Workplace Activity Limitations Scale
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Workplace Activity Limitations Scale

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Workplace Activity Limitations Scale Infographic

Purpose

A twelve-item measure designed to measure limitations people with arthritis experience while performing workplace activities.

Acronym WALS

Area of Assessment

Bodily Functions
Activities & Participation

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Free

Actual Cost

$0.00

CDE Status

Not a CDE as of 5/1/2023

Populations

Arthritis/Joint Conditions

Key Descriptions

  • Twelve-item measure that asks respondents how much difficulty they had getting to and from work; getting around the workplace; sitting and standing for long periods of time at work; lifting; working with your hands; crouching, bending, or kneeling; reaching; the schedule, hours, and pace of work; and meeting current job demands.
  • Uses a four point frequency response scale: 0 = no difficulty, 1 = some difficulty, 2 = a lot of difficulty and 3 = not able to do. Other information regarding scoring unavailable.
  • Self- or interviewer administration
  • Scoring can be expressed as the mean of all scale items (range 0–3) or as a summed total score (range 0–36). Higher scores indicate greater workplace activity limitations:` A score of 0–4 reflects low difficulty, 5–8 medium difficulty and ≥ 9 high difficulty

Number of Items

12

Equipment Required

  • WALS measure
  • Pencil

Time to Administer

10-15 minutes

Required Training

No Training

Age Ranges

Adult

18 - 64

years

Instrument Reviewers

May Ramirez, M.S., CRC, LPC-IT & Lindsay Clark, PhD, University of Wisconsin-Madison

Kevin Fearn, Shirley Ryan AbilityLab

Body Part

Head
Neck
Upper Extremity
Lower Extremity
Back

ICF Domain

Activity
Participation

Measurement Domain

Activities of Daily Living
Cognition
Motor
General Health

Considerations

A 5-item version of the WALS successfully identified impaired work productivity in RA patients (Gorial et al., 2023).

Arthritis/Joint Conditions

back to Populations

Cut-Off Scores

Arthritis: (Gignac et al., 2011; n = 490; mean age = 51.1 (9.3))

  • From summed responses on the 12-item WALS (score range 0 to 36):
    • 0–4 reflects low difficulty
    • 5–8 reflects medium difficulty
    • ≥ 9 reflects high difficulty

Normative Data

Arthritis: (Gignac et al., 2006; n = 492; mean age = 50.9 (9.3))

  • Mean WALS total score: 6.4 (4.4)

Arthritis: (Gignac et al., 2007; n = 292; mean age = 53.2 (9.3))

  • Mean WALS total score: 7.1 (4.7)

Arthritis: (Beaton et al., 2010; n = 250; mean age = 50.6 (9.2); 82.7% female)

  • Mean WALS total score: 8.0 (5.1)

Internal Consistency

Arthritis: (Gignac et al., 2004, n = 492; mean age = 50.9 (9.3))

  • Adequate internal consistency (Cronbach’s alpha = 0.78)

Arthritis: (Gignac et al., 2006)

  • Adequate internal consistency (Cronbach’s alpha = 0.79)

Arthritis: (Gignac et al., 2007)

  • Excellent internal consistency (Cronbach’s alpha = 0.81)

Arthritis: (Beaton et al., 2010)

  • Excellent internal consistency (Cronbach’s alpha = 0.87)

Construct Validity

Convergent validity:

Arthritis: (Beaton et al., 2010)

  • Adequate to excellent correlation with a series of work-oriented constructs (self-reported global items) (r = -0.43 to 0.66)
  • Adequate to excellent correlations against other work-specific measures:
    • Excellent correlation with 6-item Stanford Presenteeism Scale scores (r = 0.66)
    • Adequate correlation with Endicott Work Productivity Scale score (r = 0.55),
    • Excellent correlation with Work Instability Scale for Rheumatoid Arthritis scores (r = 0.77)
    • Excellent correlation with Work Limitations Questionnaire Index scores (r = 0.61)

Responsiveness

Arthritis: (Beaton et al., 2010)

  • Moderate responsiveness of the WALS to 1-year improvements (standardized response mean [SRM] = 0.79) and 1-year deteriorations (SRM = 0.50) in work ability

Bibliography

Beaton DE, Tang K, Gignac MA, Lacaille D, Badley EM, Anis AH, Bombardier C. Reliability, validity, and responsiveness of five at-work productivity measures in patients with rheumatoid arthritis or osteoarthritis. Arthritis Care Res (Hoboken). 2010 Jan 15;62(1):28-37. doi: 10.1002/acr.20011. PubMed PMID: 20191488.

Gignac MA, Badley EM, Lacaille D, Cott CC, Adam P, Anis AH. Managing arthritis and employment: making arthritis-related work changes as a means of adaptation. Arthritis Rheum. 2004 Dec 15;51(6):909-16

Gignac, MA, Cao X, Tang K, Beaton DE. Examination of arthritis-related work place activity limitations and intermittent disability over four-and-a-half years and its relationship to job modifications and outcomes. Arthritis Care & Research, 2011 March;63(7):953-962

Gignac MA, Sutton D, Badley EM. Reexamining the arthritis-employment interface: perceptions of arthritis-work spillover among employed adults. Arthritis Rheum. 2006 Apr 15;55(2):233-40

Gignac MA, Sutton D, Badley EM. Arthritis symptoms, the work environment, and the future: measuring perceived job strain among employed persons with arthritis. Arthritis Rheum. 2007 Jun 15;57(5):738-47

Gorial FI, Awadh NI, Humadi YA, Mutar MT, Hameed MM, Ali SB, Hasan HF, Aljafr AN. A 5 item version of the Workplace Activity Limitation Scale successfully identifies impaired work productivity in rheumatoid arthritis patients: A split-sample factor analysis approach. International Journal of Rheumatic Diseases, 2023 Mar; 26(3): 501-509.

Tang K, Beaton DE, Boonen A, Gignac MA, Bombardier C. Measures of work disability and productivity: Rheumatoid Arthritis Specific Work Productivity Survey (WPS-RA), Workplace Activity Limitations Scale (WALS), Work Instability Scale for Rheumatoid Arthritis (RA-WIS), Work Limitations Questionnaire (WLQ), and Work Productivity and Activity Impairment Questionnaire (WPAI). Arthritis Care Res (Hoboken). 2011 Nov;63 Suppl 11:S337-49. doi: 10.1002/acr.20633. Review. PubMed PMID: 22588755.

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