Outcome measures used in lower extremity amputation: Review of clinical use and psychometric properties
Keywords:Amputation, Lower extremity, Outcome assessment, health care, Psychometrics
Decreased mobility and negative effects of poor functional status (FS) significantly reduce the quality of life in individuals with lower extremity amputation (LEA). These parameters should be evaluated in detail, and FS should be revealed. Measuring the results is important in terms of enabling clinicians to evaluate the quality of care and the effectiveness of treatment. The fact that the measurements are not purposeful makes the obtained results (evidence) and consecutively treatments unreliable. To obtain valid and reliable results, it is important to use measurement tools that are valid and reliable. Considering all these, the current FS should be evaluated using valid and reliable outcome measures (OMs). Numerous OMs are used to evaluate the FS of individuals with LEA. The multiplicity of available criteria, when coupled with the concept of multidimensional FS, complicates the selection of appropriate OMs for use with this population. Resources providing information about OMs used in the domain of LEA are limited in the literature. Many of the commonly used OMs are not included in the available sources. This review is designed to provide up-to-date information on clinical suitability and psychometric properties of OMs used in individuals with LEA. We believe that this study will help healthcare professionals serving in the field of LEA and prosthetics to learn about and choose the appropriate OMs.
Gordon R, Magee C, Frazer A, Evans C, McCosker K. An interim prosthesis program for lower limb amputees: comparison of public and private models of service. Prosthet Orthot Int. 2010;34(2):175-83.
Liedberg E, Persson BM. Increased incidence of lower limb amputation for arterial occlusive disease. Acta Odontol. Scand. 1983;54(2):230-4.
Agrawal V. Clinical outcome measures for rehabilitation of amputees: a review. Phys Med Rehabil Int. 2016;3(2):1080-4.
Deathe B, Miller WC, Speechley M. The status of outcome measurement in amputee rehabilitation in Canada. Arch Phys Med Rehab. 2002;83(7):912-8.
Ustun TB, Chatterji S, Bickenbach J, Kostanjsek N, Schneider M. The International Classification of Functioning, Disability and Health: a new tool for understanding disability and health. Disabil Rehabil. 2003;25(11-12):565-71.
Kane RL. Approaching the outcomes question. In: Kane RL edt. Understanding health care outcomes research. 1st ed. Canada: Jones and Bartlett Publishers; 1997. pp. 1-15.
Daltroy LH, Larson MG, Eaton HM, Phillips CB, Liang MH. Discrepancies between self-reported and observed physical function in the elderly: the influence of response shift and other factors. Soc Sci Med. 1999;48(11):1549-61.
Reuben DB, Seeman TE, Keeler E, Hayes RP, Bowman L, Sewall A, et al. Refining the categorization of physical functional status: the added value of combining self-reported and performance-based measures. J Gerontol A Biol Sci Med Sci. 2004;59(10):1056-61.
Heinemann AW, Connelly L, Ehrlich-Jones L, Fatone S. Outcome instruments for prosthetics: clinical applications. Phys Med Rehabil Clin N Am. 2014;25(1):179-98.
Akturk Z, Acemoglu H. [Reliability and Validity in Medical Research]. Dicle Tıp Dergisi. 2012;39(2):316-9.
Hebert JS, Wolfe DL, Miller WC, Deathe AB, Devlin M, Pallaveshi L. Outcome measures in amputation rehabilitation: ICF body functions. Disabil Rehabil. 2009;31(19):1541-54.
Miller WC, Deathe AB, Speechley M. Psychometric properties of the activities-specific balance confidence scale among individuals with a lower-limb amputation. Arch Phys Med Rehab. 2003;84(5):656-61.
Sakakibara BM, Miller WC, Backman CL. Rasch analyses of the activities-specific balance confidence scale with individuals 50 years and older with lower-limb amputations. Arch Phys Med Rehab. 2011;92(8):1257-63.
Wong CK, Gibbs W, Chen ES. Use of the Houghton scale to classify community and household walking ability in people with lower-limb amputation: criterion-related validity. Arch Phys Med Rehab. 2016;97(7):1130-6.
Bayramlar K, Bumin G, Yakut Y, Sener G. [Validity of Turkish version of the amputee body image scale (ABIS)]. Fizyoter Rehabil. 2007;18(2):79-83.
Bumin G, Bayramlar K, Yakut Y, Sener G. Cross cultural adaptation and reliability of the Turkish version of amputee body image scale (ABIS). J Back Musculoskelet Rehabil. 2009;22(1):11-6.
Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the hospital anxiety and depression scale: an updated literature review. J Psychosom Res. 2002;52(2):69-77.
Singh R, Hunter J, Philip A. The rapid resolution of depression and anxiety symptoms after lower limb amputation. Clin Rehabil. 2007;21(8):754-9.
Yilmaz H, Gafuroglu U, Ryall N, Yuksel S. Establishing the Turkish version of the SIGAM mobility scale, and determining its validity and reliability in lower extremity amputees. Disabil Rehabil. 2018;40(3):346-52.
Franchignoni F, Giordano A, Ferriero G, Orlandini D, Amoresano A, Perucca L. Measuring mobility in people with lower limb amputation: Rasch analysis of the mobility section of the prosthesis evaluation questionnaire. J Rehabil Med. 2007;39(2):138-44.
Resnik L, Borgia M. Reliability of outcome measures for people with lower-limb amputations: distinguishing true change from statistical error. Phys Ther. 2011;91(4):555-65.
Miller WC, Deathe AB, Speechley M. Lower extremity prosthetic mobility: a comparison of 3 self-report scales. Arch Phys Med Rehab. 2001;82(10):1432-40.
