Sensitivity to change and minimal clinically important difference of the Locomotor Capabilities Index-5 in people with lower limb amputation undergoing prosthetic training

2019 ◽  
Vol 62 (3) ◽  
pp. 137-141 ◽  
Author(s):  
Franco Franchignoni ◽  
Marco Traballesi ◽  
Marco Monticone ◽  
Andrea Giordano ◽  
Stefano Brunelli ◽  
...  
2014 ◽  
Vol 39 (6) ◽  
pp. 470-476 ◽  
Author(s):  
Paula W Rushton ◽  
William C Miller ◽  
A Barry Deathe

Background:The L Test is a reliable/valid clinical evaluation of mobility that measures walking speed in seconds. It can be used with individuals with lower limb amputation. Responsiveness of the L Test is not yet determined.Objectives:The purpose of this pilot study was to determine how well the L Test identified individuals with a lower limb amputation who have/have not undergone a minimal clinically important difference.Study design:Prospective follow-up study.Methods:In total, 33 individuals with lower limb amputation, deemed to require a major intervention, were recruited consecutively from a follow-up clinic. Participants completed the L Test at baseline and follow-up. A Global Rating Change scale was also completed at follow-up.Results:The participants had a mean age ± standard deviation of 60 ± 13.0 years, and 81.8% had a transtibial amputation. The mean ± standard deviation for the L Test change scores was 6.0 ± 13.9. The area under the curve was 0.67, and the minimal clinically important difference was 4.5 s.Conclusions:The L Test identified individuals as having an important clinical change. Results must be interpreted with caution, as the accuracy, based on the Global Rating Change scale, is low. Further inquiry into the L Test is encouraged.Clinical relevanceThe L Test can guide the clinical management of individuals with lower limb amputation. Results from this pilot study indicate that individuals with a lower limb amputation who improve by at least 4.5 s on the L Test after an intervention have likely undergone an important change. This result must be interpreted with caution given that the ability of the L Test to correctly identify individuals, who have and have not undergone an important change, using the Global Rating Change scale as the gold standard, is limited because this is a pilot study. It is plausible that the precision of the cut-point threshold could increase or decrease given a larger sample or when using a different method of identifying important clinical change.


BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
B Gwilym ◽  
C Waldron ◽  
E Thomas-Jones ◽  
P Pallmann ◽  
R Preece ◽  
...  

Abstract Introduction Major Lower Limb Amputation (MLLA) is a life changing event with significant morbidity and mortality. Inaccurate risk prediction can lead to poor decision making, resulting in delay to definitive surgery, or undertaking amputation when not in the patient’s best interest. We aim to answer: In adult patients undergoing MLLA for chronic limb threatening ischaemia or diabetes, how accurately do health care professionals prospectively predict outcomes after MLLA, and how does this compare to existing prediction tools? Methods A multicentre prospective observational cohort study is being delivered through the Vascular and Endovascular Research Network. Dissemination was via an existing network of contacts and social media. Consecutive data will be collected for seven months from site launch date, including demographic data and pre-operative outcome predictions from surgeons, anaesthetists, and allied healthcare professionals. Follow-up data will comprise 30-day (mortality, morbidity, MLLA revision, surgical site infection, and blood transfusion) and 1-year (mortality, MLLA revision and ambulation). The accuracy of surgeons’ predictions will be evaluated and compared to pre-existing risk prediction scoring tools. Results PERCEIVE launched on 01/10/2020 with 23 centres (16 UK, 7 international) registered to collect data. 50 other centres (27 UK, 23 international) have expressed interest/are pursuing local audit/ethical approval. We aim to collect data on clinicians estimate of outcomes for over 500 patients. Discussion This study will utilise a trainee research network to provide data on the accuracy of healthcare professionals’ predictions of outcomes following MLLA and compare this to the utility of existing prediction tools in this patient cohort.


Spinal Cord ◽  
2002 ◽  
Vol 40 (4) ◽  
pp. 174-177 ◽  
Author(s):  
A Cavigelli ◽  
R Fischer ◽  
V Dietz

PLoS ONE ◽  
2017 ◽  
Vol 12 (1) ◽  
pp. e0170705 ◽  
Author(s):  
Michael P. Dillon ◽  
Lauren V. Fortington ◽  
Muhammad Akram ◽  
Bircan Erbas ◽  
Friedbert Kohler

1996 ◽  
Vol 83 (1) ◽  
pp. 134-134 ◽  
Author(s):  
J. R. Kulkarni ◽  
C. Collin ◽  
J. Collin

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