scholarly journals The L Test of Functional Mobility: Measurement Properties of a Modified Version of the Timed “Up & Go” Test Designed for People With Lower-Limb Amputations

2005 ◽  
Vol 85 (7) ◽  
pp. 626-635 ◽  
Author(s):  
A Barry Deathe ◽  
William C Miller
Keyword(s):  
Test Data ◽  
Lower Limb ◽  
Concurrent Validity ◽  
Intraclass Correlation ◽  
Functional Mobility ◽  
Self Report ◽  
Measurement Properties ◽  
Limb Amputation ◽  
Walk Test ◽  
Walk Tests

AbstractBackground and Purpose. Walk tests provide essential outcome information when assessing ambulation of individuals with lower-limb amputation and a prosthetic device. Existing tests have limitations such as ceiling effects or insufficient challenge. The objective of this study was to assess the reliability and validity of data for a clinical measure of basic mobility, the L Test of Functional Mobility (L Test). Subjects. For this methodological study, 93 people with unilateral amputations (74% transtibial, 26% transfemoral; 78% male, 22% female; mean age=55.9 years) were consecutively recruited from an outpatient clinic. Twenty-seven subjects returned for retesting. Methods. To assess concurrent validity, subjects completed the L Test, Timed “Up & Go” Test (TUG), 10-Meter Walk Test, and 2-Minute Walk Test, followed by the Activities-specific Balance Confidence scale, Frenchay Activities Index (FAI), and mobility subscale of the Prosthetic Evaluation Questionnaire (PEQ-MS). Amputation cause and level, walking aid use, automatic stepping, and age variables were used to assess discriminant validity. Results. Intraclass correlation coefficients were .96 for interrater reliability and .97 for intrarater reliability, and minimal bias existed upon retesting. The magnitude of concurrent validity correlations (r) was very high between the L Test data and data for other walk tests and fair to moderate between the L Test data and data for self-report measures. The L Test discriminated between all groups as hypothesized. Discussion and Conclusion. The L Test is a 20-m test of basic mobility skills that includes 2 transfers and 4 turns. It demonstrated excellent measurement properties in this study.

scholarly journals Co-relation of functional mobility with anxiety in traumatic below knee amputees

2021 ◽  
Vol 9 (5) ◽  
pp. 4013-4018
Author(s):  
Lavanya R Ayyer ◽  
◽  
Asmita C Moharkar ◽  
Keyword(s):  
Upper Limb ◽  
Lower Limb ◽  
Holistic Approach ◽  
The Body ◽  
Functional Mobility ◽  
Mental Wellbeing ◽  
Limb Amputation ◽  
Surgical Removal ◽  
Institutional Ethics ◽  
Restricted Mobility

Background: Amputation is defined as the surgical removal of one or more parts of the body. It causes great stress to the physical and mental wellbeing of an individual. The incidence of lower limb amputation is greater as compared to upper limb amputation. Also lower limb amputees experience more restricted mobility than upper limb amputee patients. Rehabilitation is an important to the recovery of an amputee. In cases of planned amputation, rehabilitation starts before the surgery. It involves physiotherapy, occupational therapy and recreational training. There is little to no studies on the co-relation of anxiety with functional mobility in amputees. This study focusses on the same. Context and purpose: Amputation causes restricted mobility and decreased quality of life. A study on the relation between anxiety and mobility will indicate a different outlook of a holistic approach while treating mobility issues in below knee amputees. Materials and methods: This is a one group co-relational study design. Study was conducted after taking approval from the institutional ethics committee and all the subjects gave their written informed consent. The study was conducted at Yashwantrao Chavan Memorial Hospital, Pune. Result: Statistical analysis of the data was done using the Pearson’s co-relation co-efficient and a co-relation was found between anxiety and functional mobility in below knee amputee patients. Conclusion: There is a co-relation between functional mobility and anxiety. Patients with anxiety showed a reduced performance on the functional mobility scale than the patients without anxiety. KEY WORDS: Amputation, Anxiety, below knee amputation, functional mobility, rehabilitation.

