a 15-day
finally with leisure and locomotion score (r = 0.33). Other interval, values of r = 0.66 were obtained from Belgian
studies using the Minnesota questionnaire reached signifi- males19. In the analysis of longer intervals, such as between
cant correlation on the assessment of the total score and five and 11 months, coefficients of r = 0.88 and r = 0.81
submaximal heart rate in male American adults (r = 0.59)16, were obtained for PEL, and r = 0.76 and r = 0.71 for LLA in
and in American males and females as a group (r = 0.45)7. Dutch adults and elders, respectively18. Such reliability re-
There was significant correlation between energy exer- sults from Baecke’s HPA scores are similar to those found
tion measured by IPE and the physical exercises score, which for the population of the present study.
remained constant even after adjusted for age and BMI. The
standard used in this study was a detailed recording of phys- CONCLUSION
ical exercises over the past 12 months. This means that the
standard reflects this type of physical activity within the From the results shown for the population of the present
past year. It is to be noted that literature data are controver- study, and from comparison with results of studies from
sial as to the magnitude of the correlation of this score with developed countries, on concludes that Baecke’s HPA ques-
the recorded data and with other comparative standards. In tionnaire is a good option to assess habitual physical activ-
the analysis of daily energy exertion, an index of r = 0.58 ities in Brazilian adult males.
from physical exercises score in American adult males15,
and r = 0.51 from total score in Dutch elderly females were ACKNOWLEDGMENTS
obtained18. As to other standard measurements, such the To the Fundação de Amparo à Pesquisa do Estado de São Pau-
use of an accelerometer, values of r = 0.34 from physical lo (FAPESP) for the Ph. D. scholarship grant given to Alex Anto-
exercises score in Belgian adult males5, and r = 0.34 with nio Florindo (process # 00/09482-8), and to Conselho Nacional
physical exercises score in American adult males15 were de Pesquisas (CNPq) for the scholarship grant given to Maria do
obtained. With doubly labeled water, r = 0.46 was obtained Rosario Dias de Oliveira Latorre. To Professor Raul Santo, for
from the correlation with the physical exercises score in helping access to the Physical Education School of the Escola da
134 Rev Bras Med Esporte _ Vol. 9, Nº 3 – Mai/Jun, 2003
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This article has received corrections in agreement with the ERRATUM published in Volume 9 Number 5.

Rev Bras Med Esporte _ Vol. 9, Nº 3 – Mai/Jun, 2003 135