Trinity Amputation Research Articles

Reliability and Validity of the Turkish Version of the Comprehensive Lower Limb Amputee Socket Survey

Purpose: The aim of this study was to translate the Comprehensive Lower Limb Amputee Socket Survey (CLASS) into Turkish and examine its reliability and validity in lower limb amputees. Material and Methods: This cross-sectional study included 97 lower limb amputees. Cronbach's alpha coefficient was used to evaluate internal consistency, and intraclass correlation coefficient was used to evaluate test-retest reliability. The retest of the CLASS was applied one week later. The satisfaction with the prosthesis subscale of the Trinity Amputation and Prosthesis Experience Scale (TAPES) was used to assess convergent validity. Results: The mean age of the participants was 46.78±15.04 years and 71.1 % were male. Internal consistency was found to be high for all domains of the Turkish CLASS (Cronbach's alpha ranged from 0.81 to 0.90). Test-retest reliability was found to be high (intraclass correlation coefficient ranged from 0.82-0.95). A significant relationship was found between all domains of the CLASS and TAPES prosthesis satisfaction subscale (r=0.553 for stability domain, r=0.509 for suspension domain, r=0.482 for comfort domain, r= 0.444 for appearance domain, p

Reliability and validity of the Turkish version of the Prosthesis Embodiment Scale for Lower Limb Amputees.

Prosthetic embodiment is the perception of the prosthesis as a part of the body, and it is important for acceptance and adequate and effective use of the prosthesis. The aim of this study was to investigate the validity and reliability of the Turkish version of the Prosthesis Embodiment Scale for Lower Limb Amputees. This cross-sectional study included a total of 88 lower limb amputees. Internal consistency was evaluated using Cronbach α coefficient. The test-retest reliability of the scale, which was reapplied after 7-10 d, was evaluated using intraclass correlation coefficient. Principal component analysis with Varimax rotation was used to analyze the factor structure. Spearman correlation coefficient with Trinity Amputation and Prosthesis Experience Scale subscales was calculated for concurrent validity. The mean age of the participants was 45.13 ± 15.05 years, and 76.1% were male. Internal consistency (Cronbach α = 0.905) and test-retest reliability (intraclass correlation coefficient = 0.822) were high. 76.1% of the total variance could be explained by the 3 dimensions. Significant correlation was found with the Trinity Amputation and Prosthesis Experience Scale subscales (r = 0.542 for psychosocial adjustment subscale, r = -0.452 for activity restriction subscale, r = 0.490 for prosthesis satisfaction subscale, p < 0.001). The results of this study showed that the Turkish version of the Prosthesis Embodiment Scale for Lower Limb Amputees is a valid and reliable tool that can be used to evaluate prosthetic rehabilitation outcomes.

Effectiveness of telerehabilitation-based structured exercise program in individuals with unilateral transtibial amputation: a randomized controlled study

Purpose The study aimed to compare the effects of home exercise alone and telerehabilitation combined with home exercise in individuals with transtibial amputation. Materials and methods The telerehabilitation group (n = 24) received telerehabilitation combined with home exercise, while the control group (n = 24) received home exercise alone. Outcomes included the timed up-and-go (TUG) test and the 30-second chair-stand test (30CST), the Activities-specific Balance Confidence (ABC) Scale, the Trinity Amputation and Prosthesis Experience Scales (TAPES), the Amputee Body Image Scale (ABIS), and the Nottingham Health Profile (NHP). The analysis used a 2 × 2 mixed repeated measures ANOVA. Results The group-by-time interactions were significant for TUG (p = 0.002, F[1;41] = 10.74) and 30CST (p = 0.001, F[1;41] = 11.48). The mean difference (6th week-baseline) was −0.49 for TUG and 0.95 for 30CST in the telerehabilitation group and −0.14 for TUG and 0.13 for 30CST in the control group. There were statistically meaningful group-by-time interactions on the ABC (p = 0.0004, F[1;41] = 14.47), the TAPES-activity restriction (p = 0.0001, F[1;41] = 28.96), TAPES-prosthesis satisfaction (p = 0.004, F[1;41] = 9.19), and the NHP (p = 0.0002, F[1;41] = 16.07) favoring the telerehabilitation group. Conclusions Telerehabilitation combined with home exercise can offer greater benefits in improving gait, muscle strength, balance confidence, activity restriction, prosthesis satisfaction, and quality of life compared to home exercise alone for individuals with transtibial amputation. Implications for rehabilitation Exercise helps individuals with lower limb amputation overcome their physical limitations and enables them to use their prostheses effectively. Physiotherapy and rehabilitation after amputation are not at the desired level, and individuals with lower limb amputation encounter various difficulties in accessing physiotherapy. Telerehabilitation has great potential to facilitate access to physiotherapy for individuals with amputation and reduce resource utilization. In a relatively small sample of amputees, this study shows that telerehabilitation-based exercise improves physical health and quality of life.

