Scoring the C-PPAC

This section provides information on how to obtain the final scores after administering the C-PPAC.

To obtain the C-PPAC scores (total, amount and difficulty), the two data sources (questionnaire and activity monitor) need to be aggregated. For this, it is necessary to merge:

  • Median values of daily steps and VMU/min of three to seven valid days prior to the administration of the clinical visit questionnaire. Valid and adequate physical activity data is considered for days where more than eight hours of wearing time are available, irrespective if week days or weekend days).
  • Response to valid (i.e., no missing answers) clinical visit questionnaire, obtained the day after wearing the monitor (only one measure).

Regarding the activity monitor outputs, the score is assigned for each of the outputs based on its value (see below). Daily steps and VMUs per minute need to be converted into the appropriate daily or weekly score categories.

For the questionnaire, each question is scored depending on the answer.

The score is assigned as follows:

Difficulty score Amount score
1. Activity monitor
Weekly mean of steps/day  
Actigraph Dynaport    
≤1000  ≤1500    0
1001-2000  1501-2500   1
2001-4000 2501-4500   2
4001-6000 4501-6500   3
>6000 >6500   4
Weekly mean of daily VMU/min
Actigraph Dynaport    
≤100 ≤60   0
101-200 61-130   1
201-300 131-210   2
301-500 211-370   3
>500 >370   4
2. Questionnaire
In the past 7 days, how much walking did you do outside?
None at all   0
A little bit (up to 10 minutes in total)   1
Some (up to 30 minutes in total)   2
A lot (up to 1 hour in total)   3
A great deal (more than 1 hour in total)   3
In the past 7 days, how many chores did you do outside the house? Some examples are gardening, taking the rubbish out, or doing small errands.
None at all   0
A few   1
Some   2
A lot   3
A large amount   4
In the past 7 days, how much difficulty did you have getting dressed?
None at all 4  
A little bit 3  
Some 2  
A lot 1  
A great deal 0  
In the past 7 days, how much difficulty did you have getting out and about?
Not at all 4  
A little bit 3  
Some 2  
A lot 1  
A great deal 0  
In the past 7 days, how often did you avoid doing activities because of your lung problems?
Not at all 4  
Rarely 3  
Sometimes 2  
Frequently 1  
All the time 0  
In the past 7 days, how breathless were you in general during your activities?
Not at all 4  
A little bit 3  
Moderately 2  
Very 1  
Extremely 0  
In the past 7 days, how often did you lack physical strength to do things because of your lung problems?
Not at all 4
Rarely 3
Sometimes 2
Frequently 1
All the time 0
In the past 7 days, how tired were you in general during your activities?
Not at all 4
A little bit 3
Moderately 2
Very 1
Extremely 0
In the past 7 days, how often did you have to take breaks during your physical activities?
Not at all 4
A little bit 3
Sometimes 2
Very 1
Extremely 0
In the past 7 days, how breathless were you when walking on level ground indoors and outdoors?
Not at all 4
A little bit 3
Moderately 2
Very 1
Extremely 0
In the past 7 days, how much time did you need to recover from your physical activities?
None at all 4
A little bit 3
Some 2
A lot 1
A great deal 0
In the past 7 days, did you need to consider your lung problems when you planned your activities because of your lung problems? Examples are a trip out, an appointment or expecting visitors.
No 4
A little bit 3
Some 2
A lot 1
A great deal 0
Total score (sum above) Difficulty Amount

The PROactive instrument is scored in a three-step process:

  • First, domains are scored by simple adding scores from individual items. This gives amount a score between 0 and 15, that represents the combination of questionnaire items and activity monitor items; and it gives difficulty a score between 0 and 40. 
  • Second, raw scores are scaled to a score ranging from 0 to 100, based on results of Rasch analyses (see tables of equivalences below). 
  • Third, the ‘total score’ is calculated as an average between the scaled amount and difficulty domains. This score has a 0 to 100 scale.
Difficulty (C-PPAC) Amount (C-PPAC)
Raw Rasch 0-100 Raw Rasch 0-100
0 0 0 0
1 8 1 13
2 15 2 25
3 20 3 33
4 24 4 39
5 28 5 45
6 31 6 50
7 34 7 54
8 36 8 59
9 38 9 63
10 40 10 67
11 42 11 72
12 44 12 77
13 46 13 83
14 48 14 91
15 50 15 100
16 51
17 53
18 55
19 56
20 58
21 60
22 61
23 63
24 65
25 66
26 68
27 70
28 72
29 73
30 75
31 77
32 79
33 81
34 83
35 86
36 89
37 92
38 94
39 97
40 100

Managing missing data and/or extra activity monitoring days

It is possible that you have missings in your days with activity monitoring. A data plan for missing data needs to be in place in this case. The figure below shows a graphical example of possible scenarios with missing data and how data should be treated in those exemplary cases:

Have a look at:

Scroll to Top