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Psychosocial Impact of Assistive Devices

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Purpose

The PIADS is a 26-item self-reported questionnaire designed to assess the effects of an assistive device on functional independence, well-being and quality of life.

Link to Instrument

Acronym PIADS

Area of Assessment

Functional Mobility
General Health
Mental Health
Quality of Life

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Free

CDE Status

Not a CDE--last searched 2/27/2025

Diagnosis/Conditions

  • Multiple Sclerosis
  • Spinal Cord Injury
  • Stroke Recovery

Populations

Sensory Disorders
Spinal Injuries
Osteoarthritis
Non-Specific Patient Population
Multiple Sclerosis
Mixed Populations

Key Descriptions

  • It is a 26-item self-reported questionnaire based on three subscales: competence (12 items), adaptability (6 items) and self-esteem (8 items).
  • Competence subscale items:
    1) Competence
    2) Independence
    3) Adequacy
    4) Confusion
    5) Efficiency
    6) Productivity
    7) Usefulness
    8) Expertise
    9) Skillfulness
    10) Capability
    11) Quality of life
    12) Performance
  • Adaptability subscale items:
    1) Well-being
    2) Willingness to take chances
    3) Ability to participate
    4) Eagerness to try new things
    5) Ability to adapt to activities of daily living
    6) Ability to take advantage of opportunities
  • Self-esteem subscale items:
    1) Happiness
    2) Self-esteem
    3) Security
    4) Frustration
    5) Self-confidence
    6) Sense of power
    7) Sense of control
    8) Embarrassment
  • Each item is scored separately on a 7 point Likert Scale as follows
    A) ?3 (Maximum Negative Impact)
    B) ?2 and?1 (Somewhat Negative Impact)
    C) zero(No Impact)
    D) +1 and +2 (Somewhat Positive Impact)
    E) +3 (Maximum Positive Impact)
  • The Competence subscale score is derived by adding the values corresponding to items 1, 3, 4, 6, 8, 11, 13 ,14, 16, 17, and 18, subtracting the value corresponding to item 5, and dividing the total by 12.

    The Adaptability subscale score is derived by adding the values corresponding to items 15, 22, 23, 24, 25, and 26 and dividing the total by 6.

    The Self-esteem subscale score is derived by adding the values corresponding to items 2, 7, 9, 12, 19, and 20, subtracting the values corresponding to items 10 and 21, and dividing the total by 8.
  • PIADS comes with a manual that presents the conceptual basis and intended applications for the instrument, summarizes its measurement properties and describes its administration and scoring procedures in detail with examples. A glossary is also included to aid users in interpretation. The manual may be found by clicking on the "Link to Instrument" bar above.

Number of Items

26

Equipment Required

  • Paper
  • Pen
  • Telephone (if administered by phone)

Time to Administer

5-10 minutes

Required Training

Reading an Article/Manual

Age Ranges

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Initially reviewed by Pavni Shrivastava on 09/24/2014.

Updated 2/27/2025 by Brooke Pantano, PT, DPT and Francesca Kaspar, PT, DPT, Kessler Institute for Rehabilitation, Neuro Residency Program.

ICF Domain

Activity

Measurement Domain

Activities of Daily Living
Emotion
Cognition

Professional Association Recommendation

None found--last searched 2/27/2025

Considerations

The process of selecting an assistive device is very complex for persons with disabilities. PIADS can assist with this complex process particularly when used in conjunction with relevant modes of practice, occupation based assessments and assessments that are focused on matching the person’s physical abilities to a wheelchair.

Incorporating PIADS in follow up studies and evaluation in rehabilitation may lead to improved methods of supporting the users of assistive devices in the best way.

Utilizing PIADS will help clinicians in identifying patients who are likely to comply with assistive device use. PAIDS is best used in conjunction with occupation-based assessments.

Do you see an error or have a suggestion for this instrument summary? Please e-mail us!

