Animated Activity Questionnaire

Abstract

The Animated Activity Questionnaire (AAQ) is an innovative, technologically enhanced self-reported measure designed to quantify functional limitations in patients diagnosed with hip and/or knee osteoarthritis. It specifically assesses restrictions in basic daily activities (ADL) such as walking, climbing stairs, and transitioning from sitting to standing (e.g., from a chair, couch, or toilet). The AAQ distinguishes itself by utilizing video stimuli rather than static text descriptions to gauge performance.

The instrument consists of 17 core activities. For each activity, the respondent views between three and five short video clips, each depicting a different level of difficulty or execution effort. The patient selects the video that most accurately reflects their own typical performance of that activity. The total score is derived by summing the scores across all 17 items, resulting in a scale ranging from 0 to 100. A score of 0 indicates maximum functional restriction in AAQ activities, while a score of 100 signifies the complete absence of restrictions.

Keywords

Animated Activity Questionnaire, AAQ, Osteoarthritis, Functional limitation, Mobility, Activities of daily living, Self-report, Video assessment, Lower extremity.

Authors

Peter WF (2015)

Purpose

The primary purpose of the Animated Activity Questionnaire (AAQ) is to provide a standardized, objective, and patient-centered assessment of functional capacity related to mobility in individuals suffering from joint pathology, specifically osteoarthritis of the hip or knee. Traditional self-report measures often rely on subjective interpretation of verbal descriptions of pain or difficulty, which can lead to variance in reporting. The AAQ seeks to mitigate this subjectivity by using visual, animated representations of activities.

By presenting videos demonstrating varying levels of difficulty—from effortless execution to severe restriction—the AAQ allows patients to benchmark their own performance against clear, observable standards. This methodology is intended to yield more precise and reliable data regarding the actual physical limitations experienced by the patient in their daily activities, aiding clinicians in treatment planning, monitoring disease progression, and evaluating intervention efficacy.

Construct

The AAQ is designed to measure the construct of Functional Limitation in Basic Mobility, specifically within the context of chronic musculoskeletal pain and joint degeneration (osteoarthritis). This construct encompasses the individual’s perceived ability to execute essential, non-sporting physical tasks that require movement and weight-bearing of the lower extremity.

The construct is operationalized through 17 specific activities, which are chosen because they are critical components of independent living and are commonly impaired by hip or knee pain. The core theoretical underpinning is that functional limitation is a multidimensional construct influenced by both physical capacity and perceived difficulty. By using video modeling, the AAQ captures the patient’s subjective assessment of their physical capacity relative to a standardized visual scale of performance.

Validity

Validation studies for the AAQ, typically detailed in the primary publication by Peter WF (2015) and subsequent research, focus on several key aspects of validity. Content validity is established by ensuring that the 17 chosen items comprehensively cover the range of basic mobility tasks most affected by hip and knee osteoarthritis, often guided by expert consensus and patient input.

Criterion validity is generally assessed by correlating AAQ scores with established gold-standard measures of mobility, such as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) or objective measures like gait analysis or timed physical performance tests. High correlations with these established measures would support the AAQ’s ability to accurately reflect the patient’s true functional status. Furthermore, construct validity examines whether the AAQ scores align theoretically with related, but distinct, constructs, such as pain intensity (expected moderate correlation) and quality of life (expected high correlation).

Reliability

Reliability of the Animated Activity Questionnaire primarily focuses on its internal consistency and test-retest stability. Internal consistency, typically measured using Cronbach’s alpha, should be high (usually above 0.80) to demonstrate that all 17 items measure the same underlying construct of functional limitation. This ensures that the scale provides a coherent measure.

Test-retest reliability is crucial for a self-reported functional assessment. This involves administering the AAQ to a stable patient population on two separate occasions within a short interval (e.g., 7 to 14 days) and correlating the resulting scores. High correlation coefficients (e.g., above 0.90) indicate that the scale is stable over time and that the video-based methodology consistently elicits the same response from the patient, assuming no true change in their functional status.

Factor Analysis

Although specific details of the factor structure are typically found in the instrument’s development papers (Peter WF, 2015), factor analysis is commonly employed to determine the dimensionality of the Animated Activity Questionnaire. Given that the AAQ measures limitations in basic mobility across various types of movement (e.g., walking, transferring, stair climbing), exploratory or confirmatory factor analysis would investigate whether the 17 items load onto a single, dominant factor (Unidimensionality of Functional Limitation) or multiple sub-factors (e.g., Gait, Transfers, Vertical Movement).

A strong argument for a single factor would support the use of the total summed score (0-100) as the primary outcome measure. If multiple distinct factors emerge, researchers may recommend using subscale scores in addition to the total score, providing a more nuanced understanding of where the patient’s functional deficits are most pronounced within the lower extremity mobility construct.

Instrument

Test Type: Self-reported measure (Questionnaire)

Format: Video-assisted response format. Patients select one of 3 to 5 videos per item that best represents their performance.

Language Available: Original development likely in Dutch/English, with potential translations available via the publisher/website.

Population Group: Clinical population diagnosed with osteoarthritis of the hip and/or knee.

Age Group: Adults and Elderly.

Population Details: Individuals experiencing functional limitations in basic daily activities due to musculoskeletal conditions affecting the lower extremity.

Test Methodology: The instrument uses a standardized set of 17 activities. For each activity, patients are presented with animated or recorded videos demonstrating various levels of difficulty. The patient’s selection is scored, and the sum of these scores yields a final composite score ranging from 0 (maximal restriction) to 100 (no restriction).

Keywords

Video assessment, Joint disease, Musculoskeletal, Functional impairment, Hip osteoarthritis, Knee osteoarthritis, Patient outcome, ADL, Health status.

Authors

Author ORCID Identifier: N/A (Information not provided in source content)

Affiliation Email addresses: N/A (Information not provided in source content)

Correspondence Address: N/A (Information not provided in source content)

Permissions & Fee and Test Year

The scale was developed and published in 2015 by Peter WF. The official website for the instrument is http://www.myaaq.com, which typically governs access, licensing, and any associated usage fees. Researchers or clinicians seeking to implement the AAQ should consult the official website or contact the primary author for current permission requirements and licensing costs.

The original explanatory form (Toelichtingsformulier) for the instrument can be downloaded here: AAQ-form.pdf.

Reference’s

Peter WF (2015). The Animated Activity Questionnaire (AAQ) [Primary publication detailing scale development and psychometric properties]. (Specific journal citation required for full academic reference, assumed to be available via official website or databases).

Items of the Animated Activity Questionnaire

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

The source content did not provide the specific list of the 17 items comprising the Animated Activity Questionnaire. However, the activities measured focus on basic daily mobility tasks such as:

• lopen (walking)
• traplopen (climbing stairs)
• gaan zitten en opstaan van bank stoel of toilet (sitting down and getting up from a couch, chair, or toilet)