Kvalitet života bolesnika nakon transtibijalne amputacije i različiti periodi nošenja proteze

Introduction. Research into patients with lower limb amputation (LLA) puts strong emphasis on quality of life (QoL) and importance of the research in that regard as a measure for the rehabilitation outcomes. The aim of this study was to show which aspects of QoL are related to the duration of wearing a prosthesis in patients with transtibial amputation (TTA). Methods. The study sample comprised 40 patients who used prosthesis for 1 - 3 years (group A), 4 - 7 years (group B) and &gt; 8 years (group C). All patients completed Trinity Amputation and Prosthesis Experience Scale-Revised (TAPES-R). Results. Prosthesis wearing history was significantly different between the groups: group A (2.2 ± 0.7 years), group B (5.5 ± 1.3 years) and group C (22.9 ± 13.6 years), p&lt;0.001. Patients in group B were significantly (p &lt; 0.05) older compared to patients in group C, displayed a significantly (p &lt; 0.05) lower rate of employment and significantly (p &lt; 0.05) longer duration of diabetes mellitus. Patients in group C displayed a significantly (p = 0.005) lower rate of diabetes mellitus. TAPES-R showed that social adjustment was significantly lower (p &lt; 0.05) in patients in group C compared to patients in group A (3.14 ± 0.46 vs. 3.55 ± 0.41). Conclusion. Although patients with TTA showed good QoL, the group with a long history of wearing a prosthesis differed significantly in social adjustment compared to patients with a short period of wearing a prosthesis. The age and etiology of amputation differed significantly between the groups.

Depression and Anxiety Symptoms Among Lebanese Lower Limb Traumatic Amputees: Association with Education, Employment, Adjustment to Amputation and Prosthesis Satisfaction

Objective To examine and compare the association between the presence of depression and anxiety symptoms and different sociodemographic and clinical factors including the adjustment to amputation and prosthesis satisfaction among Lebanese individuals with lower limb amputation (LLA). Method: This cross-sectional study was conducted between December 2022 and May 2023 among 72 participants with LLA. Participants completed a questionnaire that included sociodemographic and clinical variables, the revised Trinity Amputation and Prosthesis Experience Scale (TAPES-R), and the Hopkins Symptom Checklist (HSCL-25). Result: Using the HSCL depression and anxiety cut-off, 25% of participants were categorized as having depression symptoms, with unemployment being significantly associated (p-value < .05) with depression. Similarly, 25% were classified as having anxiety symptoms, with both lower education and unemployment (p-value < .05) significantly linked to anxiety. TAPES-R subscales scores exhibited significant differences between non-depressed and depressed, as well as non-anxious and anxious participants (p-value < .05). Correlation analysis demonstrated significant relationship between HSCL scales and TAPES-R subscales; lower scores in adjustment to amputation and prosthesis satisfaction were moderately associated with increased rates of depression (r ranging between −0.331 and −0.500, p-values < .005) and increased rates of anxiety symptoms (r ranging between −0.362 and −0.441, p-values < .002). In addition, higher scores in activity limitation were moderately correlated to increased rates of depression and anxiety (r = 0.438 for anxiety and 0.490 for depression; p < .001). Conclusion: Mental health symptoms are associated with educational level, employment status, and adjustment to amputation and prosthesis satisfaction in Lebanese individuals with LLA. These findings should be considered to achieve optimal prosthetic rehabilitation.

