355
ORIGINAL SCIENTIFIC ARTICLE
Cross-cultural adaptation of the International Physical Activity Questionnaire (IPAQ) for use in education
Copyright (c) 2022 Slovenian Medical Journal. This work is licensed under a
Creative Commons Attribution-NonCommercial 4.0 International License.
Cross-cultural adaptation of the International Physical 
Activity Questionnaire (IPAQ) for use in education
Medkulturna priredba mednarodnega Vprašalnika telesne dejavnosti (IPAQ) za rabo 
na področju izobraževanja
Miha Marinšek,1 Klemen Bedenik,2 Janja Tekavc1
Abstract
Background: Regular moderate and vigorous-intensity physical activity (PA) is very important for health promotion and 
prevention of diseases. Frequency and the amount of PA can be monitored with direct and indirect measurements; the 
former is more accurate than the latter, which is, on the other hand, easier to use and more cost-effective. One of the 
most commonly used indirect methods is a self-report International Physical Activity Questionnaire (IPAQ), which comes 
in short (SF) and long forms (LF). Despite its wide cross-cultural use, IPAQ has not yet been adapted for use in the Slovenian 
language. The main purposes of the study were to produce a reliable Slovenian version of IPAQ-LF for use in education. 
Methods: A back-translation method involving four translators and one native English-speaking reviewer was used to 
adapt an IPAQ-LF questionnaire from English into the Slovenian language. The ease of use and comprehensibility of 
Slovenian IPAQ-LF was first pilot-tested on four teachers, then the reliability of a questionnaire was tested and retested on 
a sample of sixty-eight preschool and primary school teachers. 
Results: Collected data were analysed with several statistical methods, and the results revealed a high degree of test-re-
test reliability and internal consistency for both groups of teachers. Preschool teachers reported higher levels of moderate 
(1138±265 min/week vs. 870±1074 min/week) and vigorous-intensity (446±430 min/week vs. 106±157 min/week) PA as well 
as walking (996±337 min/week vs. 690±1173 min/week) than primary school teachers. 
Conclusions: The study has proven that the Slovenian IPAQ-LF version is reliable for use in education.
1 Faculty of Education, University of Maribor, Maribor, Slovenia
2 Association of Maribor Sports Clubs Branik, Maribor, Slovenia
Correspondence / Korespondenca: Miha Marinšek, e: miha.marinsek@um.si
Key words: physical activity; public health; teachers; validity; reliability
Ključne besede: telesna dejavnost; javno zdravje; učitelji; veljavnost; zanesljivost
Received / Prispelo: 17. 6. 2021 | Accepted / Sprejeto: 8. 5. 2022
Cite as / Citirajte kot: Marinšek M, Bedenik K, Tekavc J. Cross-cultural adaptation of the International Physical Activity Questionnaire 
(IPAQ) for use in education. Zdrav Vestn. 2022;91(9–10):355–62. DOI: https://doi.org/10.6016/ZdravVestn.3286
eng slo element
en article-lang
10.6016/ZdravVestn.3286 doi
17.6.2021 date-received
8.5.2022 date-accepted
Public health, epidemiology Javno zdravstvo, epidemiologija discipline
Original scientific article Izvirni znanstveni članek article-type
Cross-cultural adaptation of the International 
Physical Activity Questionnaire (IPAQ) for use 
in education
Medkulturna priredba mednarodnega Vprašalnika 
telesne dejavnosti (IPAQ) za rabo na področju 
izobraževanja
article-title
Cross-cultural adaptation of the International 
Physical Activity Questionnaire (IPAQ) for use 
in education
Medkulturna priredba mednarodnega Vprašalnika 
telesne dejavnosti (IPAQ) za rabo na področju 
izobraževanja
alt-title
physical activity, public health, teachers, 
validity, reliability
telesna dejavnost, javno zdravje, učitelji, veljav-
nost, zanesljivost kwd-group
The authors declare that there are no conflicts 
of interest present.
