Determining Reliability of a Dual-Task Functional Mobility Protocol for Individuals With Lower Extremity Amputation |
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| Institution: | 1. Department of Physical Medicine and Rehabilitation, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada;2. School of Physical Therapy, University of Western Ontario, London, Ontario, Canada;3. Faculty of Health Sciences, University of Western Ontario, London, Ontario, Canada;4. School of Occupational Therapy, University of Western Ontario, London, Ontario, Canada;5. Department of Physical Medicine and Rehabilitation, Parkwood Institute, London, Ontario, Canada;1. School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan;2. Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan;3. Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung, Taiwan |
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| Abstract: | ObjectiveTo determine the relative and absolute reliability of a dual-task functional mobility assessment.DesignCross-sectional study.SettingAcademic rehabilitation hospital.ParticipantsIndividuals (N=60) with lower extremity amputation attending an outpatient amputee clinic (mean age, 58.21±12.59y; 18, 80% male) who were stratified into 3 groups: (1) transtibial amputation of vascular etiology (n=20); (2) transtibial amputation of nonvascular etiology (n=20); and (3) transfemoral or bilateral amputation of any etiology (n=20).InterventionsNot applicable.Main Outcome MeasuresTime to complete the L Test measured functional mobility under single- and dual-task conditions. The addition of a cognitive task (serial subtractions by 3's) created dual-task conditions. Single-task performance on the cognitive task was also reported. Intraclass correlation coefficients (ICCs) measured relative reliability; SEM and minimal detectable change with a 95% confidence interval (MDC95) measured absolute reliability. Bland-Altman plots measured agreement between assessments.ResultsRelative reliability results were excellent for all 3 groups. Values for the dual-task L Test for those with transtibial amputation of vascular etiology (n=20; mean age, 60.36±7.84y; 19, 90% men) were ICC=.98 (95% confidence interval CI], .94–.99), SEM=1.36 seconds, and MDC95=3.76 seconds; for those with transtibial amputation of nonvascular etiology (n=20; mean age, 55.85±14.08y; 17, 85% men), values were ICC=.93 (95% CI, .80–.98), SEM=1.34 seconds, and MDC95=3.71 seconds; and for those with transfemoral or bilateral amputation (n=20; mean age, 58.21±14.88y; 13, 65% men), values were ICC=.998 (95% CI, .996–.999), SEM=1.03 seconds, and MDC95=2.85 seconds. Bland-Altman plots indicated that assessments did not vary systematically for each group.ConclusionsThis dual-task assessment protocol achieved approved levels of relative reliability values for the 3 groups tested. This protocol may be used clinically or in research settings to assess the interaction between cognition and functional mobility in the population with lower extremity amputation. |
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| Keywords: | Amputation Cognition Rehabilitation Walking ABC"} {"#name":"keyword" "$":{"id":"kwrd0040"} "$$":[{"#name":"text" "_":"Activities-specific Balance Confidence CI"} {"#name":"keyword" "$":{"id":"kwrd0050"} "$$":[{"#name":"text" "_":"Confidence interval ICC"} {"#name":"keyword" "$":{"id":"kwrd0060"} "$$":[{"#name":"text" "_":"Intraclass correlation coefficient LEA"} {"#name":"keyword" "$":{"id":"kwrd0070"} "$$":[{"#name":"text" "_":"Lower extremity amputation Minimal detectable change with a 95% confidence interval MoCA"} {"#name":"keyword" "$":{"id":"kwrd0090"} "$$":[{"#name":"text" "_":"Montreal Cognitive Assessment TFA"} {"#name":"keyword" "$":{"id":"kwrd0100"} "$$":[{"#name":"text" "_":"Transfemoral amputation TTA"} {"#name":"keyword" "$":{"id":"kwrd0110"} "$$":[{"#name":"text" "_":"Transtibial amputation |
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