Outcome Measure Consensus in Lower Limb Absence

2021 ◽  
Author(s):  
Gregory Halford
Keyword(s):  
Lower Limb ◽  
Outcome Measure

scholarly journals What matters to children with lower limb deformities: an international qualitative study guiding the development of a new patient-reported outcome measure

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Harpreet Chhina ◽  
Anne F. Klassen ◽  
Jacek A. Kopec ◽  
John Oliffe ◽  
Christopher Iobst ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Conceptual Framework ◽  
Lower Limb ◽  
Outcome Measure ◽  
Treatment Options ◽  
Patient Reported Outcome ◽  
Complication Rates ◽  
Patient Reported Outcome Measure ◽  
Patient Reported ◽  
Limb Deformities

Abstract Background Lower limb deformities include conditions such as leg length discrepancy, lower limb deficiency and associated angular and rotational deformities of the hips, knees, ankles and feet. Children with lower limb deformities often have physical limitations due to gait irregularities and pain. The differences in the appearance and function of their lower limbs can discourage participation in social, recreational and leisure activities, which may result in behavioural, emotional, psychological and social adjustment problems. The health-related quality of life (HRQL) of these children is often impacted due to the factors discussed above, as well as by the complex surgical procedures. Surgical treatment options for limb deformities in children vary from limb lengthening and reconstruction to amputation. The lack of evidence demonstrating superiority of either treatment options and their effect on HRQL limits the ability of healthcare providers to counsel families on the best evidence-based treatment option for them. This manuscript describes the international qualitative study which guided the development of a new patient-reported outcome measure (PROM). Individual semi-structured face-to-face interviews with children with lower limb deformities and their parents were conducted at five sites: Canada (2 sites), Ethiopia, India and the USA. Results Seventy-nine interviews were conducted at five international sites. Five main themes emerged from the qualitative interviews and formed the basis of the conceptual framework. These themes were: 1) appearance, 2) physical health, 3) psychological health 4) school and 5) social health. Conclusions Lower limb deformities have a substantial impact on the HRQL of children. The concepts of interest identified in our study were similar across children from all countries. The conceptual framework guided the development of outcome scales specific to these patients. The information about the impact of various treatment options on the HRQL of children with lower limb deformities, collected using this new PROM, could be used to inform parents and children about outcomes (physical, social, psychological) associated with specific treatment options. This information could supplement other objective outcome information (e.g., complication rates, how the leg will look, etc.) to help families to come to a more informed decision on a child’s course of treatment.

Timed walking test — an all-embracing outcome measure for lower-limb amputees?

1996 ◽  
Vol 10 (3) ◽  
pp. 227-232 ◽  
Author(s):  
D. Datta ◽  
R. Ariyaratnam ◽  
S. Hilton
Keyword(s):  
Lower Limb ◽  
Outcome Measure ◽  
Walking Test ◽  
Lower Limb Amputees

scholarly journals Patient-Reported Outcome Measure for Early Postoperative Recovery Following Lower Limb Arthroplasty: A Systematic Review

2016 ◽  
Vol 31 (12) ◽  
pp. 2933-2940 ◽  
Author(s):  
Louise H. Strickland ◽  
Thomas W. Hamilton ◽  
Crispin C. Jenkinson ◽  
David W. Murray ◽  
Hemant G. Pandit
Keyword(s):  
Systematic Review ◽  
Lower Limb ◽  
Outcome Measure ◽  
Patient Reported Outcome ◽  
Postoperative Recovery ◽  
Patient Reported Outcome Measure ◽  
Patient Reported

Palpating Ankle Pulses is Insufficient in Detecting Arterial Insufficiency in Patients with Leg Ulceration

1994 ◽  
Vol 9 (4) ◽  
pp. 170-172 ◽  
Author(s):  
C. J. Moffatt ◽  
M. I. Oldroyd ◽  
R. M. Greenhalgh ◽  
P. J. Franks
Keyword(s):  
Lower Limb ◽  
Outcome Measure ◽  
Arterial Disease ◽  
Ankle Brachial Pressure Index ◽  
Main Outcome Measure ◽  
Pressure Index ◽  
Poor Predictor ◽  
Pulse Palpation ◽  
District Nurses ◽  
Arterial Insufficiency

