Rehabilitation Measures Database
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  2. Rapid Assessment of Physical Activity

Rapid Assessment of Physical Activity

Last Updated

Purpose

A 9-item questionnaire that quickly assesses levels of physical activity for older adults.

Link to Instrument

Link to instrument

Acronym RAPA

Area of Assessment

Aerobic Capacity
Functional Mobility
Strength

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Free

CDE Status

None found--last searched 4/24/2025

Populations

Immune System Disorders
Musculoskeletal Conditions
Pulmonary Diseases
Older Adults and Geriatric Care
Non-Specific Patient Population

Key Descriptions

  • Level of physical activity, including aerobic, strength, and flexibility is self-assessed.
  • The assessment is presented in two parts, RAPA1, which assesses aerobic activity, and RAPA2, which assesses strength and flexibility.
  • The total score of the first seven items (RAPA1) is from 1 to 7 points, which is then categorized into one of five levels of physical activity: 1 = sedentary, 2 = underactive, 3 = regular underactive (light activities), 4 = regular underactive, and 5 = regular active.
  • Responses to the strength and flexibility items (RAPA2) are scored separately, with strength training = 1, flexibility = 2, or both = 3.
  • Maximum score of RAPA1 = 7, RAPA2 = 3
  • Higher score = higher level of physical activity
  • RAPA1 cut-off score = 6

Number of Items

9

Time to Administer

~2 minutes

Required Training

No Training

Age Ranges

Adults

18 - 64

years

Elderly adults

65 +

years

Instrument Reviewers

Initially reviewed 4/24/2025 by Tiana Hess SPT and Kevin Nguyen SPT, under the supervision of Dr. Neha Dewan PT, PhD, Western University of Health Sciences, Lebanon, Oregon

ICF Domain

Activity
Participation

Measurement Domain

Activities of Daily Living
General Health

Professional Association Recommendation

University of Washington Health Promotion Research Center (UW HPRC)

Considerations

  • RAPA identifies the level of physical activity in older adults.
  • RAPA can be used for a younger age group (Pérez et al., 2015).
  • Easy to administer scale.
  • Lack of information about normative data, MCID, and interrater/intrarater reliability.
  • Cross-cultural adaptations of the RAPA include Turkish, Gujarati, Arabic, and Hungarian versions (Çekok et al., 2017; Shah & Khatri, 2022; Alqahtani & Alenazi, 2020; Miszory et al., 2022).
  • A telephone-based version of the tool (TAPA) for assessing physical activity in older adults is also available.

 

Older Adults and Geriatric Care

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Test/Retest Reliability

Persian Elderly: (Barati et al., 2024; n = 300; mean age = 64.6 (5.24) years; test-retest interval = one week) 

  • Excellent test-retest reliability (n = 30): (ICC = 0.94)

 

Hungarian Elderly: (Miszory et al., 2022; n = 222; mean age = 61.1 (7.9) years; test-retest interval = one week)

  • Excellent test-retest reliability (n = 32): (ICC = 0.996)

 

Portuguese Elderly: (Silva et al., 2014; n = 55; mean age = 71.5 (10.4) years; test-retest interval = one week; European Portuguese translation of RAPA)

  • Good test-retest reliability: (weighted κ = 0.67)

 

Turkish Elderly: (Çekok et al., 2017; n = 110; mean age = 70.5 (10.5) years; age range = 53-93 years; test-retest interval = one week)

  • Very Good test-retest reliability for the RAPA2 (weighted κ = 0.894)
  • Very Good test-retest reliability for each of the 9 items of the RAPA (weighted κ > 0.81)

 

Arabic Elderly: (Alqahtani & Alenazi, 2020; n = 96; mean age = 71 (5.3) years)

  • Very Good test-retest reliability for RAPA1 and RAPA2 (κ = 0.87, (95% CI: 0.76-0.98) and κ = 0.83 (95% CI: 0.70-0.96), respectively) 

 

Gujarati Elderly: (Shah & Khatri, 2022; n = 108; mean age = 61.6 (7.82) years)

  • Very Good test-retest reliability for Gujarati RAPA1 (κ = 0.82)
  • Good agreement test-retest reliability for Gujarati RAPA2 (κ = 0.73)

 

Criterion Validity (Predictive/Concurrent)

Concurrent validity:

