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Clinimetrics of performance-based functional outcome measures for vascular