A cross-sectional study for assessment of activity of daily living and health-related quality of life among adults with physical disabilities in the Wardha district

Aditi Nath; Dr. Sonali Choudhari

doi:10.12688/f1000research.135494.1

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Study Protocol

A cross-sectional study for assessment of activity of daily living and health-related quality of life among adults with physical disabilities in the Wardha district

[version 1; peer review: 1 approved with reservations]

Aditi Nath ¹, Dr. Sonali Choudhari²

PUBLISHED 06 Dec 2023

Author details Author details

¹ School Of Epidemiology and Public Health, Datta Meghe Institute Of Higher Education and Research, MH, Wardha, Maharashtra, 442001, India
² Department of Community Medicine, School of Epidemiology and Public Health, Datta Meghe Institute of Higher Education and Research, MH, Wardha, Maharashtra, 442001, India

Aditi Nath
Roles: Conceptualization, Data Curation, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Dr. Sonali Choudhari
Roles: Conceptualization, Formal Analysis, Investigation, Methodology, Project Administration, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

OPEN PEER REVIEW

REVIEWER STATUS

This article is included in the Datta Meghe Institute of Higher Education and Research collection.

Abstract

Introduction

Physical disabilities can affect a person’s ability to operate, move about, and endure physical strain. Physically challenged individuals have fewer social opportunities than physically healthy individuals, which is linked to a lower degree of well-being and a worse standard of living (QoL).

Objectives

This study set out to evaluate how physically disabled people’s everyday activities and their physical impairments have an impact on their quality of life in terms of health.

Methods

The study will concentrate on physically handicapped persons and how their everyday activities and quality of life are affected by their impairment. To evaluate and obtain insight into their knowledge about the laws and facilities available to them. In order to gather the research on the subject, search terms like “disability,” “quality of life,” and “activities of daily living” were employed in PubMed and Google Scholar.

Study implications

The goal of the study is to address any knowledge gaps regarding how physical disability disrupts a normal lifestyle and how challenging it is to carry out essential daily tasks (activities of daily living).

Keywords

Activities of daily living (ADL), Quality of life (QOL), Physical disability

Corresponding author: Aditi Nath

Competing interests: No competing interests were disclosed.

Grant information: The author(s) declared that no grants were involved in supporting this work.

Copyright: © 2023 Nath A and Choudhari DS. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to cite: Nath A and Choudhari DS. A cross-sectional study for assessment of activity of daily living and health-related quality of life among adults with physical disabilities in the Wardha district [version 1; peer review: 1 approved with reservations]. F1000Research 2023, 12:1565 (https://doi.org/10.12688/f1000research.135494.1) First published: 06 Dec 2023, 12:1565 (https://doi.org/10.12688/f1000research.135494.1) Latest published: 06 Dec 2023, 12:1565 (https://doi.org/10.12688/f1000research.135494.1)

Introduction

Background

According to the World Health Organization (WHO), “health” refers to a state of complete physical, psychological, and social wellness as opposed to just the absence of disease or incapacity. Disability is not just a physical ailment or a personality attribute; it also includes challenges that people may encounter in social and physical contexts. The term “disability” refers to limitations on function, activities, and participation. Even though health is defined in terms of a person’s ability to function in a range of health categories, such as vision, hearing ability, and agility, the global burden of disease (GBD) uses the term “disability” to refer to a person’s worsening health.¹ There are numerous definitions of “disability” that coexist.² The quality of life, on the other hand, is a person’s perception of where they are in life in respect to their goals, standards, and concerns, alongside the social and cultural context in which they live. It is a broad concept that is profoundly affected by an individual’s mental and physical fitness, degree of independence, social ties, and personal beliefs.³ According to estimates, 10% of people worldwide have a handicap or impairment.² Due to population increase, aging, the advent of long-term diseases, and preventive advancements that protect and lengthen life, there are an increasing number of persons with impairments.⁴ Negative outcomes like reliance and institutionalization result from physical disability and functional limits.

