Validation of a Limitations in Daily Activities Scale for Chronic Pain

Keith G Wilson; Dyana Castillo; John Kowal; An Gie Yong; Lachlan A McWilliams

doi:10.1016/j.jpain.2018.08.004

Validation of a Limitations in Daily Activities Scale for Chronic Pain

J Pain. 2019 Jan;20(1):68-82. doi: 10.1016/j.jpain.2018.08.004. Epub 2018 Aug 31.

Authors

Keith G Wilson¹, Dyana Castillo², John Kowal³, An Gie Yong², Lachlan A McWilliams⁴

Affiliations

¹ Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Medicine, University of Ottawa, Ottawa, ON, Canada; School of Psychology, University of Ottawa, Ottawa, ON, Canada; Department of Psychology, The Ottawa Hospital Rehabilitation Centre, Ottawa, ON, Canada. Electronic address: kewilson@toh.on.ca.
² School of Psychology, University of Ottawa, Ottawa, ON, Canada.
³ School of Psychology, University of Ottawa, Ottawa, ON, Canada; Department of Psychology, The Ottawa Hospital Rehabilitation Centre, Ottawa, ON, Canada; Department of Anesthesiology, University of Ottawa, Ottawa, ON, Canada.
⁴ Department of Psychology, University of Saskatchewan, Saskatoon, SK, Canada.

PMID: 30172706
DOI: 10.1016/j.jpain.2018.08.004

Abstract

Limitations in physical function and participation are important domains of assessment in chronic pain. In 1995, the International Association for the Study of Pain distributed a self-report measure of functional limitations. Although the questionnaire has been used in research studies, it has never been subjected to a thorough investigation of its measurement properties. In this study, 941 patients with chronic pain completed the 16-item Limitations in Daily Activities Scale (LIDAS) at 2 pretreatment and 1 post-treatment assessment points. Individual item analysis favored a 13-item scale. This 13-item LIDAS had a confirmed 3-factor structure consisting of limitations in personal care, global participation, and specific tasks. Reliability analyses for the total scale (α = .90), as well as for each factor individually (αs = .82-.84), indicated good internal consistency, test-retest reliability (intraclass correlations = .65-.88 over varying time intervals), and responsiveness to change with treatment. LIDAS scores correlated as expected with measures of pain intensity, pain cognitions, and depression, as well as with other self-report and clinician-administered measures of functional performance. Using patient global ratings as anchors, a minimal clinically important difference of 5 points was established as a criterion for meaningful individual improvement after treatment. In conclusion, the LIDAS is a reliable, valid, and clinically relevant option for assessing limitations in physical function and participation in patients with chronic pain. PERSPECTIVE: Physical function and participation comprise a core dimension in the assessment of chronic pain. This study demonstrates that the LIDAS is a reliable and valid measure of this dimension, with good applicability for documenting clinically important change with treatment.

Keywords: Chronic pain; daily activities; disability; functional limitations; pain interference.

Publication types

Research Support, Non-U.S. Gov't
Validation Study

MeSH terms

Activities of Daily Living*
Adult
Chronic Pain / diagnosis*
Chronic Pain / therapy
Female
Humans
Male
Middle Aged
Musculoskeletal Pain / diagnosis*
Musculoskeletal Pain / therapy
Pain Measurement / standards*
Psychometrics / standards*
Reproducibility of Results
Severity of Illness Index*

Grants and funding

MOP 93645/CIHR/Canada