Questionnaire for the assessment of subjective physical functioning



Two versions of the Hep-Test-Q are available:

  • the original version for adult patients with haemophilia (≥18 years)
  • an adapted version for paediatric patients with haemophilia (6-17 years)

The original adult version was adapted for the use in children. This adaptation was based on reformulation of some items, cognitive interviews of the newly adapted version with children with haemophilia and psychometric testing.

Items and Dimensions of the HEP-Test-Q

The HEP-Test-Q consists of 25 items pertaining to 4 domains ‘mobility’, ‘strength & coordination’, ‘endurance’ and ‘body perception’ and one single item, which assesses changes in physical functioning in comparison to the previous year:

DimensionsNo. Items
Strength & Coordination8
Body Perception5
Total Score HEP-Test-Q25
Change in comparison to past year1

The recall period for the assessment of physical functioning is over “the past four weeks”.

The response options range on a 5-point Likert scale from “never” to “always”.

Some of the items have to be re-coded. Subscales and the total score are transformed to a scale of 0–100 with high scores indicating better physical functioning.

Psychometric Characteristics

The original HEP-Test-Q was pilot-tested (n=24) and field-tested (n=43) in adult haemophilia patients in Germany attending the Hemophilia & Exercise Project (HEP); the paediatric version was pilot-tested (n=67) and field-tested (n=127) in children with haemophilia in the UK participating in the EIS and the SO-FIT Study. Both versions showed good psychometric characteristics in terms of reliability and validity.

The internal consistency of the adult version ranged from Cronbach's alpha 0.85 to 0.96 and for the paediatric version Cronbach's alpha ranged from 0.80 to 0.94.

With regard to convergent validity high correlations were revealed between the adult version of the HEP-Test-Q with the disease-specific questionnaires Haem-A-QoL for the assessment of health-related quality of life (r = -0.82) and HAL (Haemophilia Activity List) for the assessment of physical performance of daily life (r = .76); moderate correlations were found between the paediatric HEP-Test-Q and the disease-specific quality of life questionnaire Haemo-QoL SF (r = −.575) and the disease-specific instrument for the assessment of physical functioning PedHAL (r = .634).

Concerning known groups validity significant differences were demonstrated for the adult HEP-Test-Q concerning age, hepatitis infections and number of target joints; significant differences were found for the paediatric HEP-Test-Q concerning pain, target joints, orthopaedic status (OJS) and body mass index (BMI).

Dimensions No.
  Adult Version   Paediatric Version
Mobility4   56.98 22.0 6.25 100 0.87   83.65 20.5 6.25 100 0.86
Strength & coordination 8   50.29 24.9 6.25 90.63 0.92   84.28 16.0 28.13 100 0.82
Endurance 8   49.93 21.4 9.38 90.63 0.87   72.53 19.1 18.75 100 0.80
Body perception 5   56.86 19.9 5.00 95.00 0.85   83.59 22.2 0 100 0.92
Total score 25   52.56 20.3 7.00 93.00 0.96   80.32 16.1 29.0 100 0.94

***p ≤ 0.001