Prostheses Use and Satisfaction among People with Lower-limb Amputation in 10 districts of Bhutan

2019 ◽  
Vol 5 (2) ◽  
pp. 21-27
Author(s):  
Ugyen Norbu ◽  
Tandin Zangpo ◽  
Jit Bahadur Darnal ◽  
Hari Prasad Pokhrel ◽  
Roma Karki
Keyword(s):  
Service Delivery ◽  
Lower Limb ◽  
Cross Sectional Study ◽  
Functional Mobility ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Cross Sectional ◽  
Face To Face ◽  
Level Of Satisfaction ◽  
Lower Limb Prostheses

Introduction: The use of lower-limb prostheses restores functional mobility and improves quality of life for people with lower limb amputation. However, the use of prostheses is significantly impacted by users’ satisfaction with their prostheses and service delivery. Therefore, the excellence of prosthetic rehabilitation is not only assessed by the number of prostheses users but is also determined by the level of satisfaction with the prostheses and services received. The study was conducted to determine prostheses use and satisfaction among people with lower-limb amputation. Methods: A cross-sectional study was conducted among lower-limb prosthetic users in 10 districts of Bhutan. Data was collected by face-to-face interview using the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) questionnaire. Participants were recruited by purposive sampling. Results: The study found that 96.4% of persons with lower-limb amputation currently used prostheses and 79% of them have used it for more than 7 hours/day. However, 44% of prostheses needed repair. The total QUEST score of satisfaction was 4.0 (SD 0.5). Conclusion: Majority of lower-limb prostheses are in use and the users reported being quite satisfied with their prostheses and service delivery. The study recommends initiating follow-up services to improve prosthetic use and overall satisfaction scores for both prostheses and service delivery.

scholarly journals 751 Preoperative Factors Influencing Functional Rehabilitation After Major Lower Limb Amputation

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
S Premnath ◽  
M Cox ◽  
A Hostalery ◽  
G Kuhan ◽  
T Rowlands ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Lower Limb ◽  
Arterial Disease ◽  
Functional Mobility ◽  
Limb Amputation ◽  
P Value ◽  
Rehabilitation Centre ◽  
Functional Rehabilitation ◽  
Peripheral Arterial ◽  
Preoperative Factors

Abstract Introduction To identify the preoperative factors that influence functional rehabilitation after Major Lower Limb (MLL) amputation. Method This retrospective study analyzed all patients referred post-amputation to an amputee rehabilitation centre over a period of 1 year. The level of functional outcome at 6 and 12 months were recorded using SIGAM (Special Interest Group in Amputee Medicine) grading. Data on various preoperative factors were collected and analyzed for association with functional outcome. Results A total of 71 cases were analyzed. The mean age was 65.18 (range 24 - 91) years and 45 were males (63.4 %). Peripheral arterial disease was the major cause of amputation (80.3%). The level of amputation was above / through knee in 60.6%. Contralateral limb problems were present in 28.2%. Functional mobility was achieved by 38% of the MLL amputees within 6 months of rehabilitation, which increased to 46.5% at 12 months. Pre amputation mobility was a significant factor for a good functional outcome (p-value 0.002). An increasing value of BLARt (Blatchford Leicester Allman-Russell Tool) score showed a significant correlation with poor functional outcome. Conclusions Pre amputation mobility and BLARt score can be used in the prediction of functional outcome and can aid in better pre-operative decision making and rehabilitation planning.

Effects of including core strengthening exercise as part of a comprehensive rehabilitation programmes on people with lower-limb amputation: a pilot study

2021 ◽  
Vol 28 (3) ◽  
pp. 1-10
Author(s):  
Sofía Mosteiro-Losada ◽  
Silvia Varela ◽  
Oscar García-García ◽  
Iván Martínez-Lemos ◽  
Carlos Ayán
Keyword(s):  
Quality Of Life ◽  
Pilot Study ◽  
Range Of Motion ◽  
Lower Limb ◽  
Walking Speed ◽  
Exercise Programme ◽  
Functional Mobility ◽  
Lower Limb Amputation ◽  
Limb Amputation

Background/aims Exercise can be a useful rehabilitation approach for people with lower-limb amputation. However, there is a lack of research in this regard. The aim of this study was to analyse functional mobility, walking speed, range of motion and quality of life changes experienced by people with lower-limb amputation after taking part in a comprehensive exercise programme that included core strengthening exercises. Methods This was a pilot study including six individuals who carried out a comprehensive exercise programme, which was performed once a week for 5 months. During the first 2 weeks, the participants attended 1-hour sessions that focused on the execution of diaphragmatic breathing and body scheme exercises. From the fourth week until the end of the intervention, the sessions were much longer, and included a warm-up phase, two circuit training workouts for core strength and balance, and a final stretching routine. Results Significant improvements were found in the participants' functional mobility (P=0.007) and walking speed (P=0.001). The exercise intervention did not have a significant impact on the participants' range of motion and quality of life. Conclusions In a group of people with lower-limb amputation, the performance of a comprehensive exercise programme that included core strengthening, was found to be beneficial for functional mobility and walking speed, although no significant effect was observed for range of motion and quality of life measures.