Under the provisions of Article 25 of the United Nations,

1. Without encountering any prejudice, disabled people have the liberty to a higher standard of health care in order to enhance their health.
2. The state will ensure accessibility for persons with disabilities to various services of health that can be gender-sensitive.
3. Inclusion of health care and programs in the area of sexual and reproductive health.
4. Arranging health services as close to their own communities as possible.
5. Provision of services for the identification and early intervention to prevent further worsening of their condition.

The experience and degree of a handicap are significantly influenced by the person’s environment. Challenges that limit persons with disabilities from actively and completely engaging within the society on a level playing field with others are typically present in unreachable settings. Taking these barriers out of the way and aiding those with disabilities in performing everyday tasks, social engagement can be increased. Compared to auditory perception and physical mobility, people with disabilities place higher value on broader dimensions of state of life, such as safety, taking care of oneself, and attaining independence.⁵ Assessing the standard of life of patients should be the top priority of every doctor and researcher. Since it is useful for determining needs and monitoring results, it is essential for health promotion activities.⁶ A person with a disability’s opinion of their health, happiness, and well-being frequently differs from their actual health state and disability, however, as their state of life is a complicated phenomenon.⁷ Disability (specially challenged condition) leads to deprivation and dependency in underdeveloped countries. Due to physical, social, and psychological hurdles, people with special needs continue to be marginalised in society.⁸ Aspects of one’s self-perceived well-being that are connected to or impacted by the existence of disease, treatment, and health policies are referred to as health-related quality of life (HRQOL).⁹ People with and without disabilities must participate in society and the workforce since it is widely known that doing so has a positive impact on one’s health, happiness, and overall state of life.¹⁰ Every human must participate in or be involved in daily activities. WHO asserts that participation improves health and wellbeing. It has been found that involvement suffers when there is a disability because there is less variety, more time spent at home, less social ties, and less active recreation.¹¹ The multiple dimensions of quality of life (QOL) can be assessed both subjectively and quantitatively.¹² Because they can help understand how patients’ experiences, expectations, beliefs, and perceptions are impacted by their health problems, assessments of health-related quality of life (HRQoL) have become a crucial part of health care.³ A physical impairment has an impact on a person’s mental health as well as their physical health. A few research have shown strategies for improving quality of life.⁴

Rationale

Several studies have been conducted on the number of cases of disability in India, most of which concentrate on the elderly population. Young adults are rarely the subject of studies. Additionally, there is not a lot of study on the state of life (QOL) of those with physical impairments. Understanding QOL and other related concerns that affect both the younger and older population is the main objective of this study. There are some holes that must be filled in order to support the study’s central claim, which is

1. To gain awareness of the majority of laws and regulations available for the disabled.
2. How physical disability disrupts a normal lifestyle and how difficult it is to perform basic activities of daily living (ADLs).

Thus, strengthening the previous knowledge and making it a fundamental basis of what all the lacunas are will help in establishing a mindset for everybody, i.e., the general population, the disabled, the government, and the authorities to fully comprehend the knowledge and bring out necessary changes. It would be helpful to look into the social, contextual, and environmental elements that affect a person’s capacity to manage their condition.¹³

Methods

The study will be conducted at Acharya Vinoba Bhave Rural Hospital and the participants will be selected from the outpatient department and in patient department of the orthopaedic and physiotherapy department of the hospital. Interaction with patients will be done and prepared questions will be asked for the data. The patients will be selected on the basis of their diagnosis and observing their physical conditions.

Study design

A cross sectional study will be conducted among the patients visiting the hospital.

Aim and objectives

Aim

To evaluate how a physical handicap affects a person’s capacity to perform daily tasks and their ability to live a healthy life.

Objectives

Primary objective

1) To study the type and grade of physical disability.

2) To assess the activities of daily living among adults with physical disabilities.

3) To evaluate the health-related state of life for people with physical impairments.

4) To study the association of type and grade of disability with their daily routine task and health-related state of life among adults with physical disabilities.

