Abstract
BACKGROUND: Accurate assessment of physical activity (PA) is essential for epidemiological research and public health surveillance. In Arabic-speaking countries, most PA questionnaires originate from Western contexts, raising concerns about their cultural relevance and psychometric robustness when applied without proper validation. OBJECTIVE: This systematic review aimed to identify PA measurement instruments available in Arabic and to critically appraise their psychometric properties using the COSMIN methodology. METHODS: A systematic search was conducted in PubMed, Web of Science, and Scopus from inception to 2025, following PRISMA guidelines. Validation studies of PA questionnaires administered to Arabic-speaking populations were included. Data extraction and methodological quality assessment were independently performed by two reviewers. Psychometric properties were evaluated according to COSMIN criteria and classified as sufficient, insufficient, indeterminate, or variable. RESULTS: A total of 21 studies were included, encompassing 13 different instruments across diverse populations and settings. The International Physical Activity Questionnaire (IPAQ) was the most frequently validated tool. Reliability and criterion validity were the most frequently assessed properties and generally demonstrated good methodological quality. However, criterion validity was often insufficient, particularly for widely used instruments such as the IPAQ and GPAQ. Structural validity, measurement error, responsiveness, and cross-cultural validity were rarely evaluated. Instruments designed for specific populations, such as older adults or individuals with disabilities, tended to show more favorable psychometric performance. CONCLUSION: Although several PA measurement instruments are available in Arabic, their psychometric evaluation remains heterogeneous and frequently incomplete. No instrument currently meets all COSMIN recommendations for robust psychometric quality. Future validation studies should adopt more comprehensive and methodologically rigorous approaches to improve the quality and comparability of PA measurement tools in Arabic-speaking contexts. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261286986.