Osteoarthritis

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Standard Error of Measurement (SEM)

Knee Osteoarthritis: (Harada et al., 2014; n = 53; mean age = 59.5 (8.6) years; Radiographic Kellgren-Lawrence scale knee OA grade >1)

  • SEM for competence subscale = 0.26 (calculated from statistics in Harada et al., 2014)
  • SEM for adaptability subscale = 0.38 (calculated from statistics in Harada et al., 2014)
  • SEM for self-esteem subscale= 0.36 (calculated from statistics in Harada et al., 2014)

Minimal Detectable Change (MDC)

Knee Osteoarthritis: (Harada et al., 2014)

  • MDC = 2.7 (calculated from statistics from Harada et al., 2014)

Internal Consistency

Knee Osteoarthritis (Harada et al., 2014)

  • Excellent internal consistency for the Competence, Adaptability, and Self-Esteem subscales overall, for cane users and non-users, and by sex. (Note: Scores higher than 0.9 may indicate redundancy in the scale questions.) 

Internal Consistency Coefficients for PIADS

 

 

 

 

 

PIADS sub scales

All subjects

Cane users

Cane non users

Males

Females

Competence

0.96

0.97

0.95

0.96

0.96

Adaptability

0.92

0.94

0.88

0.94

0.68

Self Esteem

0.92

0.94

0.90

0.92

0.91

Criterion Validity (Predictive/Concurrent)

Predictive Validity

Knee Osteoarthritis ( Harada et al., 2014; with 6 months of cane use)

  • Adequate predictive validity of PIADS adaptability subscale with use of cane for the 45-64 years old age group (r = 0.54)
  • Poor predictive validity of all PIADS subscales in adults 65 years and over (r range = -0.09-0.13)

Multiple Sclerosis

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Standard Error of Measurement (SEM)

Multiple Sclerosis: (Demers, 2002; n = 81; mean age 47.8 (9.4) years; Expanded Disability Status Scale (EDSS) score = 6.5 or more)

  • SEM = 0.76 

Minimal Detectable Change (MDC)

Multiple Sclerosis: (Demers, 2002)

  • MDC = 2.1 (calculated from statistics from Demers, 2002) 

Normative Data

Multiple Sclerosis: (Demers et al., 2002b; Total n = 83 (French Canadian speaking, n = 53 and mean age = 47.8 (range = 24-62); English Canadian speaking, n = 30 and mean age = 47.9 (range = 26-62)) 

  • Mean PIADS scores for French-speaking sample (n = 53): Competence = 1.41 (1.11), Adaptability = 1.21 (1.10), Self-esteem = 1.09 (1.08)
  • Mean PIADS scores for English-speaking sample (n = 30): Competence = 1.74 (.91), Adaptability = 1.43 (1.27), Self-esteem = 1.09 (1.12)

 

Multiple Sclerosis: (Devitt, 2003; n = 20; mean age = 53.4 years, Median months since wheelchair users: 42 months)

  • Mean PIADS scores: Competence = 1.54 (0.85), Adaptability = 1.64 (0.82), Self-esteem=1.06 (0.78)

Internal Consistency

Multiple Sclerosis (Demers et al , 2002a)

  • Excellent internal consistency (Cronbach’s alpha range 0.87-0.95*)

Multiple Sclerosis: (Demers et al., 2002b)

  • Excellent internal consistency (Cronbach’s alpha = 0.94*) for overall score and (0.91*, 0.81, and 0.80) for the Competency, Adaptability, and Self-esteem sub-scales, respectively, for French-speaking sample (n = 53)

*Scores higher than 0.9 may indicate redundancy in the scale questions.

Construct Validity

Discriminant Validity

Multiple Sclerosis (Demers et al , 2002a)

  • Principal components analysis (n = 146) showed the PIADS explained 61 % of the total variance.