Avtorji so izjavili, da ne obstajajo nobeni 
konkurenčni interesi. conflict
year volume first month last month first page last page
2022 91 9 10 355 362
name surname aff email
Miha Marinšek 1 miha.marinsek@um.si
name surname aff
Klemen Bedenik 2
Janja Tekavc 1
eng slo aff-id
Faculty of Education, University 
of Maribor, Maribor, Slovenia
Pedagoška fakulteta, Univerza v 
Mariboru, Maribor, Slovenija 1
Association of Maribor Sports 
Clubs Branik, Maribor, Slovenia
Zveza mariborskih športnih 
društev Branik, Maribor, 
Slovenija
2
Slovenian Medical Journallovenian Medical Journal
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PUBLIC HEALTH, EPIDEMIOLOGY
Zdrav Vestn | September – October 2022 | Volume 91 | https://doi.org/10.6016/ZdravVestn.3286
1 Introduction
Physical inactivity can alter a person’s health for the 
worse. Worldwide study (1) reports that eliminating 
physical inactivity would remove between 6% and 10% 
of the major non-communicable diseases and increase 
life expectancy. By eliminating physical inactivity, the 
life expectancy of the world’s population is estimated to 
increase by 0.68 years. For substantial health benefits, 
physical activity (PA) recommendations state that adults 
should regularly participate at least 150-300 minutes a 
week in moderate-intensity or at least 75-150 minutes a 
week in vigorous-intensity aerobic PA or an equivalent 
combination of moderate and vigorous-intensity activ-
ity throughout the week (2). Performing recommended 
levels of aerobic PA with muscle-strengthening exercises 
two (2) days per week is optimal against all-cause and 
cardiovascular disease mortality.
Progress in PA and global public health research in 
the past few decades has been observed with the in-
crease in the number of countries with PA surveillance. 
In 2008, PA levels were analysed in 122 countries (3), 
and in 2016, in 168 countries, including 1.9 million par-
ticipants worldwide (4). Ongoing PA surveillance allows 
for trend assessment of insufficient activity, identifying 
the PA problems, and delivering vital information for PA 
policies. However, reliable and valid measurement is es-
sential to surveillance.
Several direct and indirect measurements have been 
developed to monitor PA and energy expenditure, in-
cluding self-report methods, direct/indirect calorimetry, 
Izvleček
Izhodišča: Redna zmerna in visoko intenzivna telesna dejavnost je ključnega pomena za ohranjanje zdravja. Pogostnost 
in količino telesne dejavnosti posameznika lahko spremljamo z neposrednimi ali posrednimi meritvami, pri čemer so prve 
bolj natančne, slednje pa bolj poceni in enostavne za uporabo. Ena najpogosteje uporabljanih posrednih metod merjenja 
telesne dejavnosti je samoocenjevalni Vprašalnik telesne dejavnosti (IPAQ), ki obstaja v krajši (IPAQ-SF) in daljši (IPAQ-LF) 
obliki. Kljub pogosti rabi vprašalnika v številnih okoljih pa vprašalnik IPAQ še ni prirejen za uporabo v slovenskem prostoru. 
Namen študije je ustvariti zanesljivo slovensko različico vprašalnika IPAQ-LF za uporabo v izobraževanju.
Metode: Za priredbo vprašalnika IPAQ-LF v slovenščini smo uporabili metodo vzvratnega prevoda v angleščino, pri kate-
rem so sodelovali 4 prevajalci in recenzent, ki je t.i. naravni govorec angleškega jezika. Uporabnost in razumljivost preve-
denega vprašalnika smo preverili s pilotno študijo, v katero so bili vključeni 4 učitelji. Zanesljivost vprašalnika smo preverili 
z metodo notranje zanesljivosti in z metodo test-retest na vzorcu 68 vzgojiteljev in osnovnošolskih učiteljev. 
