title: Environmental effects on WHODAS 2.0 among patients with stroke with a focus on ICF category e120.
abstract: OBJECTIVE
  To explore the environmental effects on the disabilities of people post stroke and to search for the best probabilistic cut-off value of the WHO Disability Assessment Schedule second edition (WHODAS 2.0) scores to predict people post stroke experiencing an access barrier to the International Classification of Functioning, Disability and Health category e120 products and technology for personal indoor and outdoor mobility and transportation (PMT).
  
  
  METHODS
  We analyzed data of 162 younger (aged 18-64 years) and 202 older (aged ≥65 years) people post stroke from the databank of persons with disability between June 1, 2011 and February 29, 2012. All participants rated each WHODAS 2.0 item with environmental intervention (performance score) and without any intervention (capacity score). We used the paired capacity-performance score difference to assess the whole environmental effects on the participants' disability, evaluated each participant's access barrier to PMT (negative PMT), and used a receiver-operating characteristic curve to predict patients having a negative PMT.
  
  
  RESULTS
  The whole environment acted as a barrier on mobility and self-care in >10 % of older people post stroke. Older patients having a summary index performance score of ≥78.8 points and younger patients having an index of ≥56.0 points were likely to experience a negative PMT. Older patients who have an access to PMT were possible to improve their daily activities performance, and younger patients could report less disability.
  
  
  CONCLUSIONS
  An environmental support to improve the PMT accessibility is important for people post stroke to reduce their disability.
authors.affiliation: Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan.
authors.forename: Kwang-Hwa
authors.initials: KH
authors.lastname: Chang
authors.forename: Yen-Nung
authors.initials: YN
authors.lastname: Lin
authors.forename: Hua-Fang
authors.initials: HF
authors.lastname: Liao
authors.forename: Chia-Feng
authors.initials: CF
authors.lastname: Yen
authors.forename: Reuben
authors.initials: R
authors.lastname: Escorpizo
authors.forename: Tze-Hsun
authors.initials: TH
authors.lastname: Yen
authors.forename: Tsan-Hon
authors.initials: TH
authors.lastname: Liou
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000145:classification* / Q000534:rehabilitation; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D064702:International Classification of Functioning, Disability and Health; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D011788:Quality of Life; D012372:ROC Curve; D012648:Self Care / Q000523:psychology / Q000706:statistics & numerical data; D012931:Social Environment; D020521:Stroke / Q000523:psychology; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D013624:Taiwan; D055815:Young Adult