Secondary objective

To assess their knowledge regarding the laws/facilities specifically available for them.

Setting

People who are physically impaired will participate in this study. Simple random sampling will be used to conduct the study. The physiotherapy and orthopedic departments at Acharya Vinoba Bhave Rural Hospital will participate in the investigation. Outpatient department and in patient department patients between the ages of 18 and 60 will be chosen for data collection.

Participants

This study will be conducted on the adult population aged 18–60 years, suffering from a physical disability.

Eligibility criteria

Inclusion criteria

Individuals between the ages of 18 and 60, males and females, who have locomotor disabilities, absence of a hand, a leg, or both due to amputation, inactivity of a body part, paralysis of a limb, deformity or dysfunction of joints impairing their “normal ability to move oneself or move different objects,” as well as other physical deformities like a hunched back, a deformed spine, etc.

Exclusion criteria

There will be an exclusion of those who are severely mentally ill.

Variables

Table 1 elucidates the variables involved.

Table 1. Variables of the study.

Independent variables

Dependent variables

1) Type of disability
Motor disability
Sensory disability
Congenital disability
Acquired disability
2) Grade of disability

1) Quality of life

2) Activity of daily living

Data sources

1) Assessment of ADL – The Barthel Index will be used to assess ADL.¹⁴ It comprises of going from a seat to a couch and back, moving around on a level surface and climbing stairs. It also involves eating, washing, dressing, grooming and using the toilet facilities available at home.
2) Assessment of QOL – The WHOQOL-BREF scale will be used for the assessment of QOL. The 26 questions on the WHOQOL-BREF scale were grouped into four primary categories: physical, psychological, social, and environmental.

Data collection will be divided into three sections. Table 2 describes the data sources.

Table 2. Data sources for the study.

Key Study Parameters

Variables

Data Sources

Data Collective Method

Socio-demographics and background

1. Age
2. Caste
3. Type of family
4. Marital status
5. Educational attainment
6. Sociodemographic status

Acharya vinoba bhave rural hospital (AVBRH) hospital (physiotherapy department) Wardha district, Maharastra

Survey using a questionnaire

Activity of daily living

1. their meals,
2. taking a bath;
3. dressing
4. bowels
5. bladder
6. toilet-use
7. transfers (from couch to seat and return)
8. stairs with mobility (on a level surface).

Questionnaire

Assessment of QOL (Quality of life)

1. Physical
2. Pshychological
3. Social
4. Environmental

Questionnaire

Section A: Barthel index assessment for

a) Activity of daily living (ADL).

Section B: structured questionnaire on

a) Socio-demographic status.
b) Disability status.

Section C: WHOQOL BREF Questionnaire for

a) Quality of life (QOL)

Sample size

Population size for (the fpc, or fixed population correction factor): N: 1000000

n = [DEFF * Np (1 - p)] / [\frac{d^{2}}{Z^{2}} 1 - \frac{α}{2} * (N - 1) + p * (1 - p)]

The population’s estimated percentage frequency of the outcome factor is: 2.21%±5

Confidence levels as a percentage of 100 (absolute ±/%)(d): 5%

Cluster survey design effect (DEFF):

The sample size (n) for different levels of confidence. Table 3 further estimates the confidence interval and the relative sample size.

Table 3. Sample size for frequency in a population.

Confidence level %	Sample size
95%	34
80%	15
90%	24
97%	41
99%	58
99.9%	94
99.99%	131

n: minimum sample size required

DEFF: design effect, which accounts for the effect of clustering or stratification in the sample design (usually set to 1 if not applicable)

Np: an estimate of the number of people in the population who exhibit the desired feature (p is the percentage of the population that exhibits the desired characteristic)

(1-p): an estimate of the number of individuals in the population without the desired characteristic

d: The intended error margin, expressed as a percentage

Z: the standard normal distribution’s critical value that corresponds to the desired level of confidence

Alpha: the level of significance (usually set to 0.005 for a 95% confidence level

N: the size of the population (or an estimate of the population size if it is not known)

Statistical methods

Simple random sampling will be used in the study’s administration. Both the inpatient and outpatient orthopaedics and physiotherapy departments will be taken into consideration for the study’s inclusion of individuals with disabilities. Patients between the ages of 18 and 60 will be enrolled. The data will be coded in an Microsoft Excel version 2305 file, and SPSS version 22 (RRID:SCR_002865) software will be used to analyse the data. Calculated descriptive data will take the form of percentages and frequencies.