Rezultati: Zbrane podatke smo analizirali s pomočjo več statističnih metod. Rezultati so pokazali visoko stopnjo notranje 
zanesljivosti vprašalnika in zanesljivosti, merjene z metodo test-retest. Vzgojitelji so v primerjavi z učitelji poročali o večji 
količini zmerne (1138±265 min/teden v primerjavi z 870±1074 min/teden) in visoko intenzivne (446±430 min/teden v pri-
merjavi s 106±157 min/teden) telesne dejavnosti, kakor tudi hoje (996±337 min/teden v primerjavi s 690±1173 min/teden).
Zaključek: Študija je dokazala, da je slovenska oblika vprašalnika IPAQ-LF zanesljiva za rabo na področju izobraževanja.
accelerometry, heart rate monitoring, pedometry, and 
direct observation (5). Direct PA measurements are gen-
erally considered more valid and accurate, as they calcu-
late energy expenditure or actual movement characteris-
tics. However, they present a higher degree of burden on 
both the participant and the researcher; these methods 
are also more expensive, intrusive, and time-consuming 
than indirect measurements (6,7).
Despite their lack of accuracy (6,7), self-report meth-
ods are still the most frequently used measurements for 
obtaining PA data. These methods are non-invasive and 
more versatile than direct measurements. They are also 
practical, easy to administer in large-scale cohort stud-
ies, and due to their low cost, also more affordable (8). 
The most widely used self-report methods for assess-
ment of PA include questionnaires and PA records or di-
aries (5). Although self-report questionnaires rely on the 
participant’s memory, they are preferred to PA records/
diaries as they present a low burden to subjects and re-
main valid.
Recent reviews have documented 85 self-adminis-
tered PA questionnaires for adults (8); nevertheless, not 
all of them are suitable for international comparison. 
The International Physical Activity Questionnaire (IP-
AQ) was developed and pilot-tested between 1998 and 
1999 as an instrument for cross-national monitoring of 
physical activity and inactivity (9). The measurement 
properties were first tested in 2000, showing acceptable 
validity and reliability for monitoring physical activity 
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ORIGINAL SCIENTIFIC ARTICLE
Cross-cultural adaptation of the International Physical Activity Questionnaire (IPAQ) for use in education
among 18- to 65-year-old adults in 12 countries (10). The 
IPAQ has become the most widely used and validated 
physical activity questionnaire, with two versions avail-
able: the 27-item long form (IPAQ-LF) and the 9-item 
short form (IPAQ-SF) (8). The IPAQ-LF consists of 27 
questions, reflecting on the PA of a person within the 
last 7 days and dividing it into the following domains: 
1) job-related; 2) transportation-related; 3) housework, 
house maintenance, and caring for the family; 4) recre-
ation, sport, and leisure-time; and 5) time spent sitting. 
The IPAQ website supports cross-cultural use of the long 
version questionnaire in 18 different languages; no Slo-
venian translation has been validated yet.
The objectives of the present study were 1) to gen-
erate a reliable translation of IPAQ-LF for cross-cultur-
al use in education, and 2) to examine the reliability of 
7-day self-administered IPAQ-LF. Firstly, the prescribed 
back-translation method of the English IPAQ-LF was 
completed to ensure the quality of translation into Slo-
vene language. Secondly, the clearness and comprehen-
sibility of translated Slovenian IPAQ-LF text were veri-
fied by four (4) preschool and primary school teachers. 
Finally, a test-retest reliability assessment of the Slove-
nian version IPAQ-LF was conducted on a convenience 
sample of 68 teachers.
2 Methods
2.1 Translation
The back-translation method was used to adapt the 
English version of IPAQ and to achieve equivalence in 
meaning (11,12). Four bilingual translators and one 
monolingual reviewer were involved throughout the 
back-translation process.
