Cross cultural equivalence testing of the Prosthetic Evaluation Questionnaire (PEQ) for an Arabic speaking population

Validity and reliability of selective control of upper extremity scale (SCUES) in patients with chronic stroke

PURPOSE

The aim of this study is to investigate the validity and reliability of the Selective Control of Upper Extremity Scale (SCUES) in patients with stroke.

MATERIALS AND METHODS

Forty-two patients with stroke aged 18-75 years, were included in the study. Patients were video-recorded while SCUES was administered. The videos were scored to determine the intrarater and inter-rater reliability. Fugl Meyer Assessment of Upper Extremity (FMA-UE), Box and Block test (BBT) and Brunnstrom Stages of Motor Recovery were measured to evaluate validity of SCUES. Spearman correlation analysis was used to assess the validity of SCUES. Intraclass correlation coefficient (ICC), Kappa (κ) and weighted Kappa (κw) were calculated to determine intrarater and inter-rater reliability.

RESULTS

There were significant positive high correlations between SCUES and FMA-UE and BBT and Brunnstrom upper extremity proximal and distal values (rho = 0.944, p = 0.01; rho = 0,875, p = 0.01; rho = 0.84, p = 0.01, rho = 0.82, p = 0.01; respectively) showing validity of SCUES. The ICC value of inter-rater reliability of SCUES was 0,99 (%95 CI: 0,989-0,997, p = 0,001) showing excellent reliability. κ and κ w values for inter-rater and intrarater reliability of individual SCUES items were above 0.7 indicating excellent reliability. ICC of SCUES and FMA-UE indicated excellent intrarater reliability (ICC = 0,99; %95 CI: 0,989-0,997, p = 0,001; ICC = 0.943; %95 CI: 0.9-0.97, p = 0,0001, consecutively).

CONCLUSIONS

SCUES showed similar validity and reliability with FMA-UE and SCUES can be used in the evaluation of upper extremity selective motor control in patients with stroke.

Test-retest reliability of the Arabic translation of the Lower Extremity Functional Status of the Orthotics and Prosthetics Users' Survey

BACKGROUND

The number of amputations secondary to diverse factors in Arabic countries is expected to rise in the coming years. Therefore, there is a need for high-quality service that can be monitored by the use of standardized patient-reported outcome measures of amputee patients' functional status. This study aimed to translate the Lower Extremity Functional status Orthotics and Prosthetics Users' Survey (OPUS-LEFS) to Arabic and test its reliability in a sample of Arabic-speaking people with amputation.

METHODS

Standard forward and backward translation, followed by an examination by a team of experts, and then preliminary testing were conducted on the final translation. The OPUS-LEFS was cross-culturally validated, and its test-retest reliability was examined in patients with lower extremity amputations (N = 67).

RESULTS

No issues were observed concerning the patients' understanding or the meaning of the items on the Arabic translation of the OPUS-LEFS. The intraclass correlation coefficient was 0.99 (95% confidence interval [CI]: 0.985 to 0.995), and the mean difference was -0.278 (95% CI: -5.83 to 5.28), indicating excellent test-retest reliability.

CONCLUSIONS

The study's results suggest that the Arabic translation of the OPUS-LEFS is a reliable tool that can be recommended for future use as an outcome measure for patients from Arabic-speaking nations with little knowledge of the English language.

Impacts of Microprocessor-Controlled Versus Non-microprocessor-Controlled Prosthetic Knee Joints Among Transfemoral Amputees on Functional Outcomes: A Comparative Study

INTRODUCTION

Selecting a prosthetic knee mechanism is an important part of transfemoral (TF) amputee rehabilitation. Prosthetic knee joint selection depends on the users' gait and their energy consumption. This study compares the feedback of transfemoral prosthesis users based on the prosthetic knee design self-reporting responses using the Prosthetic Evaluation Questionnaire (PEQ) outcome measure.

OBJECTIVE

This study aims to assess the impact of using a microprocessor-controlled prosthetic knee (MCPK) compared with a non-microprocessor-controlled prosthetic knee (NMCPK); feedback on the amputee usage can improve the clinical decision for proper prosthetic knee joint selection.

METHODS

This is a cross-sectional study with a total of 76 adult unilateral transfemoral amputees classified into two groups. The participants in the first group (38) used the MCPK (Genium, Otto Bock, Minneapolis, MN, USA), and the participants in the second group (38) used the NMCPK (hydraulic and total knee joints). Enrolment was based on a sequence of appointments where all participants answered the PEQ, with different subscale questions including utility (UT), sounds (SO), appearance (AP), residual limb health (RL), frustration (FR), perceived response (PR), social burden (SB), ambulation (AM), and quality of life (QoL). PEQ was filled out during the follow-up appointments at the prosthetic clinic through a visual analog scale (VAS). All data entered into a database were analyzed.

