The Manchester Respiratory Activities of Daily Living Questionnaire: Reliability and Validity of the Chinese Version with Pictorial Enhancement

Damian Chi Hong Siu (Corresponding Author), Chi Tao So, Cherry Wai Lee Lau, Eric Hei Man Hui, Alexandra Fung, Tak Ming Chan, Fion Siu Fun Chan, Catherine Kam Fung Chan, William Pang Wai Chen, Sammy Hoo Ming Cheung, Katherine Pui Yee Chan, Peter Poon, Michael Cheung, Cherry Chan, Justin Tse, Vanessa Fung, Kenneth N. K. Fong

Research output: Journal article publicationJournal articleAcademic researchpeer-review


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 multidimensional 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 examination 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.
Original languageEnglish
Article number16
Pages (from-to)91-100
Number of pages10
JournalInternational Journal of COPD
Publication statusPublished - 15 Jan 2021


  • Activities of daily living
  • Chronic obstructive
  • Occupational therapy
  • Patient-reported outcome measures
  • Pulmonary disease
  • Validation study

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Health Policy
  • Public Health, Environmental and Occupational Health


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