A content comparison of 4 commonly used adult upper limb amputee outcome measurements with application of the refinements of International Classification of Functioning, Disability, and Health linking rules.

The application of the refinements of linking rules to the outcome measurement methods provides an opportunity to obtain information concerning what the available instruments actually measure and how the instrument measures certain outcomes. The purpose of the study was to analyze the content of 4 commonly used upper limb amputee scales using the refined International Classification of Functioning, Disability, and Health (ICF) linking rules. The Upper Extremity Functional Status module of the Orthotics and Prosthetics User Survey (OPUS-UEFS), Trinity Amputation and Prosthesis Experience Scales, Southampton Hand Assessment Procedure (SHAP), and Quick Disability of the Arm, Shoulder, and Hand were analyzed by 2 health professionals for a content comparison based on ICF categories. The Kappa statistic was used to calculate the degree of agreement between 2 professionals. The scale questions were linked with 43 different ICF codes in this study. Trinity Amputation and Prosthesis Experience Scale addresses all ICF domains. All items of SHAP and most items of OPUS-UEFS were linked to the activity-participation domain. Quick Disability of the Arm, Shoulder, and Hand items were linked with activity-participation and body function domains. The perspectives of OPUS-UEFS and SHAP are descriptive. The perspectives of Quick Disability of the Arm, Shoulder, and Hand were descriptive and appraisal. The perspectives of Trinity Amputation and Prosthesis Experience Scale subscales were descriptive, appraisal, and needs or dependency. Estimated kappa values ranged from 0.44 to 0.91 for ICF codes. Most concepts in the scales were frequently linked to the activity-participation domain. We think that the results of this study will be a useful guide to clinicians and researchers in selecting relevant and appropriate outcome measurements for upper limb amputee rehabilitation.

Quality of Life in People with Diabetes Mellitus and Unilateral Transtibial Amputation - Aspects of Using the Berg Balance Scale.

Approximately 40%-60% of all amputations are lower limb amputations (LLAs) related to diabetes mellitus (DM). The importance of quality of life (QoL) is increasingly recognized as after amputation. The objective of this cross-sectional study was to compare QoL (evaluated by Berg Balance Scale, BBS) in DM patients with unilateral transtibial amputation (TTA) using prosthesis (group A) with that of patients amputated due to other causes (group B). Overall, 32 patients completed two questionnaires: the 36-Item Health Survey (SF - 36) for QoL assessment and the Trinity Amputation and Prosthesis Experience Scale-Revised (TAPES-R). In group A, patients were significantly older (P < .05) with shorter periods of prosthesis use (P < .05) and had significantly lower (P = .008) adjustment to limitation (TAPES-R). Correlations were found between BBS score and SF-36, including physical functioning (P < .001, r = 0.682), energy and fatigue (P < .001, r = 0.643) and emotional well-being (P < .001, r = 0.644). In the TAPES-R, a large negative correlation was found between BBS and activity restriction (P = .001, r = -0.595). Poorer balance ability, greater activity limitation, and worse psychosocial adjustment to the prosthesis were found in patients with unilateral TTA and DM compared to TTA prosthesis users without DM.

Gender differences in prosthesis-related outcomes among veterans: Results of a national survey of U.S. veterans.

