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Title: The manchester respiratory activities of daily living questionnaire : reliability and validity of the Chinese version with pictorial enhancement
Authors: Siu, DCH
So, CT
Lau, CWL
Hui, EHM
Fung, A
Chan, TM
Chan, FSF
Chan, CKF
Chen, WPW
Cheung, SHM
Chan, KPY
Poon, P 
Cheung, M 
Chan, C 
Tse, J 
Fung, V 
Fong, KNK 
Issue Date: 2021
Source: International journal of chronic obstructive pulmonary disease, 2021, v. 16, p. 91-100
Abstract: Background: The Manchester Respiratory Activities of Daily Living Questionnaire (MRADLQ) is a valid and reliable tool measuring the functional level of patients with COPD in multidimen-sional aspects. However, a local validation of the questionnaire is lacking in Hong Kong.
Objective: To develop a Chinese version of MRADLQ with pictorial enhancement (C-MRADLQ) and study its reliability and validity.
Patients and Methods: A total of 238 patients suffering from COPD were recruited from nine public hospitals and five Nurse and Allied Health Respiratory Clinics by convenient sampling. A total of 64 patients with normal spirometry results and no previous clinical diagnosis of COPD were invited to complete the C-MRADLQ for comparison and examina-tion of its validity. Ten out of 302 patients were re-assessed with the C-MRADLQ after one week by the same rater for test–retest reliability. The C-MRADLQ was correlated with spirometry result, COPD classifications and groups by Global Initiative for Chronic Obstructive Lung Disease (GOLD), the modified Medical Research Council Dyspnea Scale (mMRC Dyspnea Scale), COPD Assessment Test (CAT), Chinese Version of the Shortness of Breath Questionnaire (C-SOBQ), number of admission and the ADO index.
Results: The C-MRADLQ shows good test–retest reliability as indicated by an intra-class correlation coefficient value of 0.975. It is significantly correlated with COPD stage, COPD group, SOBQ score, CAT score, mMRC, ADO index, spirometry results, and number of admissions. The SOBQ score, number of admissions, FEV1/FVC, and COPD group could significantly predict the total C-MRADLQ score. A total of 67.9% of participants’ mMRC levels were correctly classified by using the C-MRADLQ total score. The agreement of the original and new versions of questions 20 and 21 of C-MRADLQ was 97.3% and 90.1%, respectively.
Conclusion: The pictorial version of the C-MRADLQ is a validated and reliable functional assessment tool to measure functional status among patients with COPD in the Chinese population.
Keywords: Activities of daily living
Chronic obstructive
Occupational therapy
Patient-Reported outcome measures
Pulmonary disease
Validation study
Publisher: Dove Medical Press Ltd.(Dovepress)
Journal: International journal of chronic obstructive pulmonary disease 
ISSN: 1176-9106
EISSN: 1178-2005
DOI: 10.2147/COPD.S283769
Rights: © 2021 Siu et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License ( accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (
The following publication Siu DCH, So CT, Lau CWL, Hui EHM, Fung A, Chan TM, Chan FSF, Chan CKF, Chen WPW, Cheung SHM, Chan KPY, Poon P, Cheung M, Chan C, Tse J, Fung V, Fong KNK. The Manchester Respiratory Activities of Daily Living Questionnaire: Reliability and Validity of the Chinese Version with Pictorial Enhancement. Int J Chron Obstruct Pulmon Dis. 2021;16:91-100 is available at
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