The Locomotor Capabilities Index-5 (LCI-5) is a validated measure of lower-limb amputees’ ability to perform activities with a prosthesis.
The LCI-5 showed high ability to detect change over time.
The proposed minimal clinically important difference values represent cutoffs that identify with great accuracy levels of true change in locomotor capability during prosthetic training.
To determine the sensitivity to change and minimal clinically important difference (MCID) for the self-administered Locomotor Capabilities Index-5 (LCI-5) in people with lower limb amputation undergoing prosthetic training.
Prospective single-group observational study.
The LCI-5 was administered to 110 patients (69 males [63%]; median [interquartile range] age, 60 [48–69] years) before and after prosthetic training. The external anchor administered after the program was a 7-point Global Rating of Change Scale (GRCS) designed to quantify the effect (improvement or deterioration) of the intervention.
Test–retest reliability of the LCI-5 (n=30) was high (intraclass correlation coefficient [ICC2,1]=0.92). The minimum detectable change at the 95% confidence level was 5.66 points. After triangulating these results with those of the mean-change approach and receiver operating characteristic (ROC) curve analysis (area under the ROC curve≥0.90), based on a different GRCS score splitting, we identified 2 cutoffs for the LCI-5: a change of 7 points, indicating the MCID, and 12 points, indicating “large improvement” in locomotor capabilities (12.5% and 21.4% of the maximum possible score, respectively).
The LCI-5 showed a high ability to detect change over time (responsiveness). The 2 proposed values (MCID of 7 points and large improvement of 12 points), based on a mix of distribution- and anchor-based approaches, represent cutoffs that can accurately identify 2 different levels of true change (as perceived by the patient) in locomotor capability after prosthetic training.Le texte complet de cet article est disponible en PDF.
Keywords : Lower-limb amputation, Leg prosthesis, Outcome assessment, Psychometrics, Rehabilitation, Prosthetic training