94-item activity & 8-item dyspnea measure that assesses activities of patients with COPD and other diagnoses. It measures physical activity and exhibits low- to high-energy requirements ordered based on metabolic equivalents (Fix & Daughton, 1998).
102
5-10 minutes
Jayson Zeigler, MS, OTR
The HAP was originally named the Additive Daily Activities Profile Test Quality of Life Scale (Daughton, Fix, Kass, Bell, & Patil, 1982).
Kramer et al. (2012) noted a close correlation between the HAP and the Hospital Anxiety and Depression Scale (HADS), so the HAP may be a clinically useful outcome measure for depression and anxiety.
Bennell et al. (2004) observed that women typically scored lower than males.
The HAP has been used in healthy and diseased populations (Davidson & de Morton, 2007).
A change score of 7.8 and 6.8 is required to be 90% confident that change is beyond measurement error for both maximum activity scores and adjusted activity scores (Davidson & de Morton, 2007).
Permission not granted for hyperlink to obtain PDF copy of Human Activity Profile (HAP) form. There is no cost for this outcome measure if requested for research purposes. All requests to obtain the HAP outcome measure form must go to David M. Daughton, MS.
Address:
David M. Daughton, MS
Pulmonary & Critical Care Medicine
University of Nebraska Medical Center
600 S 42nd Street
Omaha, NE 68105-2465
Hospitalized adults admitted clinically and surgically, diagnosed with acute myocardial infarction, chronic obstructive pulmonary disease, and spinal cord injury: (Souza, Wegner, Costa, Chiavegato, & Lunardi, 2017; n = 100; mean age 41 (15) years; admitted for fewer than 48 hours for clinical or surgical reasons)
Hospitalized adults admitted clinically and surgically, diagnosed with acute myocardial infarction, chronic obstructive pulmonary disease, and spinal cord injury: (Souza et al., 2017)
MDC?? for hospitalized patients, 3.34.
MDC for MAS and AAS not distinguished.
Normative data established and available for research purposes if request submitted to David M. Daughton. Normative data in HAP manual (Fix & Daughton, 1988).
|
Classification |
HAP score |
|
Low activity |
Scores < 53 |
|
Moderate activity |
Scores 54 - 73 |
|
High activity |
Scores ≥ 74 |
Heart failure: (Ribeiro-Samora et al., 2016, n = 62, mean age = 47.98 years (range 25-59 years); New York Heart Association functional classes I-III; body mass index <30 kg/m?; resting left ventricular ejection fraction ≤ 45% on transthoracic echocardiography)
Maximum activity score mean = 79.76 ± 8.76
Adjusted activity score mean = 65.81 ± 17.01
Hospitalized adults admitted clinically and surgically, diagnosed with acute myocardial infarction, chronic obstructive pulmonary disease, and spinal cord injury: (Souza et al., 2017)
All patients HAP test mean score 68.34 ± 12.83, HAP retest 68.45 ± 12.54
Clinical conditions HAP test mean score 67.23 ± 13.53, HAP retest 67.37 ± 13.24
Surgical conditions HAP test mean score 69.52 ± 12.08, HAP retest 69.60 ± 11.76. Please note these data were collected as mean scores from the sample and contribute to, but not intended as normative data.
Stem Cell Transplantation: (Kramer et al., 2013, n = 27, median age = 47 (range 16 – 69) years; 3 months after transplantation available for all evaluation time points)
At baseline, HAP maximum achievable score mean 80.8±9.6, adjusted score 67.3 ± 14.8.
Post stem cell transplant (SCT), HAP mean adjusted score 76.3 ± 12.2.
One month post SCT, HAP maximum achievable score mean 69.4 ± 19.2, adjusted 49.5 ± 21.7.
Three months post SCT, maximum achievable score mean 76.7±14.6, adjusted 58.4 ± 2.3.