The first two bilingual translators (MM, NK) were 
Slovenian citizens, one a university lecturer with more 
than a decade of experience in physical activity research, 
the other a university student (preschool education pro-
gramme), specialising in PA measurements with the 
use of questionnaires. Both translators have passed the 
English competency exam at the Faculty of Sport, Uni-
versity of Ljubljana. They had independently translated 
original English long format IPAQ text into coherent 
Slovenian versions. In the second step, one of the trans-
lators (MM) and another bilingual teacher (JT) carried 
out forward translation reconciliation by comparing two 
translated texts, discussing the problematic items, and 
merging them into a single Slovenian questionnaire.
In the back-translation step, a bilingual teacher who 
participated in the previous step (JT) and a further 
bilingual translator (KB) separately translated Slovenian 
text into English without accessing the source version 
of the IPAQ. The first person (JT) is a researcher whose 
topics primarily include PA and sport, whereas the sec-
ond person (KB) is considered a practiced translator in 
the field of sport. In step four, an expert (KB) has identi-
fied discrepancies between the newly generated English 
texts and merged them into a single document. In case 
of terminological differences, the text was compared 
with the Slovenian version, or the wording used more 
often was chosen.
The final step – back-translation review – was car-
ried out by a native monolingual English reviewer (AN), 
who has previously been involved in physical activity re-
search. He has compared the back-translated IPAQ (in 
English) with the IPAQ source version (also in English) 
and provided feedback on the equivalence of both texts.
A Slovenian version of the questionnaire was admin-
istered individually to a sample of two preschool teach-
ers and two primary school teachers, who were subse-
quently interviewed about the questionnaire to verify its 
suitability for use in education.. Teachers had to provide 
comments to establish the reasons behind their respons-
es, highlight any potential problems with terminology 
or understanding of the concept and determine the con-
ceptual and linguistic equivalence of the questionnaire. 
At the end of the procedure, the final version of ques-
tionnaire was ready to be used on Slovenian preschool 
and primary school teachers.
2.2 Data collection
A link to the Slovenian IPAQ-LF version was distrib-
uted by email to 673 Slovenian preschool and primary 
school teachers. In the first measurement, 307 teachers 
clicked on the link, and 205 started to answer the ques-
tions, with 72 preschool and 60 primary school teachers 
completing the questionnaire. Out of these 132 teachers, 
68 self-administered the questionnaire for the second 
time in less than 7 days from first measurement (Time 
range = 4-6 days; Mode = 5 days).
IPAQ questions were used to determine the frequen-
cy (“During the last 7 days, on how many days did you 
do ...”) and the average amount (“How much time did 
you usually spend on one of those days doing …”) of in-
dividual PA domains in which measured subjects partic-
ipated for at least 10 minutes per day. Collected data for 
each PA domain were added to estimate the total time 
spent in job-related, transport-related, household-relat-
ed, and leisure-time-related PA, as well as time report-
ed sitting per day during the working week and at the 
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weekend. The total weekly amount of vigorous PA was 
calculated by adding reported time spent in a week on all 
job-related and leisure-time-related vigorous PA. The to-
tal weekly amount of moderate PA was calculated by add-
ing reported time spent in a week on all job-related, lei-
sure-time-related, household-related PA, and time spent 
cycling to work. The total weekly amount of walking was 
calculated by adding reported time spent walking in all 
job-related, transportation-related, and leisure-time-re-
lated PA. Calculated values for vigorous PA, moderate 
PA, and walking were truncated to 180 minutes per the 
IPAQ scoring protocol (9).
The study design was approved by the local ethics 
committee (OPV-2018-S1-SK12, 5.10.2018).
2.3 Data analysis
Intraclass correlation coefficients (ICCs) with 95% 
confidence intervals were calculated to assess test-retest 
reliability. A two-way mixed-effects model based on sin-
gle-rating and absolute agreement was employed. ICC 
reliability values were viewed as poor (below 0.50), mod-
erate (0.50-0.74), good (0.75-0.89), and excellent (0.90 or 
above) (13).
