Response of the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 to rehabilitation in people with chronic respiratory conditions

Chayenne Chylld César Lopes, Vanessa Garcia de Lima, Magno Formiga, Rafael Mesquita
Purpose:

To investigate the responsiveness and interpretability of the WHODAS 2.0 after a rehabilitation programme with physical exercises in people with chronic respiratory conditions. 

Methods:

Observational cohort study with individuals with chronic respiratory conditions who participated in an 8-week rehabilitation programme with physical exercises. The participants performed supervised endurance and strength training on 2 days per week, plus 1 day per week unsupervised. Disability (12 questions version of WHODAS 2.0,with a summary score ranging from 0 to 100) and health-related quality of life (Saint George’s Respiratory Questionnaire – SGRQ, with a total score ranging from 0 to 100) were assessed before and after the programme 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, the most prevalent conditions were chronic obstructive pulmonary disease in 61%, post-COVID-19 condition in 24%, and asthma in 6%). There was a reduction in 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; p0.001). A regular correlation was observed between the changes in WHODAS 2.0 and SGRQ (rs=0.36; p=0.04). Using anchor and distribution-based methods the MID estimate varied between -6.22 and -5.02.

Conclusion(s):

The WHODAS 2.0 proved to be a responsive tool after a rehabilitation programme with physical exercises in people with chronic respiratory conditions, and a reduction of at least 6.22 was considered clinically important. Future work should investigate the use of WHODAS 2.0 in chronic respiratory conditions not included in this study.

Implications:

The WHODAS 2.0 seems to be an appropriate toll to be used in clinical practice to assess the impact of rehabilitation programmes on the disability levels of people with chronic respiratory conditions. Moreover, a reduction of at least 6.22 in WHODAS 2.0 summary score can be used as the threshold to reflect a clinically important change.

Funding acknowledgements:
This work was unfunded.
Keywords:
Respiratory Tract Diseases
Rehabilitation
WHODAS 2.0
Primary topic:
Disability and rehabilitation
Second topic:
Cardiorespiratory
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
Research Ethics Committee of the Walter Cantidio University Hospital.
Provide the ethics approval number:
4.400.114
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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