Condie E, Jones D, Treweek S, Scott H and Scottish Physiotherapy Amputee Research Group (SPARG). A one-year national survey of patients having a lower limb amputation. Physiotherapy. 1996;82(1):14-20.
Safaz I, Goktepe AS, Yilmaz B, Taskaynatan MA, Yazıcıoglu K. Reliability of locomotor capabilities index, Houghton Scale in young people with lower limb amputation. JPMR Sci. 2009;12:15-8.
Topuz S, Ulger O, Yakut Y, Gul Sener F. Reliability and construct validity of the Turkish version of the trinity amputation and prosthetic experience scales (TAPES) in lower limb amputees. Prosthet Orthot Int. 2011;35(2):201-6.
Gallagher P, Franchignoni F, Giordano A, MacLachlan M. Trinity amputation and prosthesis experience scales: a psychometric assessment using classical test theory and rasch analysis. Am J Phys Med Rehabil. 2010;89(6):487-96.
Heinemann AW, Bode RK, O'reilly C. Development and measurement properties of the orthotics and prosthetics users’ survey (OPUS): a comprehensive set of clinical outcome instruments. Prosthet Orthot Int. 2003;27(3):191-206.
Bilodeau S, Hebert R, Desrosiers J. Questionnaire on the satisfaction of persons with lower-limb amputations towards their prosthesis: development and validation. Can J Occup Ther. 1999;66(1):23-32.
Simsek IE, Sener G, Yakut Y. [Validity and reliability of Turkish version of satisfaction with the prosthesis questionnaire in unilateral lower extremity amputees: a pilot study]. Fizyoter Rehabil. 2010;21(2):81-6.
Hafner BJ, Gaunaurd IA, Morgan SJ, Amtmann D, Salem R, Gailey RS. Construct validity of the prosthetic limb users survey of mobility (PLUS-M) in adults with lower limb amputation. Arch Phys Med Rehab. 2017;98(2):277-85.
Gailey RS, Roach KE, Applegate EB, Cho B, Cunniffe B, Licht S, et al. The amputee mobility predictor: an instrument to assess determinants of the lower-limb amputee's ability to ambulate. Arch Phys Med Rehab. 2002;83(5):613-27.
Gailey R, Gaunaurd I, Raya M, Roach K, Linberg AA, Campbell SM, et al. Development and reliability testing of the comprehensive high-level activity mobility predictor (CHAMP) in male servicemembers with traumatic lower-limb loss. J Rehabil Res Dev. 2013;50(7):905-18.
Gailey RS, Scoville C, Gaunaurd IA, Raya MA, Linberg AA, Stoneman PD, et al. Construct validity of comprehensive high-level activity mobility predictor (CHAMP) for male service members with traumatic lower limb loss. J Rehabil Res Dev. 2013;50(7):919-30.
Major MJ, Fatone S, Roth EJ. Validity and reliability of the berg balance scale for community-dwelling persons with lower-limb amputation. Arch Phys Med Rehab. 2013;94(11):2194-202.
Medbø JI, Burgers SIMONE. Effect of training on the anaerobic capacity. Med Sci Sports Exerc. 1990;22(4):501-7.
Van de Meent H, Hopman MT, Frölke JP. Walking ability and quality of life in subjects with transfemoral amputation: a comparison of osseointegration with socket prostheses. Arch Phys Med Rehab. 2013;94(11):2174-8.
Lin SJ, Bose NH. Six-minute walk test in persons with transtibial amputation. Arch Phys Med Rehab: 2008;89(12):2354-9.
Kark L, McIntosh AS, Simmons A. The use of the 6-min walk test as a proxy for the assessment of energy expenditure during gait in individuals with lower-limb amputation. Int J Rehabil Res. 2011;34(3):227-34.
Brooks D, Hunter JP, Parsons J, Livsey E, Quirt J, Devlin M. Reliability of the two-minute walk test in individuals with transtibial amputation. Arch Phys Med Rehab. 2002;83(11):1562-5.
Butland RJ, Pang JACK, Gross ER, Woodcock AA, Geddes DM. Two, six, and 12-minute walking tests in respiratory disease. BMJ (Clinical research ed.). 1982;284(6329):1607-8.
Demirdel S, Erbahceci F. [An investigation of the effects of dual task on gait in people with trasfemoral amputation]. Turk J Physiother Rehabil. 2017;28(3):118-24.
Ulger O, Topuz S, Bayramlar K, Erbahceci F, Yakut Y, Sener G. [A comparison of traditional gait training versus gait training on the Biodex Gait Trainer 2TM in transtibial amputees]. Fizyoter Rehabil. 2009;20(2):70-5.
Kanatlı U, Yetkin H, Songur M, Ozturk A, Bolukbasi S. [Orthopedic applications of walking analysis]. TOTBİD Dergisi. 2006;5(1-2):53-9.
Yavuzer G. [Gait analysis and basic concepts]. TOTBİD Dergisi. 2014;13:304-8.
Segal AD, Orendurff MS, Klute GK, McDowell ML, Pecoraro JA, Shofer J, et al. Kinematic and kinetic comparisons of transfemoral amputee gait using C-Leg and Mauch SNS prosthetic knees. J Rehabil Res Dev 2006;43(7):857-70.
Schoppen T, Boonstra A, Groothoff JW, de Vries J, Göeken LNH, Eisma WH. The timed “up and go” test: reliability and validity in persons with unilateral lower limb amputation. Arch Phys Med Rehab. 1999;80(7):825-8.
Deathe AB, Miller WC. The L test of functional mobility: measurement
properties of a modified version of the timed “up and go” test designed for people with lower-limb amputations. Phys Ther. 2005;85(7):626-35.
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