RESULT

The MCPK participants have significantly improved utility, appearance, ambulation, and total PEQ score, the same results as the male participants. Middle-adulthood (25-40 years) MCPK participants have a significant p-value in the score of utility, frustration, ambulation, and total PEQ score compared to early-adulthood (18-24 years) and late-adulthood (41-60 years) participants. Also, there was a significant improvement in the p-value in ambulation scores in participants using MCPK with amputations caused by diseases compared to amputations caused by trauma and congenital cause.

CONCLUSION

Transfemoral amputee prosthesis utility, natural gait, and ambulation improved when using MCPK compared to when using NMCPK during prosthetic rehabilitation.

Pain issues in the victims with lower-limb amputation: 10 years after the 2008 Sichuan earthquake

PURPOSE

To study the prevalence, intensity, and bothersomeness of amputation-related pain and further to identify the potential risk factors in the victims with lower-limb amputation 10 years after the 2008 Sichuan earthquake.

METHODS

In the cross-sectional study, 66 victims with lower-limb amputation were recruited. The Prostheses Evaluation Questionnaire was used to document the prevalence, intensity, and bothersomeness of amputation-related pain. The bivariate relationships between amputation-related pain and each of demographic characteristics were analyzed.

RESULTS

Majority of the enrolled lower-limb amputees (90.9%) reported to have one or more types of amputation-related pain. The intensity and bothersomeness of amputation-related pain were considered as severe in nearly 40% of these post-earthquake victims. The potential demographic risk factors associated with the prevalence, intensity, and bothersomeness of amputation-related pain were identified, including the age, lower level of education, marital status, employment, and comorbidity.

CONCLUSIONS

The pain coming from phantom limb, residual limb, non-amputated limb, and back was found persistent in the lower-limb amputees 10 years after the 2008 Sichuan earthquake. The findings of this study could provide useful reference for optimization of post-disaster rehabilitation strategies to alleviate chronic pain in the victims following lower-limb amputation.Implications for RehabilitationThe pain coming from phantom limb, residual limb, non-amputated limb, and back was found persistent in the victims with lower-limb amputation 10 years after the 2008 Sichuan earthquake.Continuous post-earthquake assessment and management of amputation-related pain should be taken into consideration for the victims with lower-limb amputation.The comorbidity should be effectively and efficiently controlled for the victims with lower-limb amputation due to its association with the intensity and bothersomeness of amputation-related pain.

Sociodemographic Determinants for the Health-Related Quality of Life of Patients with Vascular Amputations as Determined with the Prosthesis Evaluation Questionnaire

Background: To identify the sociodemographic variables independently related to the different dimensions of the Prosthesis Evaluation Questionnaire (PEQ). Methods: An observational, cross-sectional study was conducted, with a sample of 61 Spanish vascular amputees (Valencia, Spain). Included in this study are the results of the PEQ and explanatory-sociodemographic variables, as well as a descriptive and analytic analysis. Results: Gender differences were observed in “appearance” and “perception of appearance” (significantly higher levels for men). Older patients tended to have worse scores in “utility”, “frustration”, “social burden” and “deambulation”. More favorable scores were obtained for those residing in rural areas in “social burden” and “deambulation”. Educational level had a positive correlation with scores. Conclusion: Gender, age, place of residence, and educational level could be considered determinants of the quality of health related to prosthesis adaptation in vascular amputees. Clinical relevance: Knowing the influential variables in the process of prosthetization will allow better adaptation and an improvement in the quality of life.

Reliability and construct validity of a new Danish translation of the Prosthesis Evaluation Questionnaire in a population of Danish amputees

BACKGROUND

Most amputees live with their prostheses for a long time. Therefore, quality of life is an important outcome for lower limb amputees.

OBJECTIVE

To translate the Prosthesis Evaluation Questionnaire (PEQ) and evaluate psychometric properties.

STUDY DESIGN

Methodological research.

METHODS

Lower limb amputees responded to electronic versions of the PEQ and SF-36v2 at baseline (n=64), after two weeks (n=51), and after 12 weeks (n=50). Reliability was assessed using Cronbach's alpha and intraclass correlation coefficient (ICC) analyses of the baseline and two weeks test-retest data. Estimates for standard error of measurement (SEM) were calculated based on reliability estimates. Construct validity was evaluated by testing using hypotheses testing.

RESULTS

Reliability estimates (ICC/Cronbach's alpha) for the nine subscales were: Social Burden (0.85/0.76), Appearance (0.85/0.72), Residual Limb Health (0.80/0.69), Well-Being (0.78/0.90), Utility (0.76/0.89), Frustration (0.74/0.90), Perceived Response (0.62/0.80), Ambulation (0.61/0.94), Sounds (0.51/0.65). Construct validity was supported in three out of four subscales evaluated.

CONCLUSIONS

The subscales Social Burden, Appearance, Well-Being, Utility and Frustration had consistent high reliability, supporting their use in assessing the prosthesis related quality of life in lower limb amputees. Results were mixed on three other scales (Residual Limb Health, Perceived Response, and Ambulation), while one scale, Sounds, had consistent low reliability. Clinical relevance For the first time a patient reported disease specific quality of life measure for lower limb amputees is available in Danish. Health care providers can now identify patients with reduced quality of life and measure treatment and rehabilitation effects over time.