Mixed Populations

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Standard Error of Measurement (SEM)

Multiple Neurologic Disorders: (Saeed et al, 2024; n = 19; age range = 18-60 years; assistive device use ≥ 6 months; MMSE score ≥ 23; Disorders represented: Cerebral Palsy (n = 4), Multiple Sclerosis (3), Spinal Cord Injury (9), Stroke (1), Concussion (1), and Parkinson’s Disease (1); Persian translation of PIADS) 

  • SEM for Competence subscale = 0.51
  • SEM for Adaptability subscale = 0.55
  • SEM for Self-esteem subscale = 0.47
  • SEM for average measure = 0.40

 

Minimal Detectable Change (MDC)

Multiple Neurologic Disorders: (Saeed et al, 2024)

  • MDC for Competence subscale = 1.4
  • MDC for Adaptability subscale = 1.5
  • MDC for Self-esteem subscale = 1.3
  • MDC for average measure = 1.1

 

Normative Data

Multiple Conditions (Spinal Cord Injury, Multiple Sclerosis, Cerebral Palsy, Thoracic Outlet Syndrome, Radiculopathy, Degenerative Spinal Condition, Rheumatoid arthritis)( De Rosier, 2004; n = 10; mean age = 43.9 (13.98) years; mean years of disability = 18.1)

  • Mean PIADS scores : Competence = 1.79, Adaptability = 1.79, Self-esteem=1.49 (De Rosier et al, 2004)
  • Mean PIADS scores : Competence = 2.32, Adaptability = 1.77, Self-esteem=1.67 (Burton et al, 2008)

Multiple Conditions: (Chae et al., 2014; n = 48; mean age = 35.7 (15.8) years; Conditions represented: Orthopedic (n = 18), Spinal Cord Injury (7), Hearing impairment (6), Vision impairment (3), Cognitive impairment (14); Korean sample and translation into K-PIADS)

  • Mean K-PIADS scores: Overall score = 1.21 (0.74), Competence = 1.16 (0.76), Adaptability = 1.00 (0.69), Self-esteem = 0.94 (0.78)

 

Multiple Conditions: (Diez et al., 2021; n = 417; mean age = 55.2(23) years; Conditions represented: Acquired brain injury (50), hearing loss (288), neurodegenerative diseases (20), neuromuscular disorders (60), Other diagnoses (9); Spanish translation of PIADS)

  • Mean PIADS scores: Competence = 1.13 (1.03), Adaptability = 1.32 (1.11), Self-esteem = 0.98 (1.11)

Assistive Technology Users: (Boyle et al, 2024; n = 67; age ≥ 18 years; disabilities included: blind/visual impairment (61%), physical disability (20%), deaf/hearing impairment (6%), and learning difficulty (13%); Arabic translation of PIADS into AR-PIADS)

  • Mean PIADS scores: Competence = 1.49 (0.42) and Self-esteem = 1.29 (0.56)

 

Test/Retest Reliability

Multiple Neurologic Disorders: (Tofani et al., 2020; n = 87; mean age = 33.35 (24.16) years; Conditions represented: Stroke (n =5), Spinal Cord Injury (25), Parkinson’s Disease (4), Children w/Cerebral palsy (38), Pediatric Traumatic Brain Injury (15); Italian translation of PIADS into IT-PAIDS)

  • Excellent test-retest reliability (ICC = 0.91) for the total score and (ICC = 0.96, 0.90, and 0.93) for the Competence, Adaptability, and Self-Esteem subscales, respectively.

