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Outcomes and evaluation in lower limb amputees - 26/09/17

Doi : 10.1016/j.rehab.2017.07.008 
Isabelle Loiret , Noël Martinet, Jean Paysant
 Institut régional de réadaptation, centre Louis-Pierquin, Nancy, France 

Corresponding author.

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Riassunto

Objective

Assessment is part of our professional practices. Moreover, the arrival of several new microprocessor prosthetic knee and bionic prosthetic feet requires lower limb amputee assessment particularly to help rehab professionals to prescribe devices considering the amputee life project. Amputee evaluation, wearing or not a lower limb prosthesis, is organised according 3 axes: prosthesis assessment (technology), amputee assessment (deficiency, satisfaction) and the “amputee-prosthesis” couple assessment in terms of capability and disability. The aim of the study was to realize a review of the literature over the last 10 years to define the significant outcomes in lower limb amputees.

Material/patients and methods

Medline, Reedoc, Scopus were interviewed between January 2006 and September 2016 with the following words: lower limb amputee, lower limb amputation, survey, questionnaire, evaluation, assessment, outcome and their equivalent in French. Only studies in English and in French were selected. Self-reports and clinical tests assessing mobility and balance were included. Instrumental objective measures (biomechanics, kinematics, and energetics) realized with motion capture optoelectronic systems or with wearable systems were not retained.

Results

More than 52 different outcomes (either generic or specific) were found. These outcomes covered a wide range of assessment such as mobility, balance, satisfaction, coping strategy, quality of life or body image. Questionnaires and clinical tests were listed from the most to the less used. The clinical test AMP-Pro (amputee mobility predictor) evaluates the predicted mobility of amputee with and without a prosthesis. By differentiating Medicare Functional Classification Level, this test is already used for feet prescription in the USA. Several specific self-reports are available in French as Amputee Body Image Scale (ABIS), Trinity Amputation Prosthetics Profil Evaluation Scale (TAPES) or Special Interest Group in Amputee Medicine mobility grades (SIGAM).

Discussion, conclusion

In lower limb amputees, many specific or generic outcomes could be used either in clinical purpose–help for rehab professionals to prescribe devices, follow-up–or in clinical research–cohort follow-up, devices evaluation by the couple “amputee-prosthesis” assessment–. Minimum detectable change for the dedicated population as well as psychometric properties like ceiling or floor effect must be considered for their “good use”. Moreover, questionnaires are increasingly available in French.

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Keywords : Lower limb amputees, Outcomes, Evaluation, Self-reports, Clinical tests


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