Reliability and validity of the Finnish version of the prosthesis evaluation questionnaire

BACKGROUND

Thus far there have been no specific patient-reported outcome instrument in Finnish for health-related quality of life (HRQoL) assessment after major lower extremity amputation and successful prosthesis fitting.

METHODS

The prosthesis evaluation questionnaire (PEQ) was translated and cross-culturally adapted into Finnish. Participants completed a questionnaire package including the Finnish version of the PEQ and the 15 D HRQoL instrument. Scales (n = 10) were tested for internal consistency, floor-ceiling effect, and reproducibility for which participants completed the PEQ twice within a 2-week interval. Validity was tested by estimating the correlation between the 15 D index and the scales. The authors included 122 participants who had completed the questionnaire on two separate occasions in the final analysis.

RESULTS

Mean scale scores of the 10 scales varied from 52 to 83. Cronbach's alphas ranged from 0.67 to 0.96. The total score showed no floor-ceiling effect. Reproducibility of the scales was good (intraclass correlation coefficient, 0.78-0.87; coefficient of repeatability, 19-36). Significant correlations were observed between the 15 D index and the scales for ambulation, social burden, usefulness, and well-being.

CONCLUSIONS

This study provided evidence of the reliability and validity of the Finnish version of the PEQ in assessing the HRQoL among major lower extremity amputated patients who have been fitted with prosthesis. Implications for rehabilitation Measurement of quality of life during rehabilitation can provide important information on patients' well-being. The prosthesis evaluation questionnaire (PEQ) is a valid instrument for assessing health-related quality of life (HRQoL) after major lower extremity amputation. This study provided evidence of the reliability and validity of the Finnish version of the PEQ for assessing HRQoL among patient who have undergone major lower extremity amputation.

Cross-cultural validation of the Prosthesis Evaluation Questionnaire in vascular amputees fitted with prostheses in Spain

BACKGROUND

The lack of specific prosthetic-related outcome instruments for Spanish amputees must be addressed.

OBJECTIVE

To elaborate a culturally equivalent version of the Prosthesis Evaluation Questionnaire in the Spanish language.

STUDY DESIGN

Cross-cultural questionnaire validation.

METHODS

Two-step process for cultural adaptation: forward and backward translations of English original and Spanish translated versions; assessment of both construct and criterion validity and reliability in a group of vascular amputees.

RESULTS

A total of 61 patients were recruited, 44 men (72.1%) and 17 women (27.9%), with a median age of 71.1 years (standard deviation: 7.7 years; range: 51-87 years). In the Prosthesis Evaluation Questionnaire-Spanish, the lowest scores were for gait and frustration, and the highest scores were for noise and stump health. Internal consistency of the questionnaire was acceptable (>0.70) for four of the scales used in the Prosthesis Evaluation Questionnaire but poor (<0.50) for the scales relating to appearance and stump health. Correlations with the quality-of-life levels as measured by the Short Form-36 were positive and mostly significant.

CONCLUSION

Prosthesis Evaluation Questionnaire-Spanish could assess the quality of life in patients who have undergone vascular amputations and then been fitted with a prosthetic limb. The questionnaire shows adequate criteria validity when compared with other instruments for measuring quality of life.

CLINICAL RELEVANCE

The Prosthesis Evaluation Questionnaire-Spanish could be a valid and reliable instrument for assessing adaptation to prostheses in vascular amputees. The questionnaire adds information relevant to the patient and the physician and may identify cases with poor expected adaptation to the prosthesis.

The prosthesis evaluation questionnaire: reliability and cross-validation of the Turkish version

[Purpose] Currently, there are a limited number of amputee-specific instruments for measuring prosthesis-related quality of life with good psychometric properties in Turkey. This study translated the Prosthetic Evaluation Questionnaire to Turkish and analyzed as well as discussed its construct validity and internal consistency. [Subjects and Methods] The Prosthetic Evaluation Questionnaire was adapted for use in Turkish by forward/backward translation. The final Turkish version of this questionnaire was administered to 90 unilateral amputee patients. Second evaluation was possible in 83 participants within a median 28 day time period. [Results] Point estimates for the intraclass correlation coefficient ranged from 0.69 to 0.89 for all 9 Prosthetic Evaluation Questionnaire scales, indicating good correlation. Overall Cronbach's alpha coefficients ranged from 0.64 to 0.92, except for the perceived response subscale of 0.39. The ambulation subscale was correlated with the physical functioning subscales of Short Form-36 (SF-36) (r=0.48). The social burden subscale score of the Prosthetic Evaluation Questionnaire was correlated with social functioning subscales of SF-36 (r= 0.63). [Conclusion] The Turkish version of the Prosthetic Evaluation Questionnaire is a valid and reliable tool for implementation in the Turkish unilateral amputee population.