Assistive Technology Users: (Boyle et al, 2024, n = 20)

  • Excellent  test-retest reliability (ICC = 0.94) for overall score and (ICC = 0.92 and 0.95) for the Competence and Self-esteem subscales, respectively.
  • Adequate  test-retest reliability (ICC = 0.76) for Adaptability subscale

 

 

Internal Consistency

Multiple Conditions: (Chae et al., 2014)

  • Excellent internal consistency (Cronbach’s alpha = 0.94*) for overall score and (α = 0.89, 0.95*, and 0.95*) for the Competency, Adaptability, and Self-esteem sub-scales, respectively

 

Multiple Conditions: (Diez et al., 2021)

  • Excellent internal consistency (Cronbach’s alpha = 0.96*) for overall score and (α = 0.93*, 0.90, and 0.87) for the Competency, Adaptability, and Self-esteem sub-scales, respectively

 

Multiple Neurologic Disorders: (Saeed et al., 2024)

  • Excellent internal consistency (Cronbach’s alpha = 0.90) for the competence subscale and (α = 0.85) for the self-esteem subscale.
  • Adequate internal consistency for the Adaptability subscale (α = 0.77)

Assistive Technology Users: (Boyle et al, 2024)

  • Excellent internal consistency (Cronbach’s alpha = 0.99*) for overall score and (α = 0.98*, 0.99*,  and 0.97*) for the Competency, Adaptability, and Self-esteem sub-scales, respectively

 

*Scores higher than 0.9 may indicate redundancy in the scale questions.

 

Criterion Validity (Predictive/Concurrent)

Predictive Validity

Stroke and Multiple Sclerosis: (Barett, 2010; n = 21 (stroke), 20 (MS); mean age of stroke patients = 62 (12) years, MS patients = 56 (6.9) years; mean years since stroke = 4.2 (3.87), MS = 10.7 (7.73))

  • Spearman’s rank order correlation coefficient values; changes in walking speed versus PIADS scores

Stroke

Training effect (ρ)

Orthotic effect (ρ)

Total Orthotic effect (ρ)

Competence

0.45 (0.03)

-0.06 (0.42)

-0.15 (0.27)

Adaptability

0.11 (0.32)

0.32 (0.11)

-0.08 (0.45)

Self-esteem

0.04 (0.44)

-0.08 (0.38)

-0.38 (0.06)

Multiple Sclerosis

Training effect r (p)

Orthotic effect r (p)

Total Orthotic effect r (p)

Competence

-0.17 (0.25)

-0.18 (0.025)

-0.32 (0.10)

Adaptability

0.25 (0.17)

0.2 (0.22)

0.23 (0.19)

Self-esteem

0.23 (0.19)

0.01 (0.48)

0.22 (0.20)

Content Validity

Assistive Technology Users: (Orellano and Jutai, 2013; n = 20; Mean age = 44.4 (12.0) years; age range = 22-63; translation of Spanish PIADS into Puerto Rican-Spanish PIADS (PR-PIADS))

Content validity of the Puerto Rican-Spanish PIADS (PR-PIADS) was determined by using a minimum CVR value of 0.42 or greater by a group of 20 panelists. Their analysis resulted in the additional semantic and conceptual modifications of four items (competence, efficiency, performance, and eager to take chances) that did not reach the minimum CVR value for inclusion in the PR-PIADS.

 

Spinal Injuries

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Normative Data

Cervical Spinal Cord Injury ( Rigby, 2005; n = 32; mean age = 39.7 years)

  • Mean PIADS scores for Assistive device users: Competence = 2.02 (0.77), Adaptability = 1.66 (0.86), Self-esteem = 2.03 (0.64)
  • Mean PIADS scores for Assistive device non- users: Competence = 1.99 (0.66), Adaptability = 1.64 (0.79), Self-esteem = 1.89 (0.69)

Non-Specific Patient Population

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Test/Retest Reliability

Eye Glass wear Users : (Day, 2002; n = 153)

  • Adequate test-retest reliability over two weeks test-retest interval: (ICC = 0.45)

Eye glass wear or contact users: (Hsieh and Lenker, 2006; n = 60; mean age = 28.24 (4.0) years; translation of PIADS into Chinese PIADS (C-PIADS))

  • Adequate  test-retest reliability (n = 30) (ICC = 0.88) for overall score and (ICC = 0.79, 0.88, and 0.86) for the Competence, Adaptability, and Self-esteem subscales, respectively.

