The reliability of the modified lower extremity functional scale among adults living with HIV on antiretroviral therapy, in Rwanda, Africa

Peripheral neuropathy (PN) is common among people living with HIV (PLHIV) on antiretroviral therapy (ART), and affects their daily functional ability and quality of life. Lower extremity functional ability, which is most commonly compromised in patients with PN, has not been clearly evaluated in an African setting, with regard to functional limitations. The lower extremity functional scale (LEFS) was originally developed and validated among elderly people in the USA, where the environment and activities of daily life are very different from those in Rwanda. The purpose of this study was to adapt and establish the reliability of LEFS, among adults living with HIV on ART, in a Rwandan environment. The study translated LEFS from English to Kinyarwanda, the local language spoken in Rwanda, the LEFS was then modified accordingly, and tested for test-retest reliability among 50 adult PLHIV on ART. An average Spearman rank order correlation coefficient, ρ ≥ 0.7, was considered optimal for reliability. Prior to the modification of the LEFS and in the initial testing of the translated LEFS, none of the activities was strongly correlated (ρ ≥ 0.8); most of the activities (90%, 18/20) were moderately correlated (ρ ≥ 0.5) and 10% (2/20) were weakly correlated (ρ ≤ 0.5). The ρ of most of the functional activities improved after modification by an expert group to ρ ≥ 0.7, establishing reliability and validity of LEFS among PLHIV on ART with lower extremity functional limitations, in this environment. In conclusion, this study demonstrated the importance of modifying and establishing test - retest reliability of tools derived from developed world contexts to local conditions in developing countries, such as in Rwanda. The modified LEFS in this study can be used in Rwanda by clinicians, specifically at ART clinics to screen and identify people with functional limitations at an early stage of the limitations, for treatment, rehabilitation and/or referral to appropriate health care services

Activities of daily living · Antiretroviral therapy · Family medicine · Geography · Physical therapy · Rank correlation · Statistics · Viral load · Bone and Joint Diseases · HIV Research and Treatment · HIV-related health complications and treatments · Mathematics · Medicine · Psychology

• Prevalence and levels of disability post road traffic orthopaedic injuries in Rwanda

  Open Access•JC Allen Ingabire, Aimee Stewart et al.•African Journal of Disability•2024

  Incluir item

• Prevalence of peripheral neuropathy and its associated demographic and health status characteristics, among people on antiretroviral therapy in Rwanda

  Open Access•David Tumusiime, David Kabagema Tumusiime et al.•BMC Public Health•2014

  Incluir item

• Declining Morbidity and Mortality among Patients with Advanced Human Immunodeficiency Virus Infection

  Frank Joseph Palella, Kathleen M Delaney et al.•New England Journal of Medicine•1998

  Incluir item

• Income inequality and health

  Open Access•Martin Karlsson, Thomas Nilsson et al.•Social Science & Medicine•2010

  Incluir item

• Met and unmet palliative care needs of people living with HIV/Aids in Rwanda

  Open Access•Jeannine Uwimana, Patricia Struthers•SAHARA-J Journal of Social…•2007

  Incluir item