Objective: To investigate the ability of district nurses to detect lower limb arterial disease by palpation of ankle pulses. Design: Ankle pulse palpation of patients presenting with ulcerated limbs and comparison with Doppler ankle-brachial pressure index (ABPI). Patients: Sequential patients presenting to community ulcer clinics. Main outcome measure: Sensitivity and specificity of pulse palpation to detect arterial disease compared with ABPI. Results: Of 533 limbs with ulceration in 462 patients (mean age 74 years, 67% female), 167 (31%) had no detectable pulses at the ankle. Of the 93 limbs with ABPI <0.9, 34 (37%) had detectable pulses. Of those limbs with ABPI ≥ 0.9, 108 out of 440 (25%) had no detectable ankle pulses. Sensitivity for lack of pulses as a predictor of arterial disease (ABPI <0.9) was 63% with a specificity of 75% and positive predictive value of only 35%. Using only the absence of palpable pulses would lead to 37% of patients with arterial disease being treated inappropriately. Conclusion: Palpation of pedal pulses by community nurses is a poor predictor of leg arterial disease and must be used in combination with ABPI. Only when significant arterial disease is excluded should compression be applied.

scholarly journals Development of the Gait Outcomes Assessment List for Lower Limb Differences (GOAL-LD) Questionnaire:  A Child and Parent Reported Outcome Measure

2021 ◽  
Author(s):  
Jennifer A Dermott ◽  
Virginia Wright ◽  
Nancy M Salbach ◽  
Unni G Narayanan
Keyword(s):  
Lower Limb ◽  
Health Care Professionals ◽  
Outcome Measure ◽  
Outcomes Assessment ◽  
Psychometric Evaluation ◽  
Field Testing ◽  
Related Quality ◽  
Health Related ◽  
High Level

Abstract Background: To develop a priority-based patient/parent reported outcome measure for children with lower-limb differences (LD) by adapting the Gait Outcomes Assessment List (GOAL) questionnaire. Methods: Guided by a conceptual framework of patient priorities, the GOAL questionnaire was iteratively modified and its sensibility evaluated by field-testing it on children with LD, and their parents. Cognitive interviews were conducted with a subgroup of these children, and an e-survey administered to a multidisciplinary group of health care professionals with expertise in paediatric LD. Findings were integrated to create the final version of the GOAL-LD.Results: Twenty-five children (9-18 years), 20 parents, and 31 healthcare professionals evaluated the content and sensibility of the GOAL, with an emphasis on the relevance and importance of the items to patients’ health related quality of life (HRQL). This resulted in the retention of 26 of the original 50 items, elimination of 12, modification of 12, and addition of seven new items. The new 45-item GOAL-LD questionnaire was shown to be sensible and its content deemed important.Conclusions: The GOAL-LD questionnaire has a high level of face and content validity, and sensibility. It comprehensively captures the HRQL goals and outcomes that matter to children with LD and their parents. Following further psychometric evaluation, the GOAL-LD may serve as a much needed evaluate patient and parent reported outcome measure for this population.

scholarly journals Three measures of functional outcome for lower limb amputees: A retrospective review

1998 ◽  
Vol 22 (3) ◽  
pp. 178-185 ◽  
Author(s):  
S. P. Treweek ◽  
M. E. Condie
Keyword(s):  
Functional Outcome ◽  
Outcome Measures ◽  
Lower Limb ◽  
Barthel Index ◽  
Outcome Measure ◽  
Amputation Level ◽  
Functional Outcome Measure ◽  
Number Of Patients ◽  
Functional Outcome Measures ◽  
Lower Limb Amputees

Outcome measures are becoming increasingly important in health care. Functional outcome measures are of particular importance for lower limb amputees since much of the rehabilitation process is concerned with increasing mobility and personal independence. The Scottish Physiotherapy Amputee Research Group (SPARG) has used three measures of functional outcome: the Barthel Index, Russek's classification and the Locomotor Index. The review reported here involves 938 patients having a primary amputation at the transtibial or transfemoral level between October 1992 and July 1997. Differences in function due to age and level of amputation are well known clinically and the measures were compared by looking at their ability to detect these differences. The Barthel Index lacked sensitivity because of ceiling effects and should not be considered as a suitable functional outcome measure for amputee patients. Russek's classification does detect significant differences but requires a large number of patients making it unsuitable for single hospital investigations. The Locomotor Index demonstrates significant differences due to age and amputation level despite fewer patients being assessed by this measure during the period covered by this paper. The range of the Locomotor Index can be extended to cover more active amputees by considering its ‘advanced activities’ subscale separately. The Locomotor Index is a promising measure and should be considered by rehabilitation teams looking for a valid, reliable and sensitive functional outcome measure for use with lover limb amputees.

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