Validity, Reliability, and Responsiveness of the Dutch Version of the London Chest Activity of Daily Living Scale in Patients With Severe COPD

This study assesses the validity, reliability, and responsiveness of the Dutch version of the London Chest Activity of Daily Living scale (LCADL). The English LCADL version was translated into Dutch and then back-translated to English to check if the translation was conceptually equivalent to the original LCADL. Measurement properties were evaluated in191 patients with chronic obstructive pulmonary disease (COPD) (70 males; age 62 ± 9 years; FEV(1) 33 ± 10% pred). Construct validity was assessed using disease-specific health status, generic functional status, and functional and peak exercise capacity (Wmax). LCADL was completed twice to assess test–retest reliability. Responsiveness was assessed after 8 to 12 weeks inpatient pulmonary rehabilitation. LCADL correlated significantly with the St. George Respiratory Questionnaire (r = 0.24 to 0.64), functional status (r = 0.45 to 0.82), walking distance (r = −0.3 to −0.58), and Wmax (−0.27 to −0.38) and Wmax % pred (−0.26 to −0.43). Test–retest reliability was high (ICC 0.87 to 0.98). The smallest detectable change for the LCADL total and domain score self-care, domestic, physical, and leisure was 4.5, 2.9, 3.3, 4.9, and 2.2, respectively. Improvement in LCADL after PR correlated significantly with improvement in Chronic Respiratory Questionnaire (−0.43; P < 0.001). The Dutch LCADL is a reliable, valid, and responsive instrument to assess limitations in performing activities of daily living in patients with severe COPD.