Reliability and validity of the London Chest Activity of Daily Living scale for adults with asthma

Abstract

Introduction

Dyspnea during activities of daily living (ADL) is frequently reported by adults with asthma. However, instruments that specifically assess that in people with asthma have not yet been validated.

Objectives

To investigate the validity and reliability, including standard error of measurement (SEM) and Minimum Detectable Change (MDC), of the London Chest Activity of Daily Living (LCADL) scale for adults with asthma.

Methods

Adults with asthma answered the LCADL scale which was performed twice by the same rater. Spirometry, 6-min walk test (6MWT), St George’s Respiratory Questionnaire (SGRQ), modified Medical Research Council (mMRC) dyspnea scale, Asthma Quality of Life questionnaire (AQLQ), Asthma Control Test (ACT), and Glittre-ADL test were assessed. For statistical analyses, Spearman correlation, Wilcoxon test, Intraclass Correlation Coefficient (ICC), Cronbach’s alpha coefficient, SEM, MDC were performed.

Results

Seventy participants were included (30% men, 44 ± 15 years old, BMI 27[23-31]kg/m², FEV₁ 80 ± 17%predicted). For convergent validity, the LCADL scale was moderately correlated with SGRQ, AQLQ, and Glittre-ADL (r = 0.57, −0.46, and 0.41 respectively; p < 0.0001). The LCADL scale correlated weakly with the mMRC scale, ACT, and spirometry measures (-0.23<r < 0.39; p < 0.001). Weak to strong correlations between the domains of the LCADL scale and the domains of the SGRQ were observed (0.26<r < 0.73; p < 0.001). There was no difference between the test-retest of the scale (p = 0.65) and reliability analysis shows an ICC₃ of 0.71, a Cronbach’s alpha coefficient of 0.87, an SEM of 6.23 points, and an MDC of 17.27 points.

Conclusion

The LCADL scale is valid and reliable for assessing dyspnea during ADL in adults with asthma.

Keywords:

• Validity and reliability
• asthma
• activities of daily living
• dyspnea

Acknowledgements

The authors thank the following institutions for personal grants: VP and TA are supported by an MSc grant from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior e Programa de Suporte à Pós-Graduação de Instituições de Ensino Particulares CAPES/PROSUP, Brazil. JO is supported by a Ph.D. grant from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior e Programa de Suporte à Pós-Graduação de Instituições de Ensino Particulares CAPES/PROSUP, Brazil. FP is supported by a personal grant from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), grant number 303131/2017-9. KF is supported by a personal grant from Fundação Nacional do Desenvolvimento do Ensino Superior Particular (FUNADESP), grant number 5301164. In addition, we are grateful to our colleagues at the Laboratory of Research in Respiratory Physiotherapy and the Graduate Program in Rehabilitation Sciences for their contributions to this study.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.