 

Internal Consistency

Eye Glass wear Users : (Day, 2002)

  • Excellent internal consistency (Cronbach’s alpha = 0.95*)
  • Excellent internal consistency (Cronbach’s alpha= 0.75 to 0.94*) (Jutai et al, 2002)

Eye glass wear or contact users: (Hsieh and Lenker, 2006)

  • Excellent internal consistency (Cronbach’s alpha = .93*) for overall score and (α = 0.88 and 0.85) for the Competency and Adaptability sub-scales, respectively
  • Adequate internal consistency (α = 0.74) for the Self-esteem sub-scale

*Scores higher than 0.9 may indicate redundancy in the scale questions.

 

Criterion Validity (Predictive/Concurrent)

Concurrent Validity

Eye Glass wear Users : (Jutai et al., 2002)

  • Excellent concurrent validity (coefficient = 0.77 to 0.83)

Construct Validity

Discriminant Validity

Eye Glass wear Users : (Day et al., 1996; n = 153)

  • Positive correlation was established between total score on PIADS and Pleasure and Dominance on Mehrabian and Russell’s PIADS (coefficient not mentioned)

Content Validity

Eye Glass wear Users: (Day, 2002)

  • Content validity was established with discussion with people with disabilities. Items on the scale did represent both functional competence and quality of life, (r >0.20).

Sensory Disorders

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Normative Data

Visually Impaired: (Demers et al, 2002b; n = 37 (19 French-speaking Canadians, mean age = 56.1 (range = 32-80) and 18 bilingual Canadians, mean age = 61.9 (range = 42-86))

  • Mean PIADS scores for French-speaking sample (n = 19): Competence = 2.08 (0.61), Adaptability = 1.62 (0.75), Self-esteem = 1.73 (0.93)
  • Mean PIADS scores for bilingual sample (n = 18): Competence = 1.99 (0.83), Adaptability = 2.02 (0.83), Self-esteem = 1.59 (0.68)

 

Test/Retest Reliability

Visually Impaired: (Demers et al, 2002b)

  • Excellent  test-retest reliability (ICC = 0.90) for overall score and for the Competence subscale in French-speaking sample (n = 19)
  • Adequate  test-retest reliability (ICC = 0.77 and 0.88) for Adaptability and Self-esteem subscales, respectively, in French-speaking sample (n = 19)

 

Internal Consistency

Visually Impaired: (Demers et al, 2002b)

  • Excellent internal consistency (Cronbach’s alpha = 0.91*) for overall score and (.85) for the Competence subscale in joined samples (n = 37)
  • Adequate internal consistency (Cronbach’s alpha = 0.77 and 0.75) for Adaptability and Self-esteem subscales, respectively, in joined samples (n = 37)

*Scores higher than 0.9 may indicate redundancy in the scale questions.

 

Bibliography

Barrett, C., & Taylor, P. (2010). The Effects of the Odstock Drop Foot Stimulator on Perceived Quality of Life for People With Stroke and Multiple Sclerosis. Neuromodulation, 13(1), 58-64. doi:10.1111/j.1525-1403.2009.00250. 

Boyle, B., Arnedillo-Sanchez, I., Zahid, A., & Pennisi, Y. (2024). The Arabic psychosocial impact of assistive devices scale: Development, translation, and evaluation. Assistive Technology, 37:sup1, S105-S112. 

Burton, M., Nieuwenhuijsen, E., & Epstein, M. (2008). Computer-related assistive technology: satisfaction and experiences among users with disabilities. Assistive Technology, 20(2), 99-106. 

Chae, S. Y., & Jo, S. J. (2014). Development and validation of Korean version of psychosocial impact of assistive devices scale. Assistive Technology, 26(1), 45-50. 

Day, H., & Jutai, J. (1996). Measuring the psychosocial impact of assistive devices: The PIADS. Canadian Journal of Rehabilitation, 9, 159-168.

