Workplace Activity Limitations Scale
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Workplace Activity Limitations Scale

Last Updated

Purpose

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

Acronym WALS

Area of Assessment

Functional Mobility
Occupational Performance
Upper Extremity Function

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

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

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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