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Elderly Physical Activity Questionnaire

This document contains sample questions from the Physical Activity Scale for the Elderly (PASE) questionnaire. The questions ask about frequency and duration of various physical activities over the past 7 days, including sitting activities, walking, light sport/recreation, heavy sport/recreation, and exercises to increase muscle strength. Respondents are asked to select from multiple choice answers regarding frequency of each activity and then follow up questions regarding time spent and specific activities.

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Ferdy Lainsamputty
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94 views1 page

Elderly Physical Activity Questionnaire

This document contains sample questions from the Physical Activity Scale for the Elderly (PASE) questionnaire. The questions ask about frequency and duration of various physical activities over the past 7 days, including sitting activities, walking, light sport/recreation, heavy sport/recreation, and exercises to increase muscle strength. Respondents are asked to select from multiple choice answers regarding frequency of each activity and then follow up questions regarding time spent and specific activities.

Uploaded by

Ferdy Lainsamputty
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

SAMPLE ITEMS FROM THE

PHYSICAL ACTIVITY SCALE FOR THE ELDERLY

1. Over the past 7 days, how often did you participate in sitting activities such as reading, watching TV or doing
handcrafts?

[0.] NEVER [1.] SELDOM [2.] SOMETIMES [3.] OFTEN


↓ (1-2 DAYS) (3-4 DAYS) (5-7 DAYS)
GO TO Q. #2 ↓ ↓ ↓

1a. What were these activities?

_____________________________________________________

1b. On average, how many hours per day did you engage in these sitting
activities?

[1.] LESS THAN 1 HOUR [2.] 1 BUT LESS THAN 2 HOURS

[3.] 2-4 HOURS [4.] MORE THAN 4 HOURS

6. Over the past 7 days, how often did you do any exercises specifically to increase muscle strength and endurance, such
as lifting weights or pushups, etc.?

[0.] NEVER [1.] SELDOM [2.] SOMETIMES [3.] OFTEN


↓ (1-2 DAYS) (3-4 DAYS) (5-7 DAYS)
GO TO Q. #7 ↓ ↓ ↓

6a. What were these activities?

_____________________________________________________

6b. On average, how many hours per day did you engage in exercises to
increase muscle strength and endurance?

[1.] LESS THAN 1 HOUR [2.] 1 BUT LESS THAN 2 HOURS

[3.] 2-4 HOURS [4.] MORE THAN 4 HOURS

Revised 1/2000

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