American Elderly: (Topolski et al., 2006; n = 115; mean age = 73.3 (9.6) years; 72% female, 73% white, 18% African American, and 9% other race or ethnicity)

  • Adequate correlation between RAPA and Behavioral Risk Factor Surveillance System (BRFSS) (r = 0.59), Patient-centered Assessment & Counseling for Exercise (PACE) (r = 0.56), Community Healthy Activities Model Program for Seniors (CHAMPS) moderate calories (r = 0.54) and CHAMPS total calories (r = 0.48)

Hungarian Elderly: (Miszory et al., 2022)

  • Adequate correlation between RAPA and International Physical Activity Questionnaire (IPAQ) (r = 0.542)
  • Poor correlation between RAPA2 and IPAQ (r = 0.251)

 

 

Construct Validity

Convergent validity:

Turkish Elderly: (Çekok et al., 2017)

  • Adequate positive correlation between the RAPA1 (aerobic) and Physical Activity Score for the Elderly (PASE) (ρ = 0.491, p < 0.001) and IPAQ-Short Form (SF) total score (ρ = 0.643, p < 0.001)
  • Adequate negative correlation between the RAPA1 and IPAQ-SF sitting time (ρ = -0.498, p < 0.001)

 

Portuguese Elderly: (Silva et al., 2014)

  • Adequate negative correlation between the European Portuguese RAPA and the World Health Organization Disability Assessment Scale (WHODAS) 2.0 (r = -0.5), and the Short Physical Performance Battery (SPPB) gait test (r = -0.5)
  • Adequate positive correlation between the European Portuguese RAPA and SPPB total score (r = 0.5)

 

Arabic Elderly: (Alqahtani & Alenazi, 2020)

  • Adequate positive correlation between RAPA and SPPB (r = 0.536, p < 0.001)
  • Adequate negative correlation between RAPA and TUG time (r = -0.435, p < 0.010)
  • Adequate negative correlations between both RAPA1 and RAPA2 with age, BMI, and the number of comorbidities(r = -0.348 – -0.414, p < 0.010)

 

Persian Elderly: (Barati et al., 2024)

  • Poor to adequate convergent validity between the RAPA and the Leiden-Padua Questionnaire (LIEPAD) found in physical functioning (r = 0.379**), self-care (r = 0.199*), depression and anxiety (r = 0.213**), cognitive functioning (r = 0.167**), social functioning (r = 0.106), sexual functioning (r = 0.095), life satisfaction (r = 0.176**), and total (r = 0.313**) *p < 0.05, **p < 0.01

 

Hungarian Elderly: (Miszory et al., 2022)

  • Poor correlation between RAPA2 and age (r = -.182)
  • Adequate correlation between RAPA2 and BMI (r = -.305)

 

Discriminant validity:

Persian Elderly: (Barati et al., 2024)

  • Significantly higher RAPA scores for those with an Activities-specific Balance Confidence scale (ABC) score >50 than in those with an ABC score <50 (p = 0.0001)
    • Large effect size (d = 0.89)

Portuguese Elderly: (Silva et al., 2014)

  • Significantly higher mean scores for the European Portuguese RAPA were found in those with no depressive symptoms as measured by the Geriatric Depression Scale (p = 0.04) and those able to complete the Short Physical Performance Battery balance test (p = 0.02).

American Elderly: (Topolski et al., 2006)

  • Mean caloric expenditure was calculated from the CHAMPS. The group who met the physical activity standard had a significantly higher mean caloric expenditure. The RAPA showed superior performance to the BRFSS and PASE in the ability to discriminate between those who reported inadequate and adequate moderate or vigorous physical activity (t test = 4.81, p < 0.001).
 

Content Validity

Persian Elderly: (Barati et al., 2024)

  • 10 experts specializing in geriatrics, physical activity, and psychometrics were asked to complete the questionnaire and provide feedback based on the content validity index (CVI) and the content validity ratio (CVR).Content validity was assessed for CVI and CVR, and all items achieved satisfactory scores. The overall tool demonstrated a CVI value of 0.96 and a CVR value of 0.94. Furthermore, individual item CVR scores surpassed 0.60, while item CVI scores were above 0.8. 

 

Gujarati Elderly: (Shah & Khatri, 2022) 

  • The CVR value of item 1 was 0.88 and for all other items it was 1. All CVR values were >0.78, so all 9 items were approved. All I-CVI values for each item were >0.79%, suggesting that every item in the Gujarati RAPA was appropriate.

