Brazilian version of the ACTIVLIM: translation, cultural adaptation, and validation for neuromuscular disorders

Abstract

Background

The Activity Limitation Measure (ACTIVLIM) is a self-reported instrument consisting of 22 daily activity items graded on 3 levels (easy, difficult, or impossible).

Objective

To translate, culturally adapt, and validate the Brazilian Portuguese version of the ACTIVLIM for individuals with neuromuscular disorders.

Methods

The present was a cross-sectional observational study. The translation process followed standardized guidelines, including steps such as forward translation, synthesis, back-translation, expert committee review, and pretesting (psychometric analysis). A total of 268 individuals with neuromuscular disorders filled out the Brazilian ACTIVLIM. Test-retest reliability was assessed in a subgroup of 60 participants, who were evaluated twice by the same physiotherapist with an interval of one month.

Results

The intraclass correlation coefficient (ICC) for intrarater reliability was of 0.95. Internal consistency was high (Cronbach's alpha = 0.940). External validity showed strong correlations involving ACTIVLIM scores and the scores on the Vignos scale (r = −0.907), the Brooke scale (r = −0.908), and the Functional Independence Measure (r = 0.864), all with p < 0.001. Proximal muscle strength in the upper (r = 0.748) and lower limbs (r = 0.793), measured through the Medical Research Council scale, also correlated significantly with ACTIVLIM scores. Linear regression identified that the scores on the Vignos (R² = 0.8236), and Brooke scales (R² = 0.8132), as well as proximal muscle strength in the lower (R² = 0.6480) and upper limbs (R² = 0.5805), were the main predictors of ACTIVLIM variance.

Conclusion

The Brazilian Portuguese version of the ACTIVLIM demonstrated strong reliability and validity. Its scores were significantly associated with disability level, functional independence, and muscle strength in individuals with neuromuscular disorders.

Keywords

Motor Activity - International Classification of Functioning, Disability and Health - Motor Neuron Disease - Neuromuscular Junction Diseases - Social Participation

Authors' Contributions

Conceptualization: ACCS, MCV; Data curation: ACCS, DMA, NBP, MCV; Formal analysis: ACCS, MCV; Methodology: ACCS, MCV; Supervision: AMSS, EZ, MCV; Writing - original draft: ACCS, MCV; Writing - review & editing: ACCS, MCV.

Data Availability Statement

Data will be available upon request to the corresponding author.

Editor-in-Chief: Hélio A. G. Teive (ORCID: 0000-0003-2305-1073).

Associate Editor: Paulo José Lorenzoni (ORCID: 0000-0002-4457-7771).

Publikationsverlauf

Eingereicht: 23. Juni 2025

Angenommen: 10. Oktober 2025

Artikel online veröffentlicht:
25. Januar 2026

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