The Manchester Respiratory Activities of Daily Living Questionnaire: Reliability and Validity of the Chinese Version with Pictorial Enhancement

Figures & data

Figure 1 The Chinese version of the Manchester Respiratory Activities of Daily Living Questionnaire (C-MRADLQ) with pictorial enhancement (modified in English for submission).

Table 1 Demographic Characteristics of Patients

	COPD (n = 238)				At Risk (Normal) (n = 64)
	Mean	SD	95% CI		Mean	SD	95% CI
			Lower	Upper			Lower	Upper
Age	70.37	8.80	69.25	71.49	67.73	8.91	65.51	69.96
FEV1 (L)	1.80	3.94	1.32	1.48	3.28	8.36	1.19	5.36
FVC (L)	2.68	0.81	2.58	2.79	2.94	0.73	2.76	3.12
FEV1 /FVC (%)	51.69	13.03	50.02	53.35	76.60	4.66	75.43	77.76
FEV1% predicted (%)	58.35	23.98	55.29	61.41	91.56	16.6	87.41	95.71
FVC % predicted (%)	83.96	22.71	81.06	86.86	90.09	14.9	86.37	93.82
C-MRADLQ total score	96.30	11.34	94.85	97.75	102.84	2.61	102.19	103.48
CAT	9.01	6.38	8.20	9.83	1.39	1.96	0.90	1.88
mMRC	1.34	0.70	1.25	1.43	0.78	0.45	0.67	0.89
SOBQ	21.81	18.18	19.49	24.13	7.69	4.91	6.46	8.91
ADO index	7.61	2.22	7.32	7.89	5.20	1.83	4.75	5.66

Abbreviations: CAT, COPD Assessment Test; CI, Confidence Interval; COPD, chronic obstructive pulmonary disease; FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity; FEV1% predicted, predicted value of forced expiratory volume in 1 second; FVC % predicted, predicted value of forced vital capacity; mMRC, modified Medical Research Council Dyspnea Scale; C-MRADLQ, The Manchester Respiratory Activities of Daily Living; SD, standard deviation; SOBQ, Shortness of Breath Questionnaire.

Figure 2 Subgroup analysis of patients (n = 302).

Table 2 Correlation Matrix of C-MRADLQ with Other Criterion Parameters (n = 302)

Criterion-Related Parameters	Spearman’s Rho Coefficient
Age	−0.088
Gender	0.021
COPD stage	−0.546*
COPD group	−0.533*
Number of admissions	−0.359*
SOBQ	−0.738*
CAT	−0.534*
mMRC	−0.577*
Mobility (Q.1–7)	0.919*
Kitchen (Q.8–11)	0.688*
Domestic tasks (Q.12–17)	0.860*
Leisure (Q.18–19)	0.654*
Others (Q.20a,21a)	0.667*
FVC	0.382*
FVC % predicted	0.423*
FEV1	0.578*
FEV1% predicted	0.580*
FEV1/FVC	0.514*
ADO index	−0.494*

Note: *p ≤ 0.05.

Abbreviations: C-MRADLQ, Manchester Respiratory ADL Questionnaire; COPD, chronic obstructive pulmonary disease; SOBQ, Shortness of Breath Questionnaire; FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity; FEV1% predicted, predicted value of forced expiratory volume in 1 second; FVC % predicted, predicted value of forced vital capacity; mMRC, modified Medical Research Council Dyspnea Scale.

Table 3 Predictions of the C-MRADLQ Total Score (n = 302)

	B	SE	t	P value	R	R^2
(Constant)	98.916	2.342	42.244	<0.001***	0.795	0.632
SOBQ	−0.423	0.029	−14.593	<0.001***
Number of admissions FEV1/FVC	−1.297 0.101	0.387 0.031	−3.355 3.218	0.001*** 0.001***
COPD Group	1.108	0.522	2.125	0.034*

Notes: *p ≤ 0.05; ***p < 0.001.

Abbreviations: COPD, chronic obstructive pulmonary disease; SOBQ, Shortness of Breath Questionnaire.

Table 4 Classification of COPD Stage, COPD Group and mMRC Level Using Total Score of C-MRADLQ (n = 302)

COPD Stage	GOLD: Predicted Group Membership, n (%)
	At Risk of COPD	I	II		III		IV		Total
At risk of COPD	0(0)	0(0)	64(100)		0(0)		0(0)		64
I	0(0)	0(0)	54(98.2)		1(1.8)		0(0)		55
II	0(0)	0(0)	71(82.6)		12(14)		3(3.5)		86
III	0(0)	0(0)	40(59.7)		15(22.4)		12(17.9)		67
IV	0(0)	0(0)	7(23.3)		11(36.7)		12(40)		30
32.5% of original grouped cases correctly classified
COPD Group	COPD Group: Predicted Group Membership, n (%)
	At Risk of COPD	A		B		C	D		Total
At risk of COPD	0(0)	64(100)		0(0)		0(0)	0(0)		64
A	0(0)	108(94.7)		4(3.5)		0(0)	2(1.8)		114
B	0(0)	42(67.7)		12(19.4)		0(0)	8(12.9)		62
C	0(0)	21(65.6)		5(15.6)		0(0)	6(18.8)		32
D	0(0)	14(46.7)		7(23.3)		0(0)	9(30.0)		30
42.7% of original grouped cases correctly classified
mMRC	mMRC: Predicted Group Membership, n (%)
	0	1		2		3		4		Total
0	0(0)	30(100)		0(0)		0(0)		0(0)		30
1	0(0)	183(95.8)		7(3.7)		1(0.5)		0(0)		191
2	0(0)	44(66.7)		15(22.7)		5(7.6)		2(3.0)		66
3	0(0)	5(35.7)		2(14.3)		6(42.9)		1(7.1)		14
4	0(0)	0(0)		0(0)		0(0)		1(100)		1
67.9% of original grouped cases correctly classified

Abbreviations: COPD, chronic obstructive pulmonary disease; C-MRADLQ, Manchester Respiratory ADL Questionnaire; GOLD, Global Initiative for Chronic Obstructive Lung Disease; mMRC, modified Medical Research Council Dyspnea Scale.

Table 5 Subgroup Analysis of C-MRADLQ Total Score by COPD Stage and Group

	n	C-MRADLQ Total Score		95% CI		F Value	P value	ηp^2
		Mean	SD	Lower	Upper
COPD Stage
Normal	64	102.84	2.61	102.19	103.50	48.22	<0.001	0.39
Stage I	55	102.55	3.35	101.64	103.45
Stage II	86	99.45*	6.39	98.08	100.82
Stage III	67	94.25***	10.05	91.80	96.71
Stage IV	30	80.40***	17.50	73.87	86.93
COPD Group
Group A	114	101.50	5.99	100.39	102.61	29.93	<0.001	0.29
Group B	62	93.85***	8.79	91.62	96.09
Group C	32	92.53***	14.64	87.25	97.81
Group D	30	85.63***	16.35	79.53	91.74

Notes: Comparing patients with normal spirometry results; *p ≤0.05; ***p < 0.001.