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Rehabilitation Measures

Psychosocial Impact of Assistive Devices

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The PIADS is a 26-item self-reported questionnaire designed to assess the effects of an assistive device on functional independence, well-being and quality of life.

Acronym PIADS




  • Multiple Sclerosis
  • Spinal Cord Injury
  • Stroke Recovery

Key Descriptions

  • It is self-report questionnaire based on three subscales: competence (12 items), adaptability (6 items) and self-esteem (8 items).
  • Each item is scored separately on a 7 point Likert Scale as follows
    A) −3 (Maximum Negative Impact)
    B) −2 and−1 (Somewhat Negative Impact)
    C) zero(No Impact)
    D) +1 and +2 (Somewhat Positive Impact)
    E) +3 (Maximum Positive Impact)
  • PIADS comes with a manual that presents the conceptual basis and intended applications for the instrument, summarizes its measurement properties and describes its administration and scoring procedures in detail with examples. A glossary is also included to aid users in interpretation. Link to the manual could not be found.
  • 26 Items are included in the 3 subscales.
  • Competence:
    1) Competence
    2) Independence
    3) Adequacy
    4) Confusion
    5) Efficiency
    6) Productivity
    7) Usefulness
    8) Expertise
    9) Skillfulness
    10) Capability
    11) Quality of life
    12) Performance
  • Adaptability:
    1) Well-being
    2) Willingness to take chances
    3) Ability to participate
    4) Eagerness to try new things
    5) Ability to adapt to activities of daily living
    6) Ability to take advantage of opportunities
  • Self-esteem:
    1) Happiness
    2) Self-esteem
    3) Security
    4) Frustration
    5) Self-confidence
    6) Sense of power
    7) Sense of control
    8) Embarrassment

Number of Items


Equipment Required

  • Paper
  • Pen
  • Telephone (if administered by phone)

Time to Administer

5-10 minutes

Required Training

Reading an Article/Manual

Instrument Reviewers

Initially reviewed by Pavni Shrivastava on 09/24/2014.

ICF Domain



The process of selecting an assistive device is very complex for persons with disabilities. PIADS can assist with this complex process particularly when used in conjunction with relevant modes of practice, occupation based assessments and assessments that are focused on matching the person’s physical abilities to wheelchair.

Incorporating PIADS in follow up studies and evaluation in rehabilitation may lead to improved methods of supporting the users of assistive devices in best way.

Utilizing PIADS will help clinicians in identifying patients who are likely to comply with assistive devices.

Do you see an error or have a suggestion for this instrument summary? Please e-mail us!


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Standard Error of Measurement (SEM)

Knee Osteoarthritis: (Harada,2014; n =53; mean age= 59.5(8.6) years; Radiographic Kellgren-Lawrence scale knee OA grade >1)

  • SEM for competence subscale = 0.26 (calculated from statistics in Harada et al,2014)
  • SEM for adaptability subscale = 0.38 (calculated from statistics in Harada et al,2014)
  • SEM for self-esteem subscale= 0.36 (calculated from statistics in Harada et al,2014)

Minimal Detectable Change (MDC)

Knee Osteoarthritis: (Harada,2014)

  • MDC = 2.7 (calculated from statistics from Harada et al, 2014)

Internal Consistency

Knee Osteoarthritis (Harada et al, 2014)

  • Excellent internal consistency (Cronbach’s alpha = 0.95) for the total score and (0.92, 0.88 and 0.87) for the Competence, Adaptability, and Self-Esteem subscales, respectively.

Internal Consistency Coefficients for PIADS






PIADS sub scales

All subjects

Cane users

Cane non users















Self Esteem






Criterion Validity (Predictive/Concurrent)

Predictive Validity

Knee Osteoarthritis ( Harada et al, 2014)

  • Adequate predictive validity of PIADS adaptability sub scale with use of cane for the 45-60 years old age group (r = 0.54)
  • Poor predictive validity in adults 65 years and over (r range= 0.09-0.13)

Multiple Sclerosis

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Standard Error of Measurement (SEM)

Multiple Sclerosis: (Demers, 2002; n=81; mean age 47.8(9.4) years; Expanded Disability Status Scale (EDSS) score = 6.5 or more)

  • SEM = 0.76 

Minimal Detectable Change (MDC)

Multiple Sclerosis: (Demers, 2002)

  • MDC = 2.1 (calculated from statistics from Demers, 2001) 

Normative Data

Multiple Sclerosis: (Devitt, 2003; n =20; mean age = 53.4 years, Median months since wheelchair users: 42 months)

  • Mean PIADS scores: Competence = 1.54 (0.85), Adaptability = 1.64 (0.82), Self-esteem=1.06 (0.78)

Internal Consistency

Multiple Sclerosis (Demers et al , 2002)

  • Excellent internal consistency (Cronbach’s alpha range 0.87-0.95)

Construct Validity

Discriminant Validity

Multiple Sclerosis (Demers et al , 2002)

  • Principal components analysis showed 61 % total variance.

