Validation of the orthotics and prosthetics user survey upper extremity functional status module in people with unilateral upper limb amputation (original) (raw)
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Archives of Physical Medicine and Rehabilitation, 2011
Østlie K, Franklin RJ, Skjeldal OH, Skrondal A, Magnus P. Assessing physical function in adult acquired major upper-limb amputees by combining the Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Questionnaire and clinical examination. Arch Phys Med Rehabil 2011;92: 1636-45. Objectives: To describe physical function in adult acquired major upper-limb amputees (ULAs) by combining selfassessed arm function and physical measures obtained by clinical examinations; to estimate associations between background factors and self-assessed arm function in ULAs; and to assess whether clinical examination findings may be used to detect reduced arm function in unilateral ULAs. Design: Survey: postal questionnaires and clinical examinations. Setting: Norwegian ULA population. Clinical examinations performed at 3 clinics. Participants: Questionnaires: population-based sample (nϭ224; 57.4% response rate). Clinical examinations: combined referred sample and convenience sample of questionnaire responders (nϭ70; 83.3% of those invited). Survey inclusion criteria: adult acquired major upper-limb amputation, resident in Norway, mastering of spoken and written Norwegian. Interventions: Not applicable. Main Outcome Measures: The Disabilities of the Arm, Shoulder and Hand (DASH) Outcome Questionnaire, and clinical examination of joint motion and muscle strength with and without prostheses. Results: Mean DASH score was 22.7 (95% confidence interval [CI], 20.3-25.0); in bilateral amputees, 35.7 (95% CI, 23.0 -48.4); and in unilateral amputees, 22.1 (95% CI, 19.8 -24.5). A lower unilateral DASH score (better function) was associated with paid employment (vs not in paid employment: adjusted regression coefficient [aB]ϭϪ5.40, Pϭ.033; vs students: aBϭϪ13.88, Pϭ.022), increasing postamputation time (aBϭϪ.27, Pϭ.001), and Norwegian ethnic-ity (aBϭϪ14.45, PϽ.001). At clinical examination, we found a high frequency of impaired neck mobility and varying frequencies of impaired joint motion and strength at the shoulder, elbow, and forearm level. Prosthesis wear was associated with impaired joint motion in all upper-limb joints (PϽ.006) and with reduced shoulder abduction strength (Pϭ.002). Impaired without-prosthesis joint motion in shoulder flexion (ipsilateral: aBϭ12.19, Pϭ.001) and shoulder abduction (ipsilateral: aBϭ12.01, Pϭ.005; contralateral: aBϭ28.82, Pϭ.004) was associated with increased DASH scores. Conclusions: Upper-limb loss clearly affects physical function. DASH score limitation profiles may be useful in individual clinical assessments. Targeted clinical examination may indicate patients with extra rehabilitational needs. Such examinations may be of special importance in relation to prosthesis function.
Arch Phys Med Rehabil, 2004
Objective: To evaluate the responsiveness to change and the floor and ceiling effects of the Houghton Scale. Design: One-week and 3-month test-retest to evaluate reliability, validity, and responsiveness to change. Setting: Amputee rehabilitation program. Participants: Persons (Nϭ125) with unilateral or bilateral lower-extremity amputation who were wearing a prostheses: 1 group (nϭ49) for the reliability component and another group (nϭ76) for the responsiveness and validity component. Interventions: Not applicable. Main Outcome Measures: Responsiveness to change, ceiling and floor effects, and reliability and convergent validity. Results: Evaluation of responsiveness to change (nϭ76) showed that the total score increased from a mean Ϯ standard deviation of 6.14Ϯ2.40 at discharge to 7.70Ϯ2.62 (PϽ.001) at follow-up 3 months later. Floor and ceiling effects were not detected for the overall score but were noted for the individual subscales. The internal consistency was moderate at discharge (Cronbach ␣ϭ.71) and follow-up (Cronbach ␣ϭ.70). The Houghton Scale correlated significantly, although moderately, with the physical composite score of the Medical Outcomes Study 36-Item Short-Form Health Survey (rϭ.393, PϽ.01) and the 2-minute walk test at admission (rϭ.620, PϽ.01) and discharge (rϭ.653, PϽ.01). The reliability (intraclass correlation coefficientϭ.96) of the Houghton Scale was high (nϭ49). Conclusions: The Houghton Scale is appropriately responsive to change in prosthetic use in individuals with lower-limb amputation after rehabilitation.
Evaluation of the validity of the prosthetic upper extremity functional index for children
Archives of Physical Medicine and Rehabilitation, 2003
Objective: To evaluate the validity of the Prosthetic Upper Extremity Functional Index (PUFI), a parent-and older childreport measure that evaluates the extent of Prosthetic limb use, ease of task performance with and without the prosthesis, and its usefulness. Design: Evaluation of discriminant validity (the PUFI's ability to detect differences between children), construct validity (between the parent-report PUFI and University of New Brunswick Test of Prosthetic Function [UNB Test]), and criterion validity (comparison of parent-report PUFI responses with an assessor's scores of a child's performance of PUFI activities). Setting: Four pediatric amputee clinics. Participants: Thirty-eight children, ages 3 to 18 years, with unilateral upper-extremity amputation and a prosthesis. Interventions: Not applicable. Main Outcome Measures: The PUFI and the UNB Test. Results: The PUFI differentiated between children in high and low UNB Test score categories, and between younger and older children's functional abilities. The extent of correlation between PUFI ratings and UNB skill of performance scores was moderate for "ease of performance" and "usefulness of prosthesis" categories (rϾ.47, PϽ.05). The level of agreement between parent report and observational assessment of PUFI skills was acceptable (weighted range, .44-.65). Conclusions: The PUFI showed acceptable validity and showed promise in identifying prosthetic skill and use in children of different ages and abilities.
Annals of Physical and Rehabilitation Medicine, 2019
Major lower limb amputation (LLA), defined by any level of amputation above the foot, leads to restricted mobility, which is a key component of health-related quality of life (HRQoL) in lower limb amputees (LLAs) [1-5]. The objectives and outcome of LLA rehabilitation vary between basic prosthesis use and household ambulation to the resumption of high-energy physical activities. Researchers and rehabilitation specialists search to improve the 20 treatments available, to extend degrees of freedom and to increase 21 the number of tasks that can be accomplished by LLAs while 22 wearing a prosthesis [6,7]. 23 Assessment of mobility by use of self-reporting instruments 24 is central to selecting, optimizing, and evaluating the effective-25 ness of prosthetic interventions for people with LLA [8,9]. A wide 26 range of measures specific or non-specific to LLA used for 27 measuring the mobility of LLAs are available [8,10]. Neverthe-28 less, only a small proportion are used regularly in clinical 29 practice. Various issues concerning their feasibility, interpret-30 ability, sensitivity to change, and psychometric testing interfere 31 with their use [8,10,11]. 32 Among self-reporting questionnaires, the Prosthetic-Profile-of-33 the-Amputee-Locomotor Capabilities Index (PPA-LCI) [12], the Annals of Physical and Rehabilitation Medicine xxx (2018) xxx-xxx
Physical, Mental, and Social Predictors of Functional Outcome in Unilateral Lower-Limb Amputees
Archives of Physical Medicine and Rehabilitation, 2003
Schoppen T, Boonstra A, Groothoff JW, de Vries J, Göeken LN, Eisma WH. Physical, mental, and social predictors of functional outcome in unilateral lower-limb amputees. Arch Phys Med Rehabil 2003;84:803-11.