Validity and reproducibility of instruments to assess activities of daily living in adults with asthma: preliminary results

Abstract

<b>Introduction:</b> People with asthma may have limitations in their activities of daily living (ADL); however, metric properties of instruments to assess ADL have not been yet investigated in this population. <b>Objective:</b> To investigate the validity of the Londrina ADL-Protocol (LAP), Glittre-ADL test and the London Chest Activity of Daily Living (LCADL) scale in adults with asthma; and to verify the test-retest reproducibility of LAP and Glittre-ADL in this population. <b>Methods:</b> 50 adults with asthma had their ADL objectively assessed by LAP and Glittre-ADL tests, which were performed twice by the same rater. Subjective assessment of ADL was performed by LCADL scale. Spirometry, six-minute walk test (6MWT), St George’s Respiratory Questionnaire (SGRQ) and modified Medical Research Council (mMRC) were also assessed. <b>Results:</b> Participants were 27% men; 47±15yrs; FEV1 73±17%pred. The LAP correlated with both the 6MWT (r=-0.56; P&lt;0.0001) and the LCADL (total: r=0.43; personal care domain: r=0.52; physical activity domain: r=0.53; P=0.008). The Glittre-ADL correlated with 6MWT (r= -0.71; P&lt;0.0001) and LCADL (total: r=0.48; and all domains: 0.35&lt;r&lt;0.51; P&lt;0.02 for all). The LCADL scale correlated with SGRQ, 6MWT and mMRC (r= 0.63; r= -0.50; r= 0.34, respectively; P&lt;0.02). Both the LAP and Glittre-ADL tests had excellent Intraclass Correlation Coefficients (ICC≥0.95). Learning effects were 19s (6,23%) and 13s (5,75%), respectively. <b>Conclusion:</b> The three instruments are valid to assess ADL in adults with asthma. LAP and Glittre-ADL tests are reproducible; however, learning effects were observed in both tests and the best of two measures might avoid underestimated results.