Hospitalized adults admitted clinically and surgically, diagnosed with acute myocardial infarction, chronic obstructive pulmonary disease, and spinal cord injury: (Souza et al., 2017)
Excellent test-retest reliability (ICC = 0.99)
Hospitalized adults admitted clinically and surgically, diagnosed with acute myocardial infarction, chronic obstructive pulmonary disease, and spinal cord injury: (Souza et al., 2017)
Excellent internal consistency, Cronbach’s α = 0.937
Concurrent validity:
Heart failure: (Ribeiro-Samora et al., 2016)
|
Pain/Physical Function Measures |
HAP (MAS) (r) |
HAP (AAS) (r) |
|
WOMAC (PAIN) |
-0.23 |
-0.32 |
|
VAS: pain rest (cm) |
-0.18 |
-0.19 |
|
VAS: pain on movement (cm) |
-0.27 |
-0.39 |
|
WOMAC (Self-reported physical function) |
-0.23 |
-0.39 |
|
VAS (Self-reported physical function) |
-0.27 |
-0.48 |
|
Step test (N) (Observed physical function) |
0.34 |
0.52 |
|
TUG test (s) (Observed physical function) |
-0.46 |
-0.59 |
|
Walking speed (m/s) |
0.44 |
0.63 |
Concurrent Validity
Stem Cell Transplantation: (Kramer et al., 2013)
Predictive Validity:
Stem Cell Transplantation: (Kramer et al., 2013)
Convergent Validity:
Hospitalized adults admitted clinically and surgically, diagnosed with acute myocardial infarction, chronic obstructive pulmonary disease, and spinal cord injury: (Souza et al., 2017)
Adequate construct validity as evidenced by completed Chi-square with classification by IPAQ-6, 3.39 (p = 0.18).
Heart failure: (Ribeiro-Samora et al., 2016)
Hospitalized adults admitted clinically and surgically, diagnosed with acute myocardial infarction, chronic obstructive pulmonary disease, and spinal cord injury: (Souza et al., 2017)
Stem Cell Transplantation: (Kramer et al., 2013)
Hospitalized adults admitted clinically and surgically, diagnosed with acute myocardial infarction, chronic obstructive pulmonary disease, and spinal cord injury: (Souza et al., 2017)
Excellent floor/ceiling effect as evidenced by 10.0% floor/ceiling effects
Osteoarthritis and Rheumatoid Arthritis: (Bennell et al, 2008; n = 256; 226 diagnosed with OA and 33 diagnosed with RA)
Osteoarthritis and Rheumatoid Arthritis: (Bilek et al., 2005; n = 13; mean age = 57.14 ± 11.60; 7 diagnosed with OA and 6 with RA)
Osteoarthritis and Rheumatoid Arthritis: (Bennell et al., 2004. Data retrieved from Davidson and Morton, 2006)
MDC?? = 7 for both MAS and AAS for 20 people over 50 years with OA knee
Osteoarthritis and Rheumatoid Arthritis: (Calculated using data from Bilek et al., 2005)
MDC for maximum activity score: 3.05
MDC for adjusted activity score: 5.54
Osteoarthritis and Rheumatoid Arthritis: (Bennell et al., 2004)
Osteoarthritis and Rheumatoid Arthritis: (Bilek et al., 2005)
Osteoarthritis and Rheumatoid Arthritis: (Bilek et al., 2005)
Excellent for maximum achievable score test-retest reliability (ICC = 0.76)
Excellent adjusted score test-retest reliability (ICC = 0.87)
Osteoarthritis and Rheumatoid Arthritis: (Bennell et al., 2004)
Excellent for maximum achievable score test-retest reliability (ICC = 0.96)
Excellent adjusted score test-retest reliability (ICC = 0.95)
Concurrent validity:
Osteoarthritis and Rheumatoid Arthritis: (Bennell et al., 2004)
Osteoarthritis and Rheumatoid Arthritis: (Bilek et al., 2005)
|
Self-report questionnaires |
HAP (MAS) (ρ) |
HAP (AAS) (ρ) |
|
SF-36 Physical Functioning |
0.78 |
0.80 |
|
SF-36 Role Functioning-Physical |
0.71 |
0.73 |
|
M-HAQ |
-0.49 |
-0.51 |
|
AIMS2 Household Tasks |
-0.39 |
-0.53 |
|
AIMS2 Physical Component |
-0.49 |
-0.54 |
Discriminant Validity:
Osteoarthritis and Rheumatoid Arthritis: (Hinmam et al., 2002, cross-sectional design, n = 41, with symptomatic knee osteoarthritis and 33 controls matched for age, sex, and body mass)
Osteoarthritis and Rheumatoid Arthritis: (Bilek et al., 2008)
Osteoarthritis and Rheumatoid Arthritis: (Bilek et al., 2005)
Moderate response to change demonstrated by HAP as evidenced by effect size, ES = 0.5
Following a 12-week exercise program, the HAP demonstrates similar response to change when compared to other questionnaires examining physical function
|
HAP |
ES = 0.5 |
|
SF-36 Physical Functioning |
ES = 0.5 |
|
SF-36 Role Functioning-Physical |
ES = 0.7 |
|
M-HAQ |
ES = 0.5 |
|
AIMS2 |
ES = 0.2-0.7 |
Community-dwelling older adult women: (Farrell et al., 1996, n = 28; older people with chronic pain)
Community-dwelling older adult women: (Farrell et al., 1996; retrieved from Davidson & Morton, 2006)
MDC?? = 7 (MAS) and MDC?? = 8 (AAS) for 28 older people with chronic pain
Community-dwelling older adult women: (Bastone et al., 2014)
|
Classification |
Cutoff point HAP |
|
Active |
> 74 |
|
Physically and mentally healthy |
> 74 |
|
Housebound |
≤ 66 |
|
Dependent |
≤ 58 |
Community-dwelling older adult women: (Bastone et al., 2014)
Excellent for maximum achievable score test-retest reliability (ICC = 0.79)
Excellent adjusted score test-retest reliability (ICC = 0.94)
Concurrent validity:
Community-dwelling older adult women: (Bastone et al., 2014)
Adequate to Excellent Spearman's rho correlation detected (rho = .47-.75) between HAP MAS and AAS scores and Accelerometer measures to include counts/day, sedentary activity/day, moderate activity/day, steps/day, and energy expenditure/day.
Community-dwelling older adult women: (Bastone et al., 2014)
American Thoracic Society. (2017). Quality of Life Resource: Human Activity Profile. Retrieved from
A. C., Moreira, B. S., Vieira, R. A., Kirkwood, R. N., Dias, J. M. D., & Dias, R. C. (2014). Validation of the Human Activity Profile questionnaire as a measure of physical activity levels in older community-dwelling women. Journal of Aging and Physical Activity, 22, 348-356.
Bennell, K. L., Hinman, R. S., Crossley, K. M., Metcalf, B. R., Buchbinder, R., Green, S., & McColl, G. (2004). Is the Human Activity Profile a useful measure in people with knee osteoarthritis. Journal of Rehabilitation Research & Development, 41(4), 621-630.
Bilek, L. D., Venema, D. M., Camp, K. L., Lyden, E. R., & Meza, J. L. (2005). Evaluation of the Human Activity Profile for use with persons with arthritis. Arthritis & Rheumatism (Arthritis Care & Research), 53(5), 756-763.
Bilek, L. D., Venema, D. M., Willett, G. M., & Lyden E. R. (2008). Use of the Human Activity Profile for estimating fitness in persons with arthritis. Arthritis & Rheumatism (Arthritis Care & Research),59(5), 659-664.
Daughton, D. M., Fix, A. J., Kass, I., Bell, C. W., & Patil, K. D. (1982). Maximum oxygen consumption and the ADAPT quality-of-life scale. Archives of Physical Medicine and Rehabilitation, 63, 620- 622.
Davidson, M. & de Morton, N. (2007). A systematic review of the Human Activity Profile. Clinical Rehabilitation, 21, 151-162.
Farrell, M. J., Gibson, S. J., & Helme, R. D. (1996). Measuring the activity of older people with chronic pain. Clinical Journal of Pain, 12, 6-12.
Fix, A. J., & Daughton, D. M. (1998). Human Activity Profile Professional Manual. Psychological Assessment Resources, Inc.
Hinman, R. S., Bennell, K. L., & Metcalf, B. R. (2002). Temporal activity of vastus medialis obliquus and vastus lateralis in symptomatic knee osteoarthritis. American Journal of Physical Medicine Rehabilitation, 81, 684-690. https://doi.org/10.1097/01.CCM.0000026919.24522.59
Kramer, M., Heussner, P., Herzberg, P.Y., Andree, H., Hilgendor, I., Leithaeuser, M., Junghanss, C., Freund, M., & Wolff, D. (2013). Validation of the grip test and Human Activity Profile for evaluation of physical performance during the intermediate phase after allogeneic hematopoietic stem cell transplantation. Support Care Cancer, 21, 1121-1129.
Ribeiora-Samora, G. A., Pereira, D. A. G., Vieira, O. A., Noman de Alencar, M. C., Rodrigues, R. S., Carvalho, M. L. V., Montemezzo, D., & Britto, R. R. (2016). Using the Human Activity Profile to assess functional performance in heart failure. Heart Failure, 36, 180-185. https://doi.org/10.1097/HCR.000000000000162
Souza, D. C., Wegner, F., Costa, L. C. M., Chiavegato, L. D., & Lunardi, A. C. (2017). Measurement properties of the Human Activity Profile questionnaire in hospitalized patients. Brazilian Journal of Physical Therapy, 21(3), 153-158.
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.