Development of an item bank for measuring prosthetic mobility in people with lower limb amputation: The Prosthetic Limb Users Survey of Mobility (PLUS-M).
Development of an item bank for measuring prosthetic mobility in people with lower limb amputation: The Prosthetic Limb Users Survey of Mobility (PLUS-M).
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DOI：
10.1002/pmrj.12962
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发表时间：
2023-04
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中科院分区：
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使用假肢实现活动性是截肢后康复的常见目标，也是假肢研究的主要结局。可用于测量假体活动度的患者报告结果测量（PROM）具有实际和心理测量的局限性，这抑制了其在临床护理和研究中的使用。开发一种简单、有临床意义且心理测量学上可靠的PROM，以测量假体活动度。进行了一项横断面研究，以管理以前开发的候选项目，以全国样本的下肢假肢用户。项目被校准到项目反应理论模型，并创建了两个固定长度的简短形式。工具进行了评估的可读性，有效的测量范围，协议与完整的项目银行，天花板和地板的影响，收敛的有效性，和已知组的有效性。参与者是通过美国各地医院和假肢诊所张贴的传单、杂志广告、张贴在消费者网站上的通知和直接邮寄招募的。由于创伤或血管障碍原因导致单侧下肢截肢的成人假体使用者（N = 1091）。不适用因候选项目（N = 105）与患者报告的结局测量信息系统简介、假体评价问卷-活动子量表和活动特定平衡信心量表以及为描述受访者而创建的问题一起沿着进行管理。一个银行的44个校准的自我报告项目，称为假肢用户的流动性调查（PLUS-M），产生。采用临床和统计学标准选择7项和12项简表的项目。PLUS-M仪器具有8年级阅读水平，在广泛的受访者中精确测量，表现出几乎没有上限或下限效应，与现有PROM的分数相关，并区分预期具有不同流动性的受访者群体。PLUS-M似乎非常适合测量下肢截肢患者的假肢活动度。建议在临床和研究环境中使用PLUS-M仪器。
Achieving mobility with a prosthesis is a common post-amputation rehabilitation goal and primary outcome in prosthetic research studies. Patient-reported outcome measures (PROMs) available to measure prosthetic mobility have practical and psychometric limitations that inhibit their use in clinical care and research. To develop a brief, clinically-meaningful, and psychometrically-robust PROM to measure prosthetic mobility. A cross-sectional study was conducted to administer previously-developed candidate items to a national sample of lower limb prosthesis users. Items were calibrated to an item response theory model and two fixed-length short forms were created. Instruments were assessed for readability, effective range of measurement, agreement with the full item bank, ceiling and floor effects, convergent validity, and known groups validity. Participants were recruited using flyers posted in hospitals and prosthetics clinics across the United States, magazine advertisements, notices posted to consumer websites, and direct mailings. Adult prosthesis users (N=1091) with unilateral lower limb amputation due to traumatic or dysvascular causes. Not applicable. Candidate items (N=105) were administered along with the Patient Reported Outcome Measurement Information System Brief Profile, Prosthesis Evaluation Questionnaire – Mobility Subscale, and Activities-Specific Balance Confidence Scale, and questions created to characterize respondents. A bank of 44 calibrated self-report items, termed the Prosthetic Limb Users Survey of Mobility (PLUS-M), was produced. Clinical and statistical criteria were used to select items for 7- and 12-item short forms. PLUS-M instruments had an 8th grade reading level, measured with precision across a wide range of respondents, exhibited little-to-no ceiling or floor effects, correlated expectedly with scores from existing PROMs, and differentiated between groups of respondents expected to have different levels of mobility. The PLUS-M appears to be well suited to measuring prosthetic mobility in people with lower limb amputation. PLUS-M instruments are recommended for use in clinical and research settings.
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