Ethical considerations

Ethical approval for this study DMIHER (DU)/IEC/2023/644 was provided by Datta Meghe Institute of Higher Education & Research (DMIHER) Sawangi (deemed to be university). Respect shall be shown for the participants. The research will use a written informed consent strategy, in which all participants will be informed of the study’s purpose prior to being interviewed.

Discussion

One of the key issues for patients with chronic diseases, which can vary depending on the patients’ age, is the environment in which they reside and the individuals who provide care for them. For instance, it has been claimed that partners, women, and younger relatives take on the care of elderly patients.¹⁵ A “Clinico-Social Model” for the best care of patients with vision loss is available for those who experience visual impairment. This model’s main objective is to give people with visual disorders access to clinical and vision rehabilitation management components. Such a strategy could potentially enhance the quality of life for those who are blind and offer useful advice to eye care administrators all throughout India. These kinds of approaches can be applied to assist those in need and create an environment that is welcoming to those who have disabilities.¹⁶ In elderly people, disability may be brought on by physiopathology or biological changes. As a person gets older, it becomes a significant health issue. From a broad standpoint, older people’s inability to do basic tasks of daily living lowers their state of life, increases sanitary expenditures and hastens their death.¹⁷

One thing which the authors found after reading several articles is that it is planned to create rehabilitation units at Community Health Centres under the National Programme for Health Care of the Elderly.¹⁸ However, in order to address geriatric disability at the community level, complete health care services must be made available. Creating possibilities for young people to learn and work, particularly for women, could lower the prevalence of handicap as people age.¹⁹ In order to identify individuals at risk for functional impairment, like senior citizens with a history of recurrent falls or hospitalizations, multimorbidity, cognitive decline, and polypharmacy, and complete geriatric assessments are required in both primary care settings and hospital settings.²⁰

There are many disabled people in India who require education, jobs, and rehabilitation programs. Rural areas demand special attention.²¹ In order to provide PWDs with a good existence, India must quickly catch up to the worldwide standards that are necessary. This can be done by providing appropriate health care.²²

In addition to a high prevalence of functional disability or restricted functional capacity, ageing is linked to an increased risk of functional reliance. The physiological changes brought on by ageing pose a threat to elderly people’s ability to function independently. Functional limitations decrease an older person’s quality of life, increase their risk of hospitalization, and make them more dependent on their family members.²³ All these things should be the focal area around which models, strategies, and assessments must be done to provide people who become vulnerable once tragedy strikes the reprieve to think carefully of their life choices and for them to have multiple options to choose from and continue to live their lives. Lower HRQoL has been associated with a higher prevalence of poor oral hygiene and neglected dental care needs. Therefore, it is essential to raise the social standing and dental health of the elderly.²⁴

Limitations

Participant bias or response bias may be present in the study, which may be a significant influence.

Scope and implications

1. To know the nature and severity of physical disability
2. To evaluate daily living activities among the adult population of people with physical imparities.
3. To evaluate the physically impaired population’s health-related state of life.
4. To examine the relationship between the kind and severity of a person’s impairments, everyday activities, and health-related quality of life.

Study status

IEC approval has been received and data collection tool for the study has been prepared.

Data availability

No data are associated with this article.