Internal consistency was tested with the calculation of 
Cronbach’s alpha with values considered as satisfactory 
(0.7-0.79), good (0.80-0.89) and excellent (0.90 or above) 
(14,15).
A Mann-Whitney test for independent samples was 
used to examine the differences in reported PA levels 
between preschool and primary school teachers.. Sta-
tistically significant differences between the parameters 
were indicated when p < 0.05. All the collected data were 
analysed using IBM SPSS programme version 27.0 (IBM 
Corp., Armonk, NY, USA).
3 Results
3.1 Demographics
One hundred and thirty-two participants aged be-
tween 21 and 61 years (M = 40; SD = 11) were included in 
the study (Table 1). The convenience sample comprised 
72 preschool teachers (assistant and core practitioner) 
and 60 primary school teachers. Collectively, participants 
represented a wide range of age, education, and activity 
levels (duration x frequency per week).
At the time of the study, all primary school teachers 
and 63% of preschool teachers held a bachelor’s degree. 
The reported age difference and gender distribution are 
similar to the population data (16).
Preschool teachers reported higher total PA level (U = 
2 881, p-value < .001, r = .66) than primary school teach-
ers, as well as higher level of vigorous PA (U = 2 486, p-val-
ue < .001, r = .43), moderate PA (U = 2 461, p-value < .001, 
r = .42) and walking (U = 2 828, p-value < .001, r = .63).
Characteristics Preschool
n = 72
Primary school
n = 60
Total
N = 132
Mean (SD) f (%) Mean (SD) f (%) Mean (SD) f (%)
Age (y) 37 (11) 44 (9) 40 (11)
Women (number) 69 (96%) 39 (65%) 108 (82%)
Education (number)
Bachelor’s degree 45 (63%) 60 (100%) 105 (80%)
Upper-secondary vocational 27 (37%) 0 (0) 27 (20%)
Activity levels (min/week)
Total PA 2 580 (687) 1 666 (2 156) 2 253 (1 461)
Vigorous-intensity PA 446 (430) 106 (157) 324 (392)
Moderate-intensity PA 1 138 (265) 870 (1 074) 1 042 (684)
Walking 996 (337) 690 (1 173) 887 (761)
Sitting (min/week) 2443 (1 888) 2273 (1 722) 2318 (1 753)
Table 1: Descriptive analysis of the socio-demographic data and reported activity levels.
Legend: SD – standard deviation; n/N – number; PA – physical activity.
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ORIGINAL SCIENTIFIC ARTICLE
Cross-cultural adaptation of the International Physical Activity Questionnaire (IPAQ) for use in education
3.2 Translation validity
A comparison of the forward translations from the 
source showed 22 differences between the two Slovenian 
IPAQ texts (see Table 4 in Appendix), and the review-
ers had to make several terminological reconciliations of 
problematic items to arrive at the final text in the Slove-
nian language. A comparison of back translations from 
the amended IPAQ version in the Slovenian language 
revealed a similar pattern as in the forward translation, 
both in number (21) and distribution of differences in 
the two English texts. 
3.3 Reliability assessment
One hundred and thirty-two participants (preschool 
teachers n = 72, primary school teachers n = 60) com-
pleted the questionnaire and were included in the in-
ternal consistency assessment. Out of these 132 partic-
ipants, 68 completed the IPAQ twice and were included 
in a test-retest reliability assessment of the questionnaire 
(preschool teachers n = 24, primary school teachers n = 
44). A similar or smaller sample has been used in other 
studies to assess test-retest reliability (19,20).
Internal consistency was found as good for total PA 
and all individual PA domains (Cronbach alpha ≥ 0.800) 
(Table 2).
