RESUMEN
BACKGROUND: The validity, reliability, and accuracy of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) for face-to-face assessment in the stroke population are well established. However, the validity and reliability of WHODAS 2.0 through tele-assessment remain uncertain. OBJECTIVE: To assess the reliability, agreement, internal consistency, criterion and discriminant validity of WHODAS 2.0 when administered through video calls. METHODS: A longitudinal methodological study included fifty individuals with chronic stroke. Both in-person and video call assessments were conducted, and their sequence was randomized. The reliability was determined using the Intraclass Correlation Coefficient (ICC2,1). Measurement errors were assessed using the standard error of measurement (SEM) and smallest detectable change (SDC). Internal consistency was assessed using Cronbach's α. Criterion validity was determined by conducting Pearson's correlation coefficient analysis between in-person and video call assessments. Discriminant validity was examined using the Receiver Operating Characteristic (ROC) curve to distinguish disability levels, with the Modified Rankin Scale as the reference standard. RESULTS: The participants had a mean age of 56.10 ± 10.8 years, with an equal distribution of genders. Adequate reliability was observed between the two methods (ICC2,1 = 0.88; 95% CI = 0.79-0.93; p < 0.001), and internal consistency was also adequate (Cronbach's α = 0.88). The criterion validity revealed a strong correlation (r = 0.78; p < 0.001). Discriminant validity demonstrated satisfactory accuracy in distinguishing disability levels via video call (AUC = 0.67; p = 0.04). DISCUSSION: This study offers evidence supporting the validity and reliability of the WHODAS 2.0 assessment through video call. Teleassessment using WHODAS 2.0 proves suitable for individuals who have had a stroke, enabling remote evaluation and care.
RESUMEN
OBJECTIVE: To identify the main biopsychosocial factors associated with disability level after stroke using the International Classification of Functioning, Disability and Health (ICF) model. METHODS: A cross-sectional study was conducted with chronic stroke survivors. Disability was assessed using the World Health Disability Assessment Schedule 2.0. The independent variables were: Body functions: emotional functioning and whether the dominant upper limb was affected. For the Activities & Participation component, satisfaction regarding the execution of activities and participation were assessed using the SATIS-Stroke, as well as the locomotion ability for adults (ABILOCO), manual ability (ABILHAND) and the return to work. For environmental factors, income and facilitators and obstacles were assessed using the Measure of the Quality of the Environment (MQE). Personal factors: age and sex. Multiple Linear Regression was employed. RESULTS: Limited locomotor ability (ß = -0.281; t = -3.231 p = 0.002), dissatisfaction regarding activities and participation (ß = -0.273; t = -3.070 p = 0.003), and the non-return to work (ß = 0.162; t = 2.085 p = 0.04) were associated with disability. CONCLUSION: The reduction in locomotor ability, dissatisfaction regarding activities and participation and the non-return to work were associated with disability in the chronic phase following a stroke.
The reduction in locomotion ability, dissatisfaction regarding activities and participation, and the non-return to work were associated with disability in the chronic phase following a stroke.Clinicians will be able to develop rehabilitation strategies focused on diminishing locomotor limitations, increasing satisfaction with activities and participation, and improving vocational planning for the return to work after a strokeThese findings underscore the importance of assessments and intervention strategies based on the individual rather than the disease as well as focusing on social and personal issues to guide clinical decision making.
