Cross-cultural adaptation of the Activities of Daily Living Questionnaire-Brazil in Parkinson’s disease

ALVES, Walter Luis Teixeira; FARIA-FORTINI, Iza de; GALVÃO, Ana Carolina Daher Ribas; CARDOSO, Francisco Eduardo Costa; SCALZO, Paula Luciana

doi:10.1590/0004-282X-ANP-2020-0396

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ARTICLE • Arq. Neuro-Psiquiatr. 79 (12) • Dec 2021 • https://doi.org/10.1590/0004-282X-ANP-2020-0396 copy

Cross-cultural adaptation of the Activities of Daily Living Questionnaire-Brazil in Parkinson’s disease

Adaptação Transcultural do Questionário de Atividades de Vida Diária-Brasil para doença de Parkinson

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Background: Culturally adapted measures to assess the performance of activities of daily living (ADL) in individuals with Parkinson’s disease (PD) are limited in Brazil. Objective: To adapt the ADL Questionnaire to the Brazilian culture and to analyze its reproducibility in individuals with PD. Methods: The ADL Questionnaire was translated and cross-culturally adapted to Brazilian Portuguese language. Reproducibility was analyzed using test-retest reliability and agreement values. The test-retest reliability of the individual items and total scores were calculated. The limits of agreement were verified using the Bland-Altman plot. The standard error of measurement (SEM) and the minimum detectable change (MDC) were calculated. Patients who were classified on a score of 1–4 on the modified Hoehn and Yahr scale were eligible. Results: No divergence was identified between the original and the adapted version, which demonstrated adequate semantic and conceptual equivalence. The Bland-Altman plot showed no systematic changes in the mean test-retest scores. The intraclass correlation coefficient (ICC) was 0.98 (95% confidence interval [95%CI] 0.93–0.99), and all individual items showed good levels of reliability (>0.60). The SEM (SEM%) and MDC (MDC%) values were 3.0 (6.75%) and 8.2 (18.7%), respectively. These values are within the recommended values. Conclusions: The ADL-Brazil Questionnaire is a reliable instrument to be used for clinical and research purposes to assess self-perceptions of ADL performance in individuals with PD.

Keywords:
Parkinson Disease; Activities of Daily Living; Reproducibility of Results

Por favor, marque a incapacidade em suas atividades diárias durante a semana passada de 0 (sem problema) a 5 (incapaz). Por favor, observe que “3” significa que você precisa usar dispositivos de assistência ou ter ajuda de outras pessoas. 0; sem problemas, 1; lento, mas sem dificuldade, 2; levemente difícil, mas não precisa de ajuda ou assistência, 3; moderadamente difícil e às vezes precisa ajuda ou assistência, 4; extremamente difícil e em geral precisa de ajuda ou assistência, 5; incapaz de executar a atividade.

		n=30
Age (years), mean±SD (min–max)		64,5±11.9 (41–86)
Sex (men), n (%)		19 (63%)
Educational level (years), mean±SD (min–max)		7.8±4.9 (1–17)
Disease duration, yr since diagnosis (years), mean±SD (min–max)		9.7±6.1 (2–30)
Cognition (MMSE), mean±SD (min-max)		25.4±3.0 (19–30)
Family context, n (%)	Living alone	4 (13)
Family context, n (%)	Living with family or partner	26 (87)
Occupation, n (%)	Salaried person	2 (7)
	Unemployed	4 (13)
	Retired	24 (80)
Modified Hoehn & Yahr score, mean±SD (min–max)		2.2±0.85 (1–4)
	Stage 1, n (%)	5 (17)
	Stage 1.5, n (%)	4 (13)
	Stage 2, n (%)	8 (27)
	Stage 2.5, n (%)	4 (13)
	Stage 3, n (%)	7 (23)
	Stage 4, n (%)	2 (7)
UPDRS II, mean±SD (min–max)		11.2±8.5 (0–30)

Item	Mean test	Median (min-max) Test	Mean retest	Median (min-max) retest	Kappa values*	Kappa (95%CI)
Get in/out of bed	2.5	3 (0–5)	2.3	2.5 (0–4)	0.63	0.28–0.97
Sitting on/getting up from the floor	2.8	3 (0–5)	2.6	3 (0–5)	0.87	nc
Dressing	2.3	2 (0–5)	2.2	2.5 (0–4)	0.75	0.47–1
Taking a bath/shower	1.7	2 (0–5)	1.8	2 (0–4)	0.75	0.47–1
Writing	2.3	2 (0–5)	2.2	2 (0–5)	0.84	nc
Swallowing	1.7	2 (0–5)	1.7	1 (0–5)	0.78	nc
Walking	2.4	2.5 (0–5)	2.3	2 (0–5)	0.88	nc
Turning	2.7	3 (0–5)	2.6	2 (0–5)	0.76	0.54–0.99
Walking up/down stairs	2.1	2 (0–4)	2.3	2 (0–5)	0.68	0.37–0.99
Getting in/out of a car	2.6	2 (0–5)	2.5	2 (0–5)	0.81	0.58–1
Turning around in bed	2.3	2 (0–5)	2.4	2 (0–5)	0.72	0.48–0.96
Sitting on/rising from a chair	2.0	2 (0–5)	2.3	2 (0–5)	0.87	nc
Standing	1.9	2 (0–4)	2.1	2 (0–5)	0.85	nc
Using the toilet	2.0	2 (0–5)	2.0	2 (0–5)	0.78	nc
Using a spoon and chopsticks	1.8	2 (0–4)	2.1	2 (0–5)	0.85	nc
Talking	1.5	1.5 (0–4)	1.8	2 (0–5)	0.73	0.46–0.99
Taking the first step	2.0	2 (0–4)	2.2	2 (0–5)	0.81	nc
Moving an object	2.2	2 (0–5)	2.1	2 (0–5)	0.86	nc
Crossing the street	2.3	2 (0–5)	2.6	3 (0–5)	0.86	nc
Getting on/off a bus or subway	2.4	2.5 (0–5)	2.5	3 (0–5)	0.86	0.74–0.98

	n=30
ADL-Brazil Questionnaire scores (test), mean±SD (range)	43±21 (0–87)
ADL-Brazil Questionnaire (retest), mean±SD (range)	45±25 (0–90)
ICC (95%CI)	0.98 (0.93–0.99)
d (95%CI)	-1.1 (-4.2 to 1.98)
SEM (SEM%)	3.0 (6.75)
MDC (MDC%)	8.2 (18.7)

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[1] Correspondence: Paula Luciana Scalzo; Email:paula@icb.ufmg.br.