scholarly journals Development and measurement properties of the Orthotics and Prosthetics Users’ Survey (OPUS): A comprehensive set of clinical outcome instruments

2003 ◽  
Vol 27 (3) ◽  
pp. 191-206 ◽  
Author(s):  
A. W. Heinemann ◽  
R. K. Bode ◽  
C. O'Reilly
Keyword(s):  
Quality Of Life ◽  
Construct Validity ◽  
Lower Limb ◽  
Item Difficulty ◽  
Research Programme ◽  
Self Report ◽  
Measurement Properties ◽  
Limb Function ◽  
Lower Limb Function

The need to measure and evaluate orthotics and prosthetics (O&P) practice has received growing recognition in the past several years. Reliable and valid self-report instruments are needed that can help facilities evaluate patient outcomes. The objective of this project was to develop a set of self-report instruments that assess functional status, quality of life, and satisfaction with devices and services that can be used in an orthotics and prosthetics clinic. Selecting items from a variety of existing instruments, the authors developed and revised four instruments that differentiate patients with varying levels of lower limb function, quality of life, and satisfaction with devices and services. Evidence of construct validity is provided by hierarchies of item difficulty that are consistent with clinical experience. For example, with the lower limb function instrument, running one block was much more difficult than walking indoors. The instruments demonstrate adequate internal consistency (0.88 for lower limb function, 0.88 for quality of life, 0.74 for service satisfaction, 0.78 for device satisfaction). The next steps in their research programme are to evaluate sensitivity and construct validity. The Orthotics and Prosthetics Users’ Survey (OPUS) is a promising self-report instrument which may, with further development, allow orthotic and prosthetic practitioners to evaluate the quality and effectiveness of their services as required by accreditation standards such as those of the American Board for Certification in Orthotics and Prosthetics that mandate quality assessment.

scholarly journals Suitability of ‘Guidelines for Screening of Prosthetic Candidates: Lower Limb’ for the Eastern Cape, South Africa: A qualitative study

2018 ◽  
Vol 74 (1) ◽  
Author(s):  
Luphiwo L. Mduzana ◽  
Surona Visagie ◽  
Gubela Mji
Keyword(s):  
Qualitative Study ◽  
Lower Limb ◽  
Resistance To Change ◽  
Occupational Therapists ◽  
Functional Mobility ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Western Cape ◽  
Eastern Cape ◽  
Group Discussions

Background: Major lower limb amputation has a severe impact on functional mobility. Mobility can be salvaged with a prosthesis, but this is not always the best option. It is often difficult to decide whether to refer someone for a prosthesis or not. A prosthetic screening tool ‘Guidelines for Screening of Prosthetic Candidates: Lower Limb’ was developed and is used for prosthetic prescription in parts of the Western Cape province of South Africa.Objectives: This study aimed to explore the suitability of the tool ‘Guidelines for Screening of Prosthetic Candidates: Lower Limb’ for use in the Eastern Cape province of South Africa.Method: A qualitative study was conducted with conveniently sampled occupational therapists (OTs) (n = 10), physiotherapists (PTs) (n = 12) and prosthetists (n = 6) in government employment in the Buffalo City Metro Municipality. Participants were trained in the use of the tool and used it for four weeks with patients. Their experiences of the tool were assessed through three focus group discussions with emergent themes being identified during inductive data analysis.Findings: Participants indicated that the tool could assist with prosthetic prescription, goal setting, communication and teamwork. They thought that the tool was multidisciplinary in nature, comprehensive and practical. Findings showed a lack of teamwork in this study setting. Resistance to change and a lack of time might also hamper implementation of the tool.Conclusion: The tool can assist with managing the backlog for prostheses and to guide prosthetic prescription in the Eastern Cape province.Clinical implications: A prosthesis can help to salvage functional mobility after lower limb amputation. However, not all people who had above knee amputation manage to walk with a prosthesis. The tool reported on in this article provides information that can guide prosthetic prescription and rehabilitation goals.

scholarly journals Locomotor Performance During Rehabilitation of People With Lower Limb Amputation and Prosthetic Nonuse 12 Months After Discharge

2016 ◽  
Vol 96 (7) ◽  
pp. 985-994 ◽  
Author(s):  
Caroline E. Roffman ◽  
John Buchanan ◽  
Garry T. Allison
Keyword(s):  
Lower Limb ◽  
Clinical Utility ◽  
Screening Tool ◽  
Area Under The Curve ◽  
Lower Limb Amputation ◽  
Step Test ◽  
Limb Amputation ◽  
Locomotor Performance ◽  
Walk Test ◽  
Four Square

