WHODAS 2.0 to Assess Disability in the Rehabilitation of Individuals With Chronic Respiratory Conditions: Responsiveness and Interpretability

ABSTRACT Background and Purpose Individuals with chronic respiratory conditions have physical impairments that lead to disability, but which can be alleviated with physical exercise. We aimed to examine the responsiveness and interpretability of the World Health Organisation Disability Assessment Schedule (WHODAS) 2.0 following an exercise‐based rehabilitation programme in people with chronic respiratory conditions. Methods Observational cohort study with individuals who participated in an 8‐week rehabilitation programme with physical exercises. Before and after the programme, disability (12 questions WHODAS 2.0) and quality of life (Saint George's Respiratory Questionnaire—SGRQ) were assessed among other characteristics. Anchors‐ and distribution‐based methods were used to investigate a minimal important difference (MID). Results 33 participants were included (mean age of 59 ± 17 years, 67% female, 61% with chronic obstructive pulmonary disease). There was a reduction in the mean WHODAS 2.0 summary score after rehabilitation (mean difference −9.49, 95% CI ‐13.90 to −5.08; p < 0.001). A reduction in SGRQ total score was also observed (−15.5, 95% CI ‐21.7 to −9.7; p < 0.001). A regular correlation between the changes in WHODAS 2.0 and SGRQ was observed ( r s = 0.36; p = 0.04). Using anchor‐ and distribution‐based methods, the MID estimate varied between −6.22 and −5.02. Discussion WHODAS 2.0, a standardised and easy‐to‐use questionnaire developed by the World Health Organisation (WHO), proved to be a responsive tool after an exercise rehabilitation programme in individuals with chronic respiratory conditions, and a reduction of at least 6.22 was considered clinically important.