Mixed Populations

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Normative Data

Multiple Conditions (Spinal Cord Injury, Multiple Sclerosis, Cerebral Palsy, Thoracic Outlet Syndrome, Radiculopathy, Degenerative Spinal Condition, Rheumatoid arthritis)( De Rosier, 2004; n = 10; mean age = 43.9 (13.98) years; mean years of disability = 18.1)

  • Mean PIADS scores : Competence = 1.79, Adaptability = 1.79, Self-esteem=1.49 (De Rosier et al, 2004)
  • Mean PIADS scores : Competence = 2.32, Adaptability = 1.77, Self-esteem=1.67 (Burton et al, 2008)

Criterion Validity (Predictive/Concurrent)

Predictive Validity

Stroke and Multiple Sclerosis: (Barett, 2010; n=21 (stroke), 20 (MS); mean age of stroke patients = 62 (12) years, MS patients = 56 (6.9) years; mean years since stroke = 4.2 (3.87), MS = 10.7 (7.73))

  • Spearman’s rank order correlation coefficient values; changes in walking speed versus PIADS scores


Training effect (ρ)

Orthotic effect (ρ)

Total Orthotic effect (ρ)


0.45 (0.03)

-0.06 (0.42)

-0.15 (0.27)


0.11 (0.32)

0.32 (0.11)

-0.08 (0.45)


0.04 (0.44)

-0.08 (0.38)

-0.38 (0.06)

Multiple Sclerosis

Training effect r (p)

Orthotic effect r (p)

Total Orthotic effect r (p)


-0.17 (0.25)

-0.18 (0.025)

-0.32 (0.10)


0.25 (0.17)

0.2 (0.22)

0.23 (0.19)


0.23 (0.19)

0.01 (0.48)

0.22 (0.20)

Spinal Injuries

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Normative Data

Cervical Spinal Cord Injury ( Rigby,2005; n= 32; mean age =39.7 years)

  • Mean PIADS scores for Assistive device users: Competence = 2.02 (0.77), Adaptability = 1.66 (0.86), Self-esteem=2.03 (0.64)
  • Mean PIADS scores for Assistive device non- users: Competence = 1.99 (0.66), Adaptability = 1.64 (0.79), Self-esteem=1.89 (0.69)

Non-Specific Patient Population

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Test/Retest Reliability

Eye Glass wear Users : (Day,2002 ; n = 153)

  • Adequate test retest reliability over two weeks test –retest interval. (ICC = 0.45)

Internal Consistency

Eye Glass wear Users : (Day,2002)

  • Excellent internal consistency (Cronbach’s alpha = 0.95)
  • Excellent internal consistency (Cronbach’s alpha= 0.75 to 0.94) (Jutai et al, 2002)

Criterion Validity (Predictive/Concurrent)

Concurrent Validity

Eye Glass wear Users : (Jutai et al,2002)

  • Excellent concurrent validity (coefficient = 0.77 to 0.83)

Construct Validity

Discriminant Validity

Eye Glass wear Users : (Day et al,1996 ; n = 153)

  • Positive correlation was established between total score on PIADS and Pleasure and Dominance on Mehrabian and Russell’s PIADS (coefficient not mentioned)

Content Validity

Eye Glass wear Users: (Day,2002)

  • Content validity was established with discussion with people with disabilities. Items on the scale did represent both functional competence and quality of life, (r >0.20).


Barrett, C., & Taylor, P. (2010). The Effects of the Odstock Drop Foot Stimulator on Perceived Quality of Life for People With Stroke and Multiple Sclerosis. Neuromodulation, 13(1), 58-64. doi:10.1111/j.1525-1403.2009.00250. Find it on PubMed

Burton, M., Nieuwenhuijsen, E., & Epstein, M. (2008). Computer-related assistive technology: satisfaction and experiences among users with disabilities. Assistive Technology, 20(2), 99-106. Find it on PubMed

Day, H., & Jutai, J. (1996). Measuring the psychosocial impact of assistive devices: The PIADS. Canadian Journal of Rehabilitation, 9 , 159-168.

Day, H. H., Jutai, J. J., & Campbell, K. A. (2002). Development of a scale to measure the psychosocial impact of assistive devices: lessons learned and the road ahead. Disability & Rehabilitation, 24(1-3), 31-37. Find it on PubMed

Day, H., Jutai, J., Woolrich, W., & Strong, G. (2001). The stability of impact of assistive devices. Disability & Rehabilitation, 23(9), 400-404. Find it on PubMed

Demers, L., Monette, M., Lapierre, Y., Arnold, D. L., & Wolfson, C. (2002). Reliability, validity, and applicability of the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0) for adults with multiple sclerosis. Disability & Rehabilitation, 24(1-3), 21-30. Find it on PubMed

DeRosier, R., & Farber, R. (2005). Speech recognition software as an assistive device: a pilot study of user satisfaction and psychosocial impact. Work, 25(2), 125-134. Find it on PubMed

Devitt, R., Chau, B., & Jutai, J. (2003). The effect of wheelchair use on the quality of life of persons with multiple sclerosis. Occupational Therapy In Health Care, 17(3/4), 63-79. Find it on PubMed

Ding, D., Souza, A., Cooper, R. A., Fitzgerald, S. G., Cooper, R., Kelleher, A., & Boninger, M. L. (2008). A preliminary study on the impact of pushrim-activated power-assist wheelchairs among individuals with tetraplegia. American Journal of Physical Medicine & Rehabilitation, 87(10), 821-829. Find it on PubMed

Harada, N., Fong, S., Heiney, C., Yentes, J. M., Perell-Gerson, K. L., & Fang, M. A. (2014). Evaluation of two cane instruments in older adults with knee osteoarthritis. Journal Of Rehabilitation Research & Development, 51(2), 275-283. Find it on PubMed

Jutai, J., & Day, H. (2002). Psychosocial impact of assistive devices scale (PIADS). Technology and Disability, 14(3), 107-111. Find it on IOSPress

Pettersson, I., Ahlström, G., & Törnquist, K. (2007). The value of an outdoor powered wheelchair with regard to the quality of life of persons with stroke: a follow-up study. Assistive Technology, 19(3), 143-153. Find it on PubMed

Rigby, P., Ryan, S., Joos, S., Cooper, B., Jutai, J., & Steggles, E. (2005). Impact of electronic aids to daily living on the lives of persons with cervical spinal cord injuries. Assistive Technology, 17 (2), 89-97. Find it on PubMed