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Koenig KD, Hall MJ, Gormley C, Kaleta M, Munger M, Laine J, Morgan SJ. Clinical outcomes measurement in pediatric lower limb prosthetics: A scoping review. J Pediatr Rehabil Med 2024:PRM230014. [PMID: 38427511 DOI: 10.3233/prm-230014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2024] Open
Abstract
PURPOSE This study aimed to identify clinical measures that have been used to evaluate function, health related quality of life (HRQoL), and/or satisfaction in children who use lower limb prostheses (LLP). The data reported on psychometric properties for children who use LLP were collected for each measure. METHODS First, PubMed, CINAHL, and Web of Science databases were searched using broad search terms to identify standardized outcome measures of function, HRQoL, and/or satisfaction with treatment used in pediatric LLP research published in 2001 or after. For each of the eligible measures found, a second search was performed to identify psychometric properties (e.g., validity, reliability) assessed with children who use LLP. RESULTS Forty-four standardized outcome measures were identified from 41 pediatric LLP research articles. Five measures (i.e., Gait Outcomes Assessment for Lower Limb Differences, Functional Mobility Assessment, Child Amputee Prosthetics Project- Prosthesis Satisfaction Inventory, Child Amputee Prosthetics Project- Functional Scale Index, and Lower Limb Function Questionnaire) had data on psychometric properties for children who use LLP. CONCLUSIONS Few studies report psychometric data for assessing the overall HRQoL, function, and/or satisfaction for children who use LLP. Further research is needed to validate or create new outcome measures that assess the HRQoL, satisfaction, and/or function of children who use LLP.
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Affiliation(s)
- Kevin D Koenig
- Orthotics, Prosthetics, Seating, and Casting Department, Gillette Children's Specialty Healthcare, St. Paul, MN, USA
| | - Michelle J Hall
- Orthotics, Prosthetics, Seating, and Casting Department, Gillette Children's Specialty Healthcare, St. Paul, MN, USA
| | - Caroline Gormley
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Mary Kaleta
- Physical Therapy, Rady Children's Hospital, San Diego, CA, USA
| | - Meghan Munger
- Outcomes Department, Gillette Children's Specialty Healthcare, St. Paul, MN, USA
| | - Jennifer Laine
- Department of Orthopaedic Surgery, Gillette Children's Specialty Healthcare, St. Paul, MN, USA
- Orthopedics Department, University of Minnesota, Minneapolis, MN, USA
- Research Department, Gillette Children's Specialty Healthcare, St. Paul, MN, USA
| | - Sara J Morgan
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
- Research Department, Gillette Children's Specialty Healthcare, St. Paul, MN, USA
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
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Andrysek J, Michelini A, Eshraghi A, Kheng S, Heang T, Thor P. Functional outcomes and user preferences of individuals with transfemoral amputations using two types of knee joints in under-resourced settings. Prosthet Orthot Int 2021; 45:463-469. [PMID: 34538819 DOI: 10.1097/pxr.0000000000000043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 07/27/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Information relating to prosthetic performance can inform clinical practice and improve patient outcomes in under-resourced countries. OBJECTIVES The main goal of this study was to compare functional outcomes and user preferences of individuals with transfemoral amputations using common types of knee joints in an under-resourced country. STUDY DESIGN Prospective, longitudinal, before and after trial. METHODS Twenty individuals with unilateral transfemoral amputations from a center in Cambodia transitioned from a commonly used single-axis manually locking knee International Committee of the Red Cross (ICRC) to a more advanced multiaxis knee joint with stance control All-Terrain Knee (ATK). Data were collected for the ICRC knee joint and the ATK immediately after fitting, after acclimation, and as part of a long-term follow-up. A timed walk test assessed walking distance and efficiency. Mobility and user-preferences were evaluated through questionnaires. RESULTS Distance during the timed walk test was significantly higher for the ATK compared with ICRC (P < 0.001), with functional gains retained at follow-up. No differences were found for gait efficiency and the mobility questionnaires. All participants, except one, preferred the ATK prosthesis. Benefits included greater knee stability and fewer perceived knee collapses; however, some disliked the appearance of the ATK. CONCLUSIONS The findings suggest positive outcomes with prosthetic services in under-resourced regions and the ICRC system, as well as the potential for improved functional outcomes with more advanced multiaxis knee components.
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Affiliation(s)
- Jan Andrysek
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Alexandria Michelini
- Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Arezoo Eshraghi
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Sisary Kheng
- Exceed Worldwide, Lisburn Square, Lisburn, United Kingdon
| | - Thearith Heang
- Exceed Worldwide, Lisburn Square, Lisburn, United Kingdon
| | - Phearsa Thor
- Exceed Worldwide, Lisburn Square, Lisburn, United Kingdon
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Bakhsh HR, Kablan N, Alammar W, Tatar Y, Ferriero G. The client satisfaction with device: a Rasch validation of the Arabic version in patients with upper and lower limb amputation. Health Qual Life Outcomes 2021; 19:134. [PMID: 33906680 PMCID: PMC8077687 DOI: 10.1186/s12955-021-01773-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/19/2021] [Indexed: 02/07/2023] Open
Abstract
Background The Client Satisfaction with Devices (CSD) module of the Orthotics and Prosthetics Users’ Survey is an extensively used questionnaire that measures patients’ satisfaction with orthosis and prosthesis. However, the validated version for Arabic speakers (CSD-Ar) is only applicable for orthosis users. Objectives The aim of this study was to evaluate the psychometric proprieties of the CSD-Ar for prosthetics users. Methods The study used a convenience sample of prosthesis users from Saudi Arabia and Turkey (N = 183), who completed the CSD-Ar. The collected data were analysed using Rasch analysis to evaluate item fit, reliability indices, item difficulty, local item dependency, and differential item functioning (DIF) using WINSTEPS version 4.6.1. Results Based on the analysis, the four-response Likert-scale was acceptable, as shown by the category functioning test, All eight items did achieve a fit to the Rasch Model [(infit) and (outfit) mean-square 0.75 to 1.3]. Person separation reliability was 0.76, and item separation reliability was 0.94. A principal component analysis (PCA) showed satisfactory unidimensionality and no local item dependency. The DIF analysis showed no notable dependency among items on participant characteristics in terms of age, gender, duration of use, country, and level of amputation. Conclusion This study contributes to the confidence of using CSD-Ar to evaluate users’ satisfaction with different prostheses, affirming the need for further refinement of the quality of the outcome measure.
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Affiliation(s)
- Hadeel R Bakhsh
- Department of Rehabilitation, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Nilüfer Kablan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Medeniyet University, Istanbul, Turkey
| | - Walaa Alammar
- Department of Rehabilitation, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Yaşar Tatar
- Faculty of Sports Sciences, Marmara Üniversity, Istanbul, Turkey
| | - Giorgio Ferriero
- Physical and Rehabilitation Medicine Unit, Scientific Institute of Tradate, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Varese, Italy. .,Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy.
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Bane HM, Sheafer V, Rispin K. Face and content validity for the Wheelchair Satisfaction Questionnaire. Disabil Rehabil Assist Technol 2019; 16:545-549. [DOI: 10.1080/17483107.2019.1684579] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Vicki Sheafer
- School of Psychology and Counseling, LeTourneau University, Longview, TX, USA
| | - Karen Rispin
- Department of Biology, LeTourneau University, Longview, TX, USA
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Rispin KL, Hamm E, Wee J. Discriminatory validity of the Aspects of Wheelchair Mobility Test as demonstrated by a comparison of four wheelchair types designed for use in low-resource areas. Afr J Disabil 2017; 6:332. [PMID: 28936413 PMCID: PMC5594268 DOI: 10.4102/ajod.v6i0.332] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 05/02/2017] [Indexed: 11/19/2022] Open
Abstract
Background Comparative effectiveness research on wheelchairs available in low-resource areas is needed to enable effective use of limited funds. Mobility on commonly encountered rolling environments is a key aspect of function. High variation in capacity among wheelchair users can mask changes in mobility because of wheelchair design. A repeated measures protocol in which the participants use one type of wheelchair and then another minimises the impact of individual variation. Objectives The Aspects of Wheelchair Mobility Test (AWMT) was designed to be used in repeated measures studies in low-resource areas. It measures the impact of different wheelchair types on physical performance in commonly encountered rolling environments and provides an opportunity for qualitative and quantitative participant response. This study sought to confirm the ability of the AWMT to discern differences in mobility because of wheelchair design. Method Participants were wheelchair users at a boarding school for students with disabilities in a low-resource area. Each participant completed timed tests on measured tracks on rough and smooth surfaces, in tight spaces and over curbs. Four types of wheelchairs designed for use in low-resource areas were included. Results The protocol demonstrated the ability to discriminate changes in mobility of individuals because of wheelchair type. Conclusion Comparative effectiveness studies with this protocol can enable beneficial change. This is illustrated by design alterations by wheelchair manufacturers in response to results.
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Affiliation(s)
- Karen L Rispin
- Department of Biology, Tourneau University, United States
| | - Elisa Hamm
- Kinesiology Department, LeTourneau University, United States
| | - Joy Wee
- School of Rehabilitation Therapy, Queens University, Canada
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Rispin KL, Huff K, Wee J. Test-retest reliability and construct validity of the Aspects of Wheelchair Mobility Test as a measure of the mobility of wheelchair users. Afr J Disabil 2017; 6:331. [PMID: 28936412 PMCID: PMC5594269 DOI: 10.4102/ajod.v6i0.331] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 05/16/2017] [Indexed: 11/08/2022] Open
Abstract
Background The Aspects of Wheelchair Mobility Test (AWMT) was developed for use in a repeated measures format to provide comparative effectiveness data on mobility facilitated by different wheelchair types. It has been used in preliminary studies to compare the mobility of wheelchairs designed for low-resource areas and is intended to be simple and flexible enough so as to be used in low-technology settings. However, to reliably compare the impact of different types of wheelchairs on the mobility of users, a measure must first be a reliable and valid measure of mobility. Methods This study investigated the test–retest reliability and concurrent validity for the AWMT 2.0 as a measure of mobility. For reliability testing, participants in a low-resource setting completed the tests twice in their own wheelchairs at least one week apart. For concurrent validity, participants also completed the Wheelchair Skills Test Questionnaire (WST-Q), a related but not identical validated assessment tool. Results Concurrent validity was indicated by a significant positive correlation with an r value of 0.7 between the WST-Q capacity score and the AWMT 2.0 score. Test–retest reliability was confirmed by an intraclass correlation coefficient greater than 0.7 between the two trials. Conclusion Results support the preliminary reliability and validity of the AWMT 2.0, supporting its effectiveness in comparing the mobility provided by different wheelchair types. This information can be used to enable effective use of limited funds for wheelchair selection at individual and organisational scales.
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Affiliation(s)
- Karen L Rispin
- Department of Biology, LeTourneau University, United States
| | - Kara Huff
- School of Rehabilitation Therapy, LeTourneau University, United States
| | - Joy Wee
- School of Rehabilitation Therapy, Queen's University, Canada
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Sasaki K, Rispin K. Assessment of physiological performance and perception of pushing different wheelchairs on indoor modular units simulating a surface roughness often encountered in under-resourced settings. Assist Technol 2016; 29:173-180. [PMID: 27647438 DOI: 10.1080/10400435.2016.1216473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
In under-resourced settings where motorized wheelchairs are rarely available, manual wheelchair users with limited upper-body strength and functionalities need to rely on assisting pushers for their mobility. Because traveling surfaces in under-resourced settings are often unpaved and rough, wheelchair pushers could experience high physiological loading. In order to evaluate pushers' physiological loading and to improve wheelchair designs, we built indoor modular units that simulate rough surface conditions, and tested a hypothesis that pushing different wheelchairs would result in different physiological performances and pushers' perception of difficulty on the simulated rough surface. Eighteen healthy subjects pushed two different types of pediatric wheelchairs (Moti-Go manufactured by Motivation, and KidChair by Hope Haven) fitted with a 50-kg dummy on the rough and smooth surfaces at self-selected speeds. Oxygen uptake, traveling distance for 6 minutes, and the rating of difficulty were obtained. The results supported our hypothesis, showing that pushing Moti-Go on the rough surface was physiologically less loading than KidChair, but on the smooth surface, the two wheelchairs did not differ significantly. These results indicate wheelchair designs to improve pushers' performance in under-resourced settings should be evaluated on rough surfaces.
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Affiliation(s)
- Kotaro Sasaki
- a School of Engineering and Engineering Technology , LeTourneau University , Longview , Texas , USA
| | - Karen Rispin
- b Department of Biology , LeTourneau University , Longview , Texas , USA
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