References

1. Chaudhary S, Srivastava AK, Vyas S, et al.: Quality of Life among Disabled Persons- A Cross-Sectional Study in Rural Area of Dehradun District. Indian J Community Health. 2019 Sep 30; 31(3): 390–395. Publisher Full Text
2. Bize R, Johnson JA, Plotnikoff RC: Physical activity level and health-related quality of life in the general adult population: A systematic review. Prev Med. 2007 Dec 1; 45(6): 401–415. Publisher Full Text
3. Kosik KB, Johnson NF, Terada M, et al.: Health-Related Quality of Life Among Middle-Aged Adults With Chronic Ankle Instability, Copers, and Uninjured Controls. J Athl Train. 2020 Jul; 55(7): 733–738. PubMed Abstract | Publisher Full Text | Free Full Text
4. Munce SEP, Perrier L, Shin S, et al.: Strategies to improve the quality of life of persons post-stroke: protocol of a systematic review. Syst Rev. 2017 Sep 7; 6: 184. Publisher Full Text
5. Crocker M, Hutchinson C, Mpundu-Kaambwa C, et al.: Assessing the relative importance of key quality of life dimensions for people with and without a disability: an empirical ranking comparison study. Health Qual Life Outcomes. 2021 Dec 14; 19(1): 264. PubMed Abstract | Publisher Full Text | Free Full Text
6. Andrew-Essien NE, Ojule IN: Health-Related Quality of Life of People with Physical Disability in South-South, Nigeria. Int J Innov Res Med Sci. 2020 Nov 21; 5(11): 542–549. Publisher Full Text
7. Gnanaselvam NA, Vinoth Kumar SP, Abraham VJ: Quality of Life of People with Physical Disabilities in a Rural Block of Tamil Nadu, India. J Psychosoc Rehabil Ment Health. 2017 Dec 1; 4(2): 171–177. Publisher Full Text
8. Shivakumar: Assessment of dentition status and treatment needs among children with disabilities attending special schools in Karad City, India.[cited 2023 May 12]. Reference Source
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11. Law M: Participation in the Occupations of Everyday Life. Am J Occup Ther. 2002 Nov 1; 56(6): 640–649. Publisher Full Text
12. Anu: Disparities in the quality of life among smokers, nonsmokers, and ex-smokers.[cited 2023 May 16]. Reference Source
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15. Duzgun Celik H, Cagliyan Turk A, Sahin F, et al.: Comparison of disability and quality of life between patients with pediatric and adult onset paraplegia. J Spinal Cord Med. 2018 Nov; 41(6): 645–652. Publisher Full Text
16. Senjam SS: Developing a disability inclusive model for low vision service. Indian J Ophthalmol. 2021 Feb; 69(2): 417–422. PubMed Abstract | Publisher Full Text | Free Full Text
17. Carmona-Torres JM, Rodríguez-Borrego MA, Laredo-Aguilera JA, et al.: Disability for basic and instrumental activities of daily living in older individuals. PLoS One. 2019 Jul 26; 14(7): e0220157. Publisher Full Text
18. Goswami AK, Ramadass S, Kalaivani M, et al.: Disability and its association with sociodemographic factors among elderly persons residing in an urban resettlement colony, New Delhi, India. PLoS One. 2019 Sep 24; 14(9): e0222992. PubMed Abstract | Publisher Full Text | Free Full Text
19. Goswami AK, Ramadass S, Kalaivani M, et al.: Disability and its association with sociodemographic factors among elderly persons residing in an urban resettlement colony, New Delhi, India. PLoS One. 2019 Sep 24; 14(9): e0222992. PubMed Abstract | Publisher Full Text | Free Full Text
20. Yau PN, Foo CJE, Cheah NLJ, et al.: The prevalence of functional disability and its impact on older adults in the ASEAN region: a systematic review and meta-analysis. Epidemiol Health. 2022 Jul 12; 44: e2022058. PubMed Abstract | Publisher Full Text | Free Full Text
21. Agarwal AK, Singh JV, Agarwal M: Prevalence Of Disability In India-An Update. Indian J Community Health. 2009 Jun 30; 21(1): 56–63.
22. Kannabirān K, Hans A: Council for Social Development (India), editors. India: social development report 2016: disability rights perspectives. First ed.New Delhi, India: Oxford University Press; 2017; 336.
23. Keshari P, Shankar H: Prevalence and spectrum of functional disability of urban elderly subjects: A community-based study from Central India. J Fam Community Med. 2017; 24(2): 86–90. Publisher Full Text
24. Shivakumar: Oral health-related quality of life of institutionalized elderly in Satara District, India.[cited 2023 May 16]. Reference Source

