# The German version of the Pregnancy Physical Activity Questionnaire: a translation, cross-cultural adaptation, reliability and validity assessment

## TL;DR

This study translated and validated a German version of a questionnaire to measure physical activity during pregnancy, showing it is reliable and can be used for research.

## Contribution

The study provides a validated German version of the Pregnancy Physical Activity Questionnaire (PPAQ-G) for use in Germany and international comparisons.

## Key findings

- The PPAQ-G showed good reliability with ICC values ranging from 0.70 to 0.90 for different activity intensities.
- Total activity and light activity showed significant correlations with accelerometer data, indicating moderate validity.
- The questionnaire was adapted to reflect German measurement units and intensity descriptions.

## Abstract

Validated and internationally standardised measurement instruments are a prerequisite for ensuring that physical activity during pregnancy is comparable and for deriving physical activity recommendations. In Germany, there has been no adapted version of the internationally used Pregnancy Physical Activity Questionnaire (PPAQ) until now. This study’s aim centred around translating the original English version into German (PPAQ-G) and determining its reliability as well as validity in a German population.

The PPAQ was translated into German using the forward-backwards technique. Its reliability and validity were tested. Thirty-four correctly completed questionnaires were analysed. The test–retest reliability was presented using the intraclass correlation coefficient (ICC) and Spearman correlation coefficient. Validity was tested by using accelerometer (n = 23) and determined by Spearman correlation coefficient.

In the transcultural adjustment, two questions were amended to describe intensity more precisely, and two other questions were adapted to reflect the units of measurement used in Germany. The ICC indicated a reliability of r = 0.79 for total activity (without sitting), and the intensity subcategories ranged from r = 0.70 (moderate-intensity activities) to r = 0.90 (sitting). Although, validity assessment showed no significant correlation for sedentary, moderate or vigorous intensity, there were significant correlations for total activity (light and above; r = 0.49; p < 0.05) and for light activity (r = 0.65; p < 0.01).

The PPAQ-G showed good reliability for use on pregnant German women and a moderately accurate measurement of physical activity. It can be used nationally for epidemiological studies, and it also enables international comparisons of physical activity during pregnancy.

DRKS00023426; Registration date 20 May 2021.

The online version contains supplementary material available at 10.1186/s12884-024-06804-5.