Women with lower extremity amputations (LEAs) tend to have poorer prosthesis-related outcomes than men, although the literature is sparse. To our knowledge, there are no prior studies examining prosthesis-related outcomes of women veterans with LEAs. To examine gender differences (overall and by type of amputation) among veterans who underwent LEAs between 2005 and 2018, received care at the Veterans Health Administration (VHA) prior to undergoing amputation, and were prescribed a prosthesis. It was hypothesized that compared to men, women would report lower satisfaction with prosthetic services, poorer prosthesis fit, lower prosthesis satisfaction, less prosthesis use, and worse self-reported mobility. Furthermore, it was hypothesized that gender differences in outcomes would be more pronounced among individuals with transfemoral than among those with transtibial amputations. Cross-sectional survey. Linear regressions were used to assess overall gender differences in outcomes and gender differences based on type of amputation in a national sample of veterans. VHA medical centers. The sample consisted of 449 veterans who self-identified their gender (women = 165, men = 284) with transtibial (n = 236), transfemoral (n = 135), and bilateral LEAs (n = 68) including all amputation etiologies. Not applicable. The Orthotics and Prosthetics User's Survey, Trinity Amputation and Prosthesis Experiences Scale, and Prosthetic Limb Users Survey of Mobility-Short Form were used to assess satisfaction with prosthetic services, prosthesis fit, prosthesis satisfaction, prosthesis use, and self-reported mobility. Women had poorer self-reported mobility than men (d = -0.26, 95% confidence interval -0.49 to -0.02, p < .05); this difference was small. There were no statistically significant gender differences in satisfaction with prosthetic services, prosthesis fit, prosthesis satisfaction, daily hours of prosthesis use, or by amputation type. Contrary to the hypothesis, prosthesis-related outcomes were similar between men and women with LEAs. Minimal differences may in part be due to receiving care from the VHA's integrated Amputation System of Care.

Psychological adjustments among lower limb amputees in North Indian population: A cross-sectional study.

Limb amputation is an extremely stressful event for an individual, following which the amputee develops inferior body image, anxiety, and changes in self-concept and identity. For holistic rehabilitation, understanding the psychosocial status of the amputee and its' predictors is of utmost importance. The aim of the article is to assess the psychological adjustments in patients with lower limb amputation and determine its clinical and sociodemographic correlates. A observational cross-sectional study was conducted from 2020 to 2022 among lower limb amputees of a tertiary care hospital in Lucknow which serves as the only rehabilitation and artificial limb center for the whole state of Uttar Pradesh. Baseline sociodemographic and clinical data were collected. The Hospital Anxiety and Depression Scale was used to determine underlying depression and anxiety, while the Trinity Amputation and Prosthesis Experience Scale was used for understanding the psychological adjustment. The mean age of the amputee was 39.47 ± 16.99 years. The mean general, social adjustment, and adjustment to limitation score was 16.3 ± 3.34, 15.19 ± 3.59, and 12.76 ± 3.15, respectively. Male amputees, aged >40 years, and pensioners had significantly higher scores for general adjustment (P < 0.05). Those aged >40 years were pensioners and had no underlying depression and anxiety and had better social adjustment (P < 0.05). Those with transfemoral amputation had a significantly lesser adjustment to limitation (P = 0.003). Young age amputees had poor general and social adjustments and more activity restriction but high prosthesis satisfaction as compared to the elderly. Those with transfemoral amputation had a poor adjustment to limitation while those wearing above-knee prosthesis had more activity restriction.

Translation of Trinity Amputation and Prosthesis Experience Scales- Revised (TAPES-R)

Translation of Trinity Amputation and Prosthesis Experience Scales- Revised (TAPES-R)

