Publication date: July 2018
Source: Archives of Physical Medicine and Rehabilitation, Volume 99, Issue 7
Author(s): Jaclyn Megan Sions, Emma Haldane Beisheim, Tara Jo Manal, Sarah Carolyn Smith, John Robert Horne, Frank Bernard Sarlo
Abstract
Objective
To determine whether differences in physical function, assessed via self-report questionnaires and physical performance tests, exist between individuals with lower-limb loss using a prosthetic device classified as a K3 versus a K4 functional level.
Design
Cross-sectional study.
Setting
A university physical therapy amputee clinic.
Participants
Participants (N=55) were included if they (1) were aged ≥18 years with a unilateral transfemoral or transtibial amputation; (2) were classified as K3 or K4 functional level; (3) completed all relevant outcome measures; and (4) were currently using a prosthesis.
Interventions
Not applicable.
Main Outcome Measures
Locomotor Capabilities Index (LCI), Prosthetic Evaluation Questionnaire–Mobility Section (PEQ-MS), Timed Up and Go (TUG), 10-Meter Walk Test (10MWT), Amputee Mobility Predictor (AMPPRO), and 6-Minute Walk Test (6MWT). K level was determined by group consensus based on a standardized clinical evaluation.
Results
After controlling for covariates, patients classified as K3 had slower TUG times (P=.002) and self-selected and fast gait speeds (P<.001), lower AMPPRO scores (P<.001), and walked shorter distances during the 6MWT (P=.003) when compared with patients classified as K4. No significant between-group differences for the LCI or PEQ-MS were found.
Conclusions
Clinicians involved in prosthetic prescription may consider including the TUG, 10MWT, AMPPRO, and 6MWT during their clinical evaluations to help differentiate between individuals of higher functional mobility. The LCI and PEQ-MS may be less useful in classifying individuals as K3 versus K4 because of a ceiling effect.
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