A high degree of test-retest reliability was found 
between the two measurements (Table 3). Total PA in-
dicates good reliability (ICC = 0.855, 95% CI = 0.769–
0.911). The single measurement ICCs for the PA domains 
(from 0.792 to 0.931) with 95% confidence intervals 
(from 0.675 to 0.958) indicates good to excellent reliabil-
ity with all p < 0.001, suggesting statistically significant 
agreement between the first and second measurement.
Despite household-related PA (ICC = 0.792, 95% CI 
= 0.675–0.871) and leisure-time related PA indicating 
good consistency through time, their CI show a 95% 
chance that reliability could be moderate. Excellent reli-
ability was revealed for the job-related PA (ICC = 0.908, 
95% CI = 0.851–0.944), transportation-related PA (ICC 
= 0.931, 95% CI = 0.887–0.958), and time spent sitting 
(ICC = 0.919, 95% CI = 0.868–0.951).
4 Discussion
4.1 Translation validity
The majority of identified differences in the source’s 
forward translations were in the instructive part of the 
text. Thus, the form and a content of the questionnaire 
title had to be rewritten and several discrepancies be-
tween contents in the two texts had to be clarified by re-
viewing the original English IPAQ text. Out of four parts 
Cronbach’s alpha
Total PA 0.850
Job-related PA 0.833
Transportation-related PA 0.834
Household-related PA 0.837
Leisure-time-related PA 0.800
Sitting 0.841
Table 2: Internal consistency of reported activity levels 
for 132 teachers that completed the International Physical 
Activity Questionnaire.
Legend: PA – physical activity.
Intraclass correlation coefficients 
(95% confidence intervals)
p value
Total PA 0.855 (0.769 – 0.911) < 0.001
Job-related PA 0.908 (0.851 – 0.944) < 0.001
Transportation-related PA 0.931 (0.887 – 0.958) < 0.001
Household-related PA 0.792 (0.675 – 0.871) < 0.001
Leisure-time-related PA 0.817 (0.711 – 0.887) < 0.001
Sitting 0.919 (0.868 – 0.951) < 0.001
Table 3: Test-retest reliability statistics of reported activity levels for 68 teachers that completed International Physical 
Activity Questionnaire twice.
Legend: PA – physical activity.
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of the questionnaire, the first part revealed the highest 
number of discrepancies, making the reconciliation 
much easier for the rest of the text after being clarified. 
As such, the expression work was selected over job in the 
title of the first part and was then used three more times 
in the same context, whereas the term intensity was cho-
sen over the term effort and was used 17 additional times 
throughout the entire questionnaire; these changes have 
been each counted as a single discrepancy. Another two 
examples of such reconciliation were travel instead of 
transportation and from one place to another instead of 
from point A to point B; both differences were identified 
and used several more times in the second part of the 
questionnaire. In the last two parts of the questionnaire, 
mainly grammatical and stylistic modifications had to 
be performed in addition to minor reconciliation of 
contents.
Almost half of the discrepancies between back trans-
lations and the amended IPAQ version in the Slovenian 
language were identified and reconciled in the instruc-
tive part of the questionnaire, the first one again resolv-
ing the form and content of the questionnaire title. Fur-
thermore, in the instructive part, a decision was made 
on some key terms, which indicated their further use 
throughout the rest of the questionnaire. To list but a 
few examples, the use of terms housework was chosen 
over domestic chores, free time was used instead of leisure 
time, and from one point to another instead of from point 
A to B. A typical example was the use of the term trans-
portation instead of commuting, which appeared in the 
first part of the questionnaire and then twice more in the 
other parts, thus solely accounting for a quarter of the 
remaining discrepancies in the text while resolving the 
correct titles in the last three parts represented half of 
the remaining discrepancies in the text.
The review of the final version of back-translated 
English text, which a native English speaker carried 
out, showed that only minor grammatical corrections 
were needed. The actual comment of the native review-
er was that “… your version reads much better than the 
original…”.