Personality traits and psychosocial adjustment in patients with limb amputation

Purpose: The aim of this cross-sectional study was to examine the relationship between psychosocial adjustment and personality traits since research regarding psychosocial adjustment and variables that influence adjustment in patients with limb amputation is relatively scarce. Methods: There were 63 (81% male) participants in this study. The sample consisted of 51 men and 12 women between the ages of 27 and 86 (M = 56.63, SD = 13.35). The Next Big Five Inventory (BFI 2; Soto &amp; John, 2017) was used to assess personality traits and The Trinity Amputation and Prosthesis Experience Scales – Revised (TAPES-R; Gallagher &amp; MacLachlan, 2000) was used to measure psychosocial adjustment (general adjustment, social adjustment and adjustment to limitation). Results: Extraversion was positively and negative emotionality negatively associated with general adjustment. No significant associations were found between social adjustment and personality traits. Extraversion, agreeableness and open-mindedness correlated positively with adjustment to limitation. Similar pattern of associations was found between personality facets and general adjustment and adjustment to limitation. The strongest associations were found with negative emotionality facet depression. Conclusions: Results indicate that personality traits are associated with psychosocial adjustment in patients with limb amputation. Since this finding can be useful for adaptation to amputation, further research in larger samples is needed.

Veteran Perspectives on Phantom Limb Pain and Non-Drug Interventions.

Phantom limb pain (PLP) commonly occurs post-amputation and can negatively affect the daily functioning of persons with amputation. Best practices for medication and non-drug management remain unclear. To better understand the PLP experience and patients' familiarity with treatments, phone interviews were conducted at the Minneapolis Veterans Affairs Regional Amputation Center in Veterans with amputations. Fifty Veteran participants (average age 66, 96% male) with lower limb amputation were recruited for phone-based data collection of patient-reported outcomes (ie, demographics using the Trinity Amputation and Prosthesis Experience Scales-Revised (TAPES-R) and pain experience using the Phantom Phenomena Questionnaire) to characterize the population and a semi-structured interview. Notes taken during interviews were analyzed using the Krueger and Casey constant comparison analysis method. Participants had an average of 15 years since amputation, and 80% reported PLP as identified with the Phantom Phenomena Questionnaire. Investigators identified several core themes from the qualitative interviews including 1) high variability in the experience of PLP, 2) acceptance and resilience, and 3) PLP treatment perceptions. The majority of participants reported trying common non-drug treatments with none endorsed consistently as highly effective. More research is needed to inform identification and implementation of clinical best practices for non-drug interventions for PLP and understand the factors that influence engagement in non-drug interventions. The participants in this study were largely male, so these results may not be generalizable to females.

Activity and Participation, Bimanual Function, and Prosthesis Satisfaction are Strong Predictors of General Well-Being Among Upper Limb Prosthesis Users

ObjectiveTo determine the role of multiple factors on general well-being for upper limb prosthesis users. DesignRetrospective cross-sectional observational design. SettingProsthetic clinics across the United States. ParticipantsAt the time of analysis, the database consisted of 250 patients with unilateral upper limb amputation seen between July 2016 and July 2021. InterventionNot applicable. Main Outcomes MeasuresDependent variable: well-being (Prosthesis Evaluation Questionnaire- Well-Being). Independent variables included in analysis: activity and participation (Patient Reported Outcomes Measurement Information System [PROMIS] Ability to Participate in Social Roles and Activities), bimanual function (PROMIS-9 UE), prosthesis satisfaction (Trinity Amputation and Prosthesis Experience Scales-Revised; TAPES-R), PROMIS pain interference, age, gender, average daily hours worn, time since amputation, and amputation level. ResultsA multivariate linear regression model using a forward enter method was applied. The model included 1 dependent variable (well-being) and 9 independent variables. Within the multiple linear regression model, the strongest predictors of well-being were activity and participation (β=0.303, P<.0001), followed by prosthesis satisfaction (β=0.257, P<.0001), pain interference (β=-0.187, P=.001), and bimanual function (β=0.182, P=.004). Age (β=-0.036, P=.458), gender (β=-0.051, P=.295), time since amputation (β=0.031, P=.530), amputation level (β=0.042, P=.385), and hours worn (β=-0.025, P=.632) were not significant predictors of well-being. ConclusionReducing pain interference and improving clinical factors such as prosthesis satisfaction and bimanual function with their associated effects on activity and participation will positively affect the well-being of individuals living with upper limb amputation/congenital deficiency.

