COSMIN database

Selection of outcome measures in lower extremity amputation rehabilitation: ICF activities

Deathe, A. B., Wolfe, D. L., Devlin, M., Hebert, J. S., Miller, W. C., and Pallaveshi, L.
PURPOSE: To identify and evaluate the lower extremity amputee (LEA) rehabilitation outcome measurement instruments that quantify those outcomes that have been classified within the ICF category of activities. This was done to assist the clinicians in the selection of the most appropriate instrument based upon four determinants of successful LEA rehabilitation and outcome measurement.

METHOD: A systematic review of the literature associated with outcome measurement in LEA rehabilitation was conducted. Only articles containing data related to metric properties (reliability, validity or responsiveness) for an instrument were included. Articles were identified by electronic and hand-searching techniques and were subsequently classified first according to the ICF and then by their clinical use.

RESULTS: Seventeen instruments were identified that were classified into one of (A) walk tests, (B) mobility grades and (C) indices (generic and amputee-specific). Evidence about metric properties and clinical utility was summarised in tables which formed the basis for conclusions and recommendations pertaining to LEA rehabilitation.

CONCLUSIONS: All instruments examined have the potential for some use within the initial rehabilitation trial following amputation. There is a universal absence of quality evidence demonstrating responsiveness and most instruments would benefit from further investigation to better define their optimal use.
Disabil Rehabil
0963-8288 (Print)
Publication year:
Functional status:
Physical functioning
Adults (18-65)
Children (0-18)
Seniors (65+)
Injury, poisoning and certain other consequences of external causes
PRO / non-PRO:
Non-patient Reported Outcome
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
2 - Interviews
4 - Performance-based tests
6 - Clinical rating scales
7 - Observations
10MWT - 10 Meter Walk Test   
2MWT - 2-Minute Walk Test   
AAS - Amputee Activity Score
AMP - Amputee Mobility Predictor
BI - Barthel Index   
CAPP-FSI - Child Amputee Prosthetics Projects-Functional Status Instruments
COVS - Clinical Outcome Variables Scale
FIM - Functional Independence Measure (Also modified version exists)
Houghton Scale
LCI - Locomotor Capabilities Index
L Test
PEQ-MS - Prosthetic Evaluation Questionnaire-Mobility Subscale
Q-TFA - Questionnaire for persons with TransFemoral Amputations
RMI - Rivermead Mobility Index   
SIGAM - Special Interest Group in Amputee Medicine (SIGAM) mobility grades questionnaire
TUG - Timed Up and Go test   
WST - Wheelchair Skills Test