 

Face Validity

Persian Elderly: (Barati et al., 2024)

  • 10 older people with inclusion criteria into research were asked to express content, clarity, readability, and simplicity and easy to understand tool expressions. The participants approved all 10 items in terms of face validity.

 

Gujarati Elderly: (Shah & Khatri, 2022) 

  • All items were acceptable and could be used for evaluation of physical activity according to 12 participants. Using the first application of the Gujarati RAPA, 18 (16.6%) participants were categorized as sedentary, 27 (25%) as underactive, 47 (43.5%) as underactive regular, and 16 (14.8%) as active participants for RAPA1. For RAPA2, 34 (31.5%) participants reported a lack of participation in strength or flexibility activities.

 

Non-Specific Patient Population

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Test/Retest Reliability

Mexican-American Adults: (Vega-López et al., 2014; n = 34; mean age = 37.6 (9.5) years; test-retest interval = 7 days; Mexican American translation of RAPA) 

  • Poor test-retest reliability (n = 34): (ICC = 0.65)

 

Chilean Adults: (Pérez et al., 2015; n = 180; mean age = 40.5 (13.8) years; Age range: 18-64; test-retest interval = 7 days)

  • Poor test-retest reliability (n = 35): (ICC = 0.61)

 

Criterion Validity (Predictive/Concurrent)

Concurrent validity:

Mexican-American Adults: (Vega-López et al., 2014)

  • Adequate correlation between RAPA and accelerometer-measured moderate and vigorous physical activity (r = 0.45, p < 0.01)

 

Chilean Adults: (Pérez et al., 2015)

  • Adequate positive correlation between RAPA and the question used to measure physical activity on the Summary of Diabetes Self-care Activities (SDCA) (r = 0.30).
  • Poor negative correlation between RAPA and BMI (r = -0.020) and waist circumference (r = -0.16).
  • No correlation between RAPA and weight (r = -0.06)

 

Pulmonary Diseases

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Construct Validity

Construct validity:

Older adults with COPD: (Aktan et al., 2021; n = 105; mean age = 64.68 (8.43) years)

  • Excellent positive correlation between RAPA1 Aerobic and IPAQ-SF total score and 6MWT (r = 0.968, p < 0.001 and r = 0.626, p < 0.001, respectively)
  • Excellent negative correlation between RAPA1 Aerobic and IPAQ-SF sitting time (r = -0.602, p < 0.001)
  • Adequate negative correlation between RAPA1 Aerobic and Modified Medical Research Council scale (mMRC) score (r = -0.454, p < 0.001)

 

Immune System Disorders

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Construct Validity

Convergent validity:

Community dwelling adults living with HIV (>18 y/o): (Noguchi et al., 2021; n = 67; mean age = 51.3 (11.5) years)

  • Excellent positive correlation between RAPA and the single-item physical activity (PA) questionnaire (ρ = 0.61)
  • Poor correlation between RAPA and divergent outcomes (ρ = 0.04 to 0.21)

 

Responsiveness

Community dwelling adults living with HIV (>18 y/o): (Noguchi et al., 2021):

  • Moderate change after 2 months of exercise training (Effect Size [ES] d = 0.50, standardized effect size [SES] = 0.47, and standardized response mean [SRM] = 0.48)
  • Adequate positive correlation between the change in RAPA and the change in the single-item PA questionnaire (ρ = 0.48)

 

Musculoskeletal Conditions

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Standard Error of Measurement (SEM)

Community Dwelling Females with Extra-articular Distal Radius Fracture: (Mehta et al., 2015; n = 21; Mean Age = 62.6 (7.6) years)

  •  SEM for entire group (n = 21): 0.9

Minimal Detectable Change (MDC)

Community Dwelling Females with Extra-articular Distal Radius Fracture: (calculated from statistics in Mehta et al., 2015) 

  • MDC95 (calculated) for entire group (n = 21): 2.49 

 

Test/Retest Reliability

Community Dwelling Females with Extra-articular Distal Radius Fracture: (Mehta et al., 2015) 

  • Poor test-retest reliability: (ICC = 0.68)

 

Construct Validity

Convergent validity:

Community Dwelling Females with Extra-articular Distal Radius Fracture: (Mehta et al., 2015)