The multi-grip and standard myoelectric hand prosthesis compared: does the multi-grip hand live up to its promise?

BackgroundMulti-grip myoelectric hand prostheses (MHPs), with five movable and jointed fingers, have been developed to increase functionality. However, literature comparing MHPs with standard myoelectric hand prostheses (SHPs) is limited and inconclusive. To establish whether MHPs increase functionality, we compared MHPs with SHPs on all categories of the International Classification of Functioning, Disability, and Health-model (ICF-model).MethodsMHP users (N = 14, 64.3% male, mean age = 48.6 years) performed physical measurements (i.e., Refined Clothespin Relocation Test (RCRT), Tray-test, Box and Blocks Test, Southampton Hand Assessment Procedure) with their MHP and an SHP to compare the joint angle coordination and functionality related to the ICF-categories ‘Body Function’ and ‘Activities’ (within-group comparisons). SHP users (N = 19, 68.4% male, mean age = 58.1 years) and MHP users completed questionnaires/scales (i.e., Orthotics and Prosthetics Users’ Survey—The Upper Extremity Functional Status Survey /OPUS–UEFS, Trinity Amputation and Prosthesis Experience Scales for upper extremity/TAPES-Upper, Research and Development-36/RAND-36, EQ-5D-5L, visual analogue scale/VAS, the Dutch version of the Quebec User Evaluation of Satisfaction with assistive technology/D-Quest, patient-reported outcome measure to assess the preferred usage features of upper limb prostheses/PUF-ULP) to compare user experiences and quality of life in the ICF-categories ‘Activities’, ‘Participation’, and ‘Environmental Factors’ (between-group comparisons).Results‘Body Function’ and ‘Activities’: nearly all users of MHPs had similar joint angle coordination patterns with an MHP as when they used an SHP. The RCRT in the upward direction was performed slower in the MHP condition compared to the SHP condition. No other differences in functionality were found. ‘Participation’: MHP users had a lower EQ-5D-5L utility score; experienced more pain or limitations due to pain (i.e., measured with the RAND-36). ‘Environmental Factors’: MHPs scored better than SHPs on the VAS-item holding/shaking hands. The SHP scored better than the MHP on five VAS-items (i.e., noise, grip force, vulnerability, putting clothes on, physical effort to control) and the PUF-ULP.ConclusionMHPs did not show relevant differences in outcomes compared to SHPs on any of the ICF-categories. This underlines the importance of carefully considering whether the MHP is the most suitable option for an individual taking into account the additional costs of MHPs.

Effects of Implementing a Self-Care Program for Adults With Lower Limb Prostheses.

An artificial replacement for a lost limb or portion of a limb, known as a prosthesis, is a tool that can assist a person to regain their independence. The aim of this project was to evaluate the effect of a self-care program for adults with lower limb prostheses. We used a quasi-experimental research design. We conducted our study at the Physical Medicine and Rehabilitation and Rheumatology Center affiliated with the Armed Forces, located in the Al-Geza Governorate of Egypt using a purposeful sample of 81 adults with lower limb prostheses. We used two tools for data collection: a structured interviewing questionnaire and the Trinity Amputation and Prosthesis Experience Scales (TAPES). The mean age of adults with lower limb prosthesis in our study was 38.91 years (10.53). A total of 64.2% of the study participants (n = 51) were men. We found that before the self-care program, 22.2% of the participants (n = 18) had a satisfactory level of knowledge about self-care, which increased to 88.9% (n = 72) after the program. Before the self-care program, the number of participants with adequate practice levels was 13.6% (n = 11), which increased to 100.0% (n = 81) after the program. We concluded that implementing the self-care program provided a significant improvement in the attendee's total satisfactory knowledge (χ2[79,81] = 72.90, p < .000) and adequate practice levels (p < .001).

