Londrina Activities of Daily Living Protocol: validity, reliability, minimal detectable change, and standard error of measurement in adults with asthma

Abstract

Introduction

Asthma symptoms are dyspnea, chronic cough, wheezing, chest tightness, or chest discomfort, which can directly limit the activities of daily living (ADL), which is frequently reported by adults with asthma. Evaluating ADL with a reliable protocol at the usual speed is necessary.

Objectives

To investigate the validity, reliability, minimal detectable change (MDC), and standard error of measurement (SEM) of the Londrina ADL Protocol (LAP) for adults with asthma.

Methods

Adults with asthma were evaluated with the LAP test. Spearman’s correlation coefficient was used to verify validity with the 6-min walk test (6MWT), Glittre-ADL test, and London Chest Activity of Daily Living (LCADL). To test the reliability, the test was reapplied in at least 30 min; the Wilcoxon test and Intraclass Correlation Coefficient (ICC), SEM, MDC, and learning effect were performed.

Results

Fifty-three individuals were included (26% men, 43 ± 15 years, BMI 28 ± 8 kg/m², FEV₁ 70 ± 24%predicted). For convergent validity, the LAP test was correlated with the 6MWT, Glittre-ADL, and LCADL scale (r = −0.49, 0.71, and 0.30, respectively; p < 0.03). There was a difference in test-retest (p < 0.0001) and reliability analysis shows ICC₃ of 0.94, SEM of 14.88 s (22%), and MDC of 41.23 s (15%). Furthermore, the individuals performed the second test with −23 ± 19 (7.9%) s.

Conclusion

The LAP test is valid and reliable for assessing limitations during ADL in adults with asthma. Considerable learning effect was observed, therefore, the best of two measures may avoid underestimation.

Keywords:

• Result validity
• result reliability
• asthma
• activities of daily living

Acknowledgments

The authors 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 authors thank the following institutions for personal grants: 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; grant from Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), grant number 303131/2017-9 and from Fundação Nacional do Desenvolvimento do Ensino Superior Particular (FUNADESP), grant number 5301164.