After confirming the content validity of the Slovenian 
translation with the review of the back-translated En-
glish version, the Slovenian version of the questionnaire 
was sent to two preschool teachers and two primary 
school teachers for pilot testing. As the aim of the study 
was to generate a reliable translation of the IPAQ for use 
in education, the translated questionnaire was tested to 
examine whether it is understandable for use in edu-
cation. Teachers selected for pilot testing had no com-
ments regarding terms and concepts comprehension in 
the text. One of the comments was: “I did not find any 
shortcomings, unclear parts, questions in the question-
naire. I think it is perfectly translated, clearly defined, 
and vivid; consequently, the respondent knows what a 
particular question is asking of her/him. Even when the 
answer to a question is NO (i.e., did not perform certain 
tasks/activities…), it is clearly marked where to contin-
ue.” Another teacher commented: “The questionnaire 
was very clear and well-defined. It is easy to understand 
how to skip a particular question”. From the received re-
sponses it can be concluded that there is a high degree to 
which IPAQ measurements are relevant to teachers for 
assessing their level of PA.
Two studies have been published during the peer-re-
view process of the present article, both using IPAQ-SF 
in the psychometric assessment (17,18). One of them 
(18) did not include an assessment of physical activity 
items and assessed solely sedentary behaviour, which in 
IPAQ is represented with two questions only. The other 
study (17) compared the validity and reliability of Slo-
venian versions of three most frequently used PAQs in 
the EU, one of them also being IPAQ-SF, which was not 
published as an open access file.
4.2 Reliability assessment
In one of the most recent studies (17), internal con-
sistency for IPAQ-SF was rather low (Cronbach alpha = 
0.297). Interestingly, it was improved when sedentary 
behaviour items were removed from calculation (Cron-
bach alpha = 0.685) but never exceeded > 0.800 as in the 
present study. These results indicate that IPAQ-LF is a 
better tool for assessing PA and sedentary behaviour in 
terms of internal consistency than the IPAQ-SF. 
In the abovementioned study on IPAQ-SF (17), 
test-retest reliability was examined with Spearman’s rank 
correlations. The results showed low to moderate reli-
ability for PA of different intensity (Spearman’s ρ = 0.461 
– 0.648) and high reliability for sedentary behaviour 
(Spearman’s ρ = 0.808).
5 Conclusion
The present study generated a reliable translation of 
the 7-day self-administered IPAQ into Slovenian lan-
guage for cross-cultural use in education and confirmed 
that overall IPAQ-LF is a reliable tool for PA assessment 
in teachers. Based on this, Slovenian IPAQ-LF version 
has acceptable reliability for assessing PA among Slove-
nian teachers.
Total physical activity and all its domains showed 
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ORIGINAL SCIENTIFIC ARTICLE
Cross-cultural adaptation of the International Physical Activity Questionnaire (IPAQ) for use in education
good internal consistency and good to excellent test-re-
test reliability. The authors would suggest an additional 
use of activity diaries or record-keeping for the house-
hold-related PA and leisure-time-related PA. Presum-
ably, these areas of PA vary more from one week to an-
other than the other domains. Providing an additional 
source of information could contribute to more reliable 
results over time as respondents tend to overreport PA 
and underreport sedentary behaviour (17). Additional-
ly, the authors would like to emphasize the importance 
of cleaning the data correctly by removing the missing 
and out-of-range values per the IPAQ scoring protocol 
before conducting analyses.
Conflict of interest
None declared.
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IPAQ Section Step 1
(Translation)
Step 2 
(Back translation)
Step 3 
(Pilot testing)
Total
Instructions 7 9 0 16
Job-related PA 5 4 0 9
Transportation-related PA 2 3 0 5
Household-related PA 1 1 0 2
Leisure-time-related PA 4 2 0 6
Time spent sitting 3 2 0 5
Table 4: Number of revisions in sections of the International Physical Activity Questionnaire during the translation steps.
Legend: PA – physical activity; IPAQ – International Physical Activity Questionnaire.
Appendix
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