Quality of Life Evaluation Through a Single-Item “Daily Prosthesis Usage Time” in Individuals with Lower-Limb Amputation

ABSTRACT Introduction The purpose of this study was to identify the relation of daily prosthesis usage time (DPUT) of individuals with amputation with quality of life (QoL) questionnaires. Methods The research was carried out on 125 individuals with amputation. Prosthetic-related parameters were searched, as well as demographic data. A generic (Nottingham Health Profile [NHP]) questionnaire and a questionnaire specific to individuals with amputation (Trinity Amputation and Prosthesis Experience Scales [TAPES]) QoL measurements were used. Results Ninety-one males and 28 females with a mean age of 42.4 ± 14.7 years participated in the study. The average DPUT was 11.1 ± 4.4 hrs/d. Study results showed that there was significant correlation between both of the QoL questionnaires (NHP and TAPES) and DPUT. High correlation was determined between DPUT and NHP total score and NHP-Pain, and very high correlation was found between DPUT and NHP–Physical Activity subscale. A moderate negative correlation was found between DPUT and NHP–Energy Level, NHP–Emotional Reaction, NHP–Social Isolation, and NHP–Sleep. A moderate negative correlation was found between DPUT and TAPES–Activity Restriction. A high correlation was found between DPUT and residual limb pain, prosthetic satisfaction, time interval after amputation, and number of prosthetic fittings. A moderate correlation was found between DPUT and walking aids, whereas a poor relationship was shown between phantom pain and DPUT. Conclusions This study showed that “the average DPUT” may be used in terms of short assessment of QoL of individuals with amputation. The outcomes of this study pointed out that especially prosthetic-related parameters affected the QoL in individuals with amputation. In problems resulting from routine assessment and questionnaires having so many items, a single-item question, “the average DPUT,” may be used effectively in a shorter period and is helpful for organizing a rehabilitation program. Clinical Relevance A single-item question, “The average daily prosthesis usage time (DPUT),” be used effectively in a shorter assessment of quality of life of individuals with amputation and is helpful for organizing a rehabilitation program.

A Modified Version of the Forgotten Joint Score-12 in Lower Limb Amputees: Validity and Reliability Study.

Adaptation to prosthesis is important for occupation, quality of life, and participation in social life, so it needs to be evaluated. The aim of this study was to determine the validity and reliability of the Forgotten Joint Score-12 (FJS-12) in lower limb amputees. The FJS-12 was applied to 80 amputees. Criterion-referenced validity was assessed using the activity restriction subparameter of Trinity Amputation and Prosthesis Experience Scale (TAPES). The internal consistency of the FJS-12 was high (Cronbach's α = .943). A statistically significant very good negative correlation was determined between the FJS-12 and the activity restriction subparameter of TAPES (r = -.641; p < .001). The results of this study showed that FJS-12 is a valid and reliable measurement tool that can be used to assess the adaptation to prosthesis in amputees. Evaluation of prosthesis awareness in daily living activities of amputees is important in terms of establishing occupational therapy and rehabilitation programs.

Assessment of Quality of Life in Patients with Lower Limb Amputation after Work Accidents

Amputation is the intentional removal, by surgery, of a limb segment or part of the body. By increasing the degree of urbanization and automation around the world, accidents are the most important cause of morbidity and mortality. Lower limb amputation is a life-changing event and has an impact on functional, work, social and recreational activities. Amputation can lead people to lose self-esteem, independence and work. Quality of life it is as a wide range of human experiences related to one's general well-being. For the specific psychosocial and functional testing of people who have undergone an amputation TAPES is more frequently used. The study included 7 patients with amputation of lower limbs, prostheses, who underwent unilateral or bilateral amputation of traumatic genesis at work. Patients filled in the Trinity Amputation and Prosthesis Experience questionnaire in order to estimate quality of life and Rosenberg scale to assess self-esteem. The adaptation to wearing the prosthesis is reported by 71.42% and more than 50% of the subjects are satisfied with their prosthesis. The factors with the greatest impact on functional abilities proved to be: the level of amputation, the duration of living with the amputation limb, the presence of other pathologies and psycho-emotional status. Medical rehabilitation programs improve the functional and psycho-emotional abilities of patients with lower limb amputations.