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Author details Author details

¹ School Of Epidemiology and Public Health, Datta Meghe Institute Of Higher Education and Research, MH, Wardha, Maharashtra, 442001, India
² Department of Community Medicine, School of Epidemiology and Public Health, Datta Meghe Institute of Higher Education and Research, MH, Wardha, Maharashtra, 442001, India

Aditi Nath
Roles: Conceptualization, Data Curation, Investigation, Methodology, Project Administration, Resources, Software, Supervision, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Dr. Sonali Choudhari
Roles: Conceptualization, Formal Analysis, Investigation, Methodology, Project Administration, Visualization, Writing – Original Draft Preparation, Writing – Review & Editing

Competing interests

No competing interests were disclosed.

Grant information

The author(s) declared that no grants were involved in supporting this work.

Article Versions (1)

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Published: 06 Dec 2023, 12:1565

https://doi.org/10.12688/f1000research.135494.1

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© 2023 Nath A and Choudhari DS. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Nath A and Choudhari DS. A cross-sectional study for assessment of activity of daily living and health-related quality of life among adults with physical disabilities in the Wardha district [version 1; peer review: 1 approved with reservations]. F1000Research 2023, 12:1565 (https://doi.org/10.12688/f1000research.135494.1)

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Reviewer Report 05 Apr 2024

Olufemi O Oyewole, Department of Physiotherapy, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria

Approved with Reservations

https://doi.org/10.5256/f1000research.148616.r256896

This study protocol assesses the activity of daily living and health-related quality of life among adults with physical disabilities in the Wardha district. I will suggest the title to reflect this.
Title
Assessment of activity of daily living and health-related quality ... Continue reading

This study protocol assesses the activity of daily living and health-related quality of life among adults with physical disabilities in the Wardha district. I will suggest the title to reflect this.
Title
Assessment of activity of daily living and health-related quality of life among adults with physical disabilities in the Wardha district: A study protocol.
Abstract
Please don't tag people with their disease/disability. Change throughout the manuscript "disabled/ physically disabled/disabled people" to "people with a physical disability" or " people who were physically disabled or people with disability".
Aims and Objectives: Let these come before the methods section. You failed to describe how you will achieve the secondary objective.
Methods
i. You state that interaction with patients will be done and prepared questions will be asked for the data. This looks like a qualitative study. Can you clarify?
ii. Setting: Most of the information in this section has been provided under the methods sections (paragraph 1) above. Please merge the information under the methods section (paragraph 1) with the information under the setting section. You can create another sub-heading 'participants' selection' (after exclusion criteria) to describe how the participants will be selected.
iii. Sample size: Let the sample size determination follow the exclusion criteria.
Please be specific, how many samples will power your study?
Statistical methods
i. The first three sentences are repeated. Not relevant here.
ii. Please explain in detail how primary objective 4 and secondary objective will be analyzed.
Scope and Implications
How do these scopes and implications differ from the primary objectives stated above?
I will suggest state clinical relevance and implication of the study here.

Is the rationale for, and objectives of, the study clearly described?

Yes
Is the study design appropriate for the research question?

Partly
Are sufficient details of the methods provided to allow replication by others?

Partly
Are the datasets clearly presented in a useable and accessible format?

Not applicable

Competing Interests: No competing interests were disclosed.

Reviewer Expertise: Musculoskeletal and rehabilitation.