AbstractBackgroundIt is recognized that multifactorial assessments are needed to evaluate balance and locomotor function in people with lower limb amputation. There is no consensus on whether a single screening tool could be used to identify future issues with locomotion or prosthetic use.ObjectiveThe purpose of this study was to determine whether different tests of locomotor performance during rehabilitation were associated with significantly greater risk of prosthetic abandonment at 12 months postdischarge.DesignThis was a retrospective cohort study.MethodData for descriptive variables and locomotor tests (ie, 10-Meter Walk Test [10MWT], Timed “Up & Go” Test [TUGT], Six-Minute Walk Test [6MWT], and Four Square Step Test [FSST]) were abstracted from the medical records of 201 consecutive participants with lower limb amputation. Participants were interviewed and classified as prosthetic users or nonusers at 12 months postdischarge. The Mann-Whitney U test was used to analyze whether there were differences in locomotor performance. Receiver operating characteristic curves were generated to determine performance thresholds, and relative risk (RR) was calculated for nonuse.ResultsAt 12 months postdischarge, 18% (n=36) of the participants had become prosthetic nonusers. Performance thresholds, area under the curve (AUC), and RR of nonuse (95% confidence intervals [CI]) were: for the 10MWT, if walking speed was ≤0.44 ms−1 (AUC=0.743), RR of nonuse=2.76 (95% CI=1.83, 3.79; P<.0001); for the TUGT, if time was ≥21.4 seconds (AUC=0.796), RR of nonuse=3.17 (95% CI=2.17, 4.14; P<.0001); for the 6MWT, if distance was ≤191 m (AUC=0.788), RR of nonuse=2.84, (95% CI=2.05, 3.48; P<.0001); and for the FSST, if time was ≥36.6 seconds (AUC=0.762), RR of nonuse=2.76 (95% CI=1.99, 3.39; P<.0001).LimitationsMissing data, potential recall bias, and assessment times that varied were limitations of the study.ConclusionsLocomotor performance during rehabilitation may predict future risk of prosthetic nonuse. It may be implied that the 10MWT has the greatest clinical utility as a single screening tool for prosthetic nonuse, given the highest proportion of participants were able to perform this test early in rehabilitation. However, as locomotor skills improve, other tests (in particular, the 6MWT) have specific clinical utility. To fully enable implementation of these locomotor criteria for prosthetic nonuse into clinical practice, validation is warranted.

scholarly journals Quantifying Step Count and Oxygen Consumption with Portable Technology during the 2-Min Walk Test in People with Lower Limb Amputation

Sensors ◽  
2021 ◽  
Vol 21 (6) ◽  
pp. 2080
Author(s):  
John D. Smith ◽  
Gary Guerra
Keyword(s):  
Oxygen Consumption ◽  
Lower Limb ◽  
Limb Amputation ◽  
Moderate Intensity ◽  
Walk Test ◽  
Activity Monitors ◽  
Step Counts ◽  
Oxygen Analyzer ◽  
Steady State Activity ◽  
Determine Step

Step counts and oxygen consumption have yet to be reported during the 2-min walk test (2MWT) test in persons with lower-limb amputations (LLA). The purpose of this study was to determine step counts and oxygen consumption during the 2MWT in LLA. Thirty-five men and women walked for two minutes as quickly as possible while wearing activity monitors (ActiGraph Link on the wrist (LW) and ankle (LA), Garmin vivofit®3 on the wrist (VW) and ankle (VA), and a modus StepWatch on the ankle (SA), and a portable oxygen analyzer. The StepWatch on the ankle (SA) and the vivofit3 on the wrist (VW) had the least error and best accuracy of the activity monitors studied. While there were no significant differences in distance walked, oxygen consumption (VO2) or heart rate (HR) between sexes or level of amputation (p > 0.05), females took significantly more steps than males (p = 0.034), and those with unilateral transfemoral amputations took significantly fewer steps than those with unilateral transtibial amputations (p = 0.023). The VW and SA provided the most accurate step counts among the activity monitors and were not significantly different than hand counts. Oxygen consumption for all participants during the 2MWT was 8.9 ± 2.9 mL/kg/min, which is lower than moderate-intensity activity. While some may argue that steady-state activity has not yet been reached in the 2MWT, it may also be possible participants are not walking as fast as they can, thereby misclassifying their performance to a lower standard.

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