Comparison of patient-reported and functional outcomes after transition from traditional upper limb prosthetics to multiarticulating hands in the user with a unilateral transradial amputation.

Multiarticulating hands (MAHs) have been commercially available for over 15 years. Despite this, their cost remains significantly higher than traditional electric hands, and they are not routinely available in many countries. The Scottish Specialist Prosthetic Service within the National Health Service has been prescribing MAHs since 2014. However, the benefits of MAHs provided in clinical settings are not well known. This study aimed to compare patient-reported and functional measures in unilateral transradial prosthetic users transitioning from a body-powered or traditional myoelectric prosthesis to a MAH. This was a retrospective cohort analysis of individuals with a unilateral transradial amputation provided with a MAH. Of 38 users provided with MAHs, 20 had complete data sets of patient-reported and functional measures before and 6 months after provision. These included Disabilities of the Arm, Shoulder, and Hand; Southampton Hand Assessment Procedure Index of Function; health-related quality of life (EQ-5D-5L Health Index); Trinity Amputation and Prosthesis Experience Scales satisfaction; and Box and Block Test. The mean age was 44 years (SD 16) (n = 20), and 75% were male. There were an 8-unit mean reduction in the Disabilities of the Arm, Shoulder, and Hand ( P = .01) and a 9.5-unit improvement in the Southampton Hand Assessment Procedure IOF ( P = .007) at 6 months after provision. Health-related quality of life did not change ( P = .581). Users reported a four-point improvement in their Trinity Amputation and Prosthesis Experience Scales ( P = .004) and transferred 3.3 blocks more completing the Box and Block Test ( P = .001). The evidence clearly supports continued provision of MAHs to this group of moderate users: the more function the user achieves, the less of a disability they perceive to have.

Measuring Satisfaction With Upper Limb Prostheses: Orthotics and Prosthetics User Survey Revision That Includes Issues of Concern to Women

ObjectiveTo (1) modify the Orthotics and Prosthetics User Survey (OPUS) Client Satisfaction with Device (CSD) instrument to incorporate issues of concern to women and (2) evaluate measure's structural and concurrent validity and reliability in persons with upper limb amputation (ULA). DesignCross-sectional survey study with retest after 2 weeks. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and Rasch analyses were used to select items and examine differential item functioning, range of coverage, and person and item reliability. Test-retest reliability was evaluated with intraclass correlation coefficients. Pearson correlations were used to estimate associations with other prosthesis satisfaction measures. SettingTelephone administered survey. ParticipantsConvenience sample of 468 participants in the US (N=468; 19.9% women) with ULA, including a 50-person retest subsample (4% female). InterventionsNot applicable. Main Outcome MeasuresModified OPUS CSD. ResultsEFA suggested 3 subscales: Comfort, Appearance, and Utility. CFA found acceptable model fit. After dropping items with poor fit and high pairwise correlations in Rasch partial credit models, CFA model fit indices were acceptable (comparative fit index=0.959, Tucker-Lewis Index=0.954, root mean square error of approximation=0.082). Rasch person reliability was 0.62 (Utility), 0.77 (Appearance), and 0.82 (Comfort). Cronbach α was 0.81, 87, and 0.71 for Comfort and Appearance, and Utility subscales, respectively. Correlations between the modified CSD, the original CSD, and the Trinity Amputation and Prosthesis Experience Satisfaction Scale were 0.54-0.94. ConclusionsWe identified 3 subscales: Comfort (6 items), Appearance (8 items), and Utility (4 items) with 7 new items identified as important to women. The subscales demonstrate evidence of sound concurrent structural and test-retest reliability and concurrent validity. The Appearance and Comfort subscales have good reliability for group-level use in clinical and research applications, whereas the Utility subscale had poor to fair person reliability but excellent item reliability.