Day, H. H., Jutai, J. J., & Campbell, K. A. (2002). Development of a scale to measure the psychosocial impact of assistive devices: lessons learned and the road ahead. Disability & Rehabilitation, 24(1-3), 31-37. 

Day, H., Jutai, J., Woolrich, W., & Strong, G. (2001). The stability of impact of assistive devices. Disability & Rehabilitation, 23(9), 400-404. 

Demers, L., Monette, M., Lapierre, Y., Arnold, D. L., & Wolfson, C. (2002a). Reliability, validity, and applicability of the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0) for adults with multiple sclerosis. Disability & Rehabilitation, 24(1-3), 21-30. 

Demers, L., Monette, M., Descent, M., Jutai, J., & Wolfson, C. (2002b). The Psychosocial Impact of Assistive Devices Scale (PIADS): translation and preliminary psychometric evaluation of a Canadian–French version. Quality of life research, 11, 583-592.

DeRosier, R., & Farber, R. (2005). Speech recognition software as an assistive device: a pilot study of user satisfaction and psychosocial impact. Work, 25(2), 125-134. 

Devitt, R., Chau, B., & Jutai, J. (2003). The effect of wheelchair use on the quality of life of persons with multiple sclerosis. Occupational Therapy In Health Care, 17(3/4), 63-79. 

Díez, E., Jiménez-Arberas, E., & Pousada, T. (2021). Psychometric properties of the Spanish version of psychosocial impact of assistive devices scale in a large sample of people with neuromuscular, neurological, or hearing disabilities. Frontiers in Psychology, 12, 659562. 

Ding, D., Souza, A., Cooper, R. A., Fitzgerald, S. G., Cooper, R., Kelleher, A., & Boninger, M. L. (2008). A preliminary study on the impact of pushrim-activated power-assist wheelchairs among individuals with tetraplegia. American Journal of Physical Medicine & Rehabilitation, 87(10), 821-829. 

Harada, N., Fong, S., Heiney, C., Yentes, J. M., Perell-Gerson, K. L., & Fang, M. A. (2014). Evaluation of two cane instruments in older adults with knee osteoarthritis. Journal Of Rehabilitation Research & Development, 51(2), 275-283. 

Hsieh, Y. J., & Lenker, J. A. (2006). The psychosocial impact of assistive devices scale (PIADS): translation and psychometric evaluation of a Chinese (Taiwanese) version. Disability and rehabilitation: Assistive Technology, 1(1-2), 49-57. 

Jutai, J., & Day, H. (2002). Psychosocial impact of assistive devices scale (PIADS). Technology and Disability, 14(3), 107-111. 

Orellano, E. M., & Jutai, J. W. (2013). Cross-cultural adaptation of the psychosocial impact of assistive device scale (PIADS) for Puerto Rican assistive technology users. Assistive Technology, 25(4), 194-203. 

Pettersson, I., Ahlstr?m, G., & T?rnquist, K. (2007). The value of an outdoor powered wheelchair with regard to the quality of life of persons with stroke: a follow-up study. Assistive Technology, 19(3), 143-153. 

Rigby, P., Ryan, S., Joos, S., Cooper, B., Jutai, J., & Steggles, E. (2005). Impact of electronic aids to daily living on the lives of persons with cervical spinal cord injuries. Assistive Technology, 17 (2), 89-97. 

Saeed, S. S., Hejazi-Shirmard, M., Akbarzadeh Baghban, A., Jutai, J., & Rezaee, M. (25 Jun 2024). Translation and validation of the Persian version of “The Psychosocial Impact of Assistive Devices Scale” in patients with neurological disorders. Assistive Technology, 1-6. 

Tofani, M., Candeloro, C., Sabbadini, M., Lucibello, L., Figura, M., Fabbrini, G., ... & Castelli, E. (2020). The psychosocial impact of assistive device scale: Italian validation in a cohort of nonambulant people with neuromotor disorders. Assistive Technology, 32(1), 54-59. 

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