Abstract
Determination of the self-reported walking capacity by interview or standardized questionnaire is important. However, the existing questionnaires require the patient to be able to read and write in a specific language. We recently proposed the WELSH (Walking Estimated Limitation Stated by History) tool to be administrable to illiterate people. The main objective was to assess the applicability of WELSH tool in the community and in a large group. We performed a prospective study in the city of Bobo-Dioulasso in Burkina Faso during June 2020. We recruited 630 interviewers among medical students. They were trained to administer the WELSH, and to conduct a 6-minute walk test. We performed a Pearson's "r" correlation between the WELSH and maximal walking distance (MWD). Of the 1723 participants available for the analysis, 757 (43.9%: 41.6-46.3) never went to school or attended only elementary school. The percentage of questionnaires with participant filling-in errors corrected by the investigator decreased with the decrease in educational level (p<0.001). The average WELSH score was 53 ± 22 and the average MWD was 383 ±142 meters. The Spearman correlation coefficient between the WELSH score and the MWD was r = 0.567 (p<0.001). Correlations ranged from 0.291 to 0.576 in males and females, (all p values < 0.05) and in different levels of education, with the highest coefficients found in illiterate people. The WELSH is feasible on the community by a wide variety of interviewers. It correlates with the MWD estimated by the 6-minutes' walk test even for people with little or no schooling.
Highlights
The assessment of functional walking ability often constitutes a decision-making element in therapeutic indications and patient follow-up [1,2,3,4]
The Walking Estimated Limitation Stated by History (WELSH) visual tool is valid to determine walking capacity
We recently proposed the Walking Estimated Limitation Stated by History (WELSH) as an adapted version of the Walking Estimated Limitation Calculated by History" (WELCH) that aims to be administrable to illiterate people
Summary
The assessment of functional walking ability often constitutes a decision-making element in therapeutic indications and patient follow-up [1,2,3,4]. The WELCH consists in three questions on the maximal time (and not distance) that a task can be performed for three different paces and one question on the usual walking pace. As for any of the questionnaires available to date, questionnaire filling requires that the patient and/or the health worker administering the test can read and write in a specific language. This makes it difficult to apply questionnaires in developing countries with low literacy rates, while walking remains an important means of travelling and working in such countries. The WELSH aimed to keep the concept of time estimation at difference paces as well as analysis of usual walking pace. The main objective of the present study was to assess the usability of the WELSH by non-expert users, its applicability in the community and in a large group and estimate whether it could be used even in people with low level of literacy to estimate MWD
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