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

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Olufemi O Oyewole, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria

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05 Apr 2024 | for Version 1

Olufemi O Oyewole, Department of Physiotherapy, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria

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Approved With Reservations

This study protocol assesses the activity of daily living and health-related quality of life among adults with physical disabilities in the Wardha district. I will suggest the title to reflect this.
Title
Assessment of activity of daily living and health-related quality of life among adults with physical disabilities in the Wardha district: A study protocol.
Abstract
Please don't tag people with their disease/disability. Change throughout the manuscript "disabled/ physically disabled/disabled people" to "people with a physical disability" or " people who were physically disabled or people with disability".
Aims and Objectives: Let these come before the methods section. You failed to describe how you will achieve the secondary objective.
Methods
i. You state that interaction with patients will be done and prepared questions will be asked for the data. This looks like a qualitative study. Can you clarify?
ii. Setting: Most of the information in this section has been provided under the methods sections (paragraph 1) above. Please merge the information under the methods section (paragraph 1) with the information under the setting section. You can create another sub-heading 'participants' selection' (after exclusion criteria) to describe how the participants will be selected.
iii. Sample size: Let the sample size determination follow the exclusion criteria.
Please be specific, how many samples will power your study?
Statistical methods
i. The first three sentences are repeated. Not relevant here.
ii. Please explain in detail how primary objective 4 and secondary objective will be analyzed.
Scope and Implications
How do these scopes and implications differ from the primary objectives stated above?
I will suggest state clinical relevance and implication of the study here.

Is the rationale for, and objectives of, the study clearly described?

Yes
Is the study design appropriate for the research question?

Partly
Are sufficient details of the methods provided to allow replication by others?

Partly
Are the datasets clearly presented in a useable and accessible format?

Not applicable

Competing Interests

No competing interests were disclosed.

Reviewer Expertise

Musculoskeletal and rehabilitation.

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

Respond to this report

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[1] 1. Chaudhary S, Srivastava AK, Vyas S, et al.: Quality of Life among Disabled Persons- A Cross-Sectional Study in Rural Area of Dehradun District. Indian J Community Health. 2019 Sep 30; 31(3): 390–395. Publisher Full Text

[2] 2. Bize R, Johnson JA, Plotnikoff RC: Physical activity level and health-related quality of life in the general adult population: A systematic review. Prev Med. 2007 Dec 1; 45(6): 401–415. Publisher Full Text

[3] 3. Kosik KB, Johnson NF, Terada M, et al.: Health-Related Quality of Life Among Middle-Aged Adults With Chronic Ankle Instability, Copers, and Uninjured Controls. J Athl Train. 2020 Jul; 55(7): 733–738. PubMed Abstract | Publisher Full Text | Free Full Text

[4] 4. Munce SEP, Perrier L, Shin S, et al.: Strategies to improve the quality of life of persons post-stroke: protocol of a systematic review. Syst Rev. 2017 Sep 7; 6: 184. Publisher Full Text

[5] 5. Crocker M, Hutchinson C, Mpundu-Kaambwa C, et al.: Assessing the relative importance of key quality of life dimensions for people with and without a disability: an empirical ranking comparison study. Health Qual Life Outcomes. 2021 Dec 14; 19(1): 264. PubMed Abstract | Publisher Full Text | Free Full Text

[6] 6. Andrew-Essien NE, Ojule IN: Health-Related Quality of Life of People with Physical Disability in South-South, Nigeria. Int J Innov Res Med Sci. 2020 Nov 21; 5(11): 542–549. Publisher Full Text

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A cross-sectional study for assessment of activity of daily living and health-related quality of life among adults with physical disabilities in the Wardha district

Abstract

Introduction

Objectives

Methods

Study implications

Keywords

Introduction

Background

Rationale

Methods

Study design

Aim and objectives

Setting

Participants

Eligibility criteria

Variables

Table 1. Variables of the study.

Data sources

Table 2. Data sources for the study.

Sample size

Table 3. Sample size for frequency in a population.

Statistical methods

Ethical considerations

Discussion

Limitations

Scope and implications

Study status

Data availability

References

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