  • Adequate correlation between RAPA and Falls Efficacy Scale (FES) (r = 0.49, p < 0.05) and RAPA and ABC (r = 0.52, p < 0.05)
  • Poor correlation between RAPA and Risk Perception Questionnaire (RPQ) (r = 0.04, p < 0.05)

 

Bibliography

Aktan, Rıdvan & Ozalevli, Sevgi & Yalcinkaya Colak, Gamze & Alpaydin, Aylin & Sevinc, Can. (2021). Validation of the rapid assessment of physical activity questionnaire in older patients with chronic obstructive pulmonary disease. Journal of Basic and Clinical Health Sciences, 5(3), 100–106. https://doi.org/10.30621/jbachs.917212 

Alqahtani, B. A., & Alenazi, A. M. (2020). Cross-cultural adaptation and psychometric properties of the arabic version of the rapid assessment of physical activity. Oman Medical Journal, 35(5), 1–6. https://doi.org/10.5001/OMJ.2020.112 

Barati, M., Hansson, E. E., Taheri-Kharameh, Z., & Topolski, T. D. (2024). Translation, validity and reliability of the persian version of the rapid assessment of physical activity questionnaire. BMC Geriatrics, 24(1). https://doi.org/10.1186/s12877-024-05065-3

Çekok, F. K., Kahraman, T., Kalkışım, M., Genç, A., & Keskinoğlu, P. (2017). Cross-cultural adaptation and psychometric study of the Turkish version of the Rapid Assessment of Physical Activity. Geriatrics and Gerontology International, 17(11), 1837–1842. https://doi.org/10.1111/ggi.12970

Mehta, S. P., MacDermid, J. C., Richardson, J., Macintyre, N. J., & Grewal, R. (2015). Reliability and validity of selected measures associated with increased fall risk in females over the age of 45 years with distal radius fracture - A pilot study. Journal of Hand Therapy, 28(1), 2–10. https://doi.org/10.1016/j.jht.2014.09.009 

Miszory, E. V., Makai, A., Pakai, A., & Járomi, M. (2022). Cross-cultural adaptation and validation of the rapid assessment of physical activity questionnaire (RAPA) in Hungarian elderly over 50 years. BMC Sports Science, Medicine and Rehabilitation, 14(1). https://doi.org/10.1186/s13102-022-00512-3

Noguchi, K. S., O’Brien, K. K., Aubry, R. L., Carusone, S. C., Avery, L., Solomon, P., Ilic, I., Pandovski, Z., Zobeiry, M., & Tang, A. (2021). Construct Validity and Responsiveness of the Rapid Assessment of Physical Activity in Adults Living With HIV. Archives of Rehabilitation Research and Clinical Translation, 3(4). https://doi.org/10.1016/j.arrct.2021.100164

Pérez, J. C., Bustamante, C., Campos, S., Sánchez, H., Beltrán, A., & Medina, M. (2015). Validation of the Rapid Assessment of Physical Activity Scale (RAPA) in the Chilean adult population consulting in Primary Care. Aquichan, 15(4), 486–498. https://doi.org/10.5294/aqui.2015.15.4.4

Silva, A. G., Queirós, A., Alvarelhão, J., & Rocha, N. P. (2014). Validity and reliability of the Portuguese version of the Rapid Assessment of Physical Activity Questionnaire. International Journal of Therapy and Rehabilitation, 21(10), 469–474. https://doi.org/10.12968/ijtr.2014.21.10.469

Shah, D., & Khatri, S. (2022). Cross-cultural Adaptation and Psychometric Properties of the Gujarati Version of Rapid Assessment of Physical Activity. Journal of Clinical and Diagnostic Research, 16(8), YC01-YC04. https://doi.org/10.7860/jcdr/2022/58115.16761 

Topolski, T. D., LoGerfo, J., Patrick, D. L., Williams, B., Walwick, J., & Patrick, M. B. (2006). The Rapid Assessment of Physical Activity (RAPA) Among Older Adults. Preventing Chronic Disease [serial online], 3(4). www.cdc.gov/pcd/issues/2006/oct/06_0001.htm

Vega-López, S., Chavez, A., Farr, K. J., & Ainsworth, B. E. (2014). Validity and reliability of two brief physical activity questionnaires among Spanish-speaking individuals of Mexican descent. BMC Research Notes, 7(29). http://www.biomedcentral.com/1756-0500/7/29

 

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