A review of clinical outcome measures and proposed Active Prosthetic Users' Mobility Evaluation Tool Set (APUMET)

Assessing prosthetic patient outcomes pre to post intervention is crucial in determining future patient management and review of practice. An earlier piece of work looked at case-based outcomes of 21 transfemoral prosthetic users who transitioned from a standard mechanical knee joint to a microprocessor-controlled prosthetic intended for active patients requiring a higher level of functional ability. Results were generally positive, however, the set of 13 outcome measures used did not include patient satisfaction or goals. Additionally, strong and significant (p<0.05) correlations were measured between the Locomotor Capability Index (LCI-5) and Activity-specific Balance Confidence (ABC) Scale scores (ρ=0.855), Amputee Mobility Predictor (AMP) and LCI-5 (ρ=0.855), 10 metre timed walk test and L-Test of functional mobility (ρ=0.943) and the L-Test and 2 Minute Walk Test (2MWT) (ρ=-0.902), indicating possible redundancy. It was also noted that there was a lack of consensus regarding use of rehabilitation outcome measures, and the methods used to assess reliability, validity, consistency, ceiling and floor effects and the minimal clinically important difference. A review of existing outcome measures was undertaken and a toolset identified specifically for active amputees - the Active Prosthetic Users’ Mobility Evaluation Tool Set (APUMET). This includes the Prosthetic Evaluation Questionnaire, 2MWT, AMP, Gait Profile Score, Goal Attainment Scale, Activity Monitoring and Cognitive Demand Task Testing.