Ability to perform daily physical activities in individuals with type 2 diabetes and moderate obesity: a preliminary validation of the Impact of Weight on Activities of Daily Living Questionnaire

Diabetes Technol Ther. 2011 Jul;13(7):705-12. doi: 10.1089/dia.2011.0027. Epub 2011 Apr 19.


Background: The aims of this study were (1) to demonstrate the reliability and validity of the Impact of Weight on Activities of Daily Living Questionnaire (IWADL), a measure of ability to perform daily physical activities, in individuals with type 2 diabetes who are moderately obese and (2) to characterize those individuals with low self-reported ability.

Methods: Data from a web-based survey of individuals with type 2 diabetes and body mass index (BMI) of 30-40 k/mg(2) were used to calculate Cronbach's α and demonstrate both IWADL factorial and construct validity. These data were entered into a multivariable multinomial logistic regression model with survey variables (demographics, health status, weight- and diabetes-related) as the independent variables and three IWADL scoring groups (Low, Medium, and High) as the dependent variables.

Results: Study participants were 349 individuals with type 2 diabetes (mean age = 59 years, 44% male, 91% white, mean BMI = 35 k/mg(2)). Factor analysis indicated a one-factor solution for a seven-item IWADL with Cronbach's α = 0.94. Significant (P < 0.05) relationships were identified between IWADL and variables previously shown to be related to level of physical activity. Ten variables remained independently (P < 0.05) related to IWADL scores, including age, gender, health status, current exercise, using exercise programs or hypnosis as a step to lose weight, and self-reported weight history.

Conclusions: The IWADL is a reliable and valid measure of the ability of individuals with type 2 diabetes and moderate obesity to perform daily physical activities. This ability may be an important patient-reported end point to include in clinical trials of antihyperglycemic medications that produce weight loss.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Activities of Daily Living* / psychology
  • Age Factors
  • Aged
  • Attitude to Health
  • Body Mass Index
  • Diabetes Mellitus, Type 2 / complications*
  • Focus Groups
  • Health Status
  • Humans
  • Hypoglycemia / psychology
  • Internet
  • Male
  • Middle Aged
  • Mobility Limitation
  • Motor Activity*
  • Movement Disorders / diagnosis*
  • Movement Disorders / etiology*
  • Movement Disorders / prevention & control
  • Obesity / complications
  • Obesity / physiopathology*
  • Obesity / psychology
  • Obesity / therapy
  • Range of Motion, Articular
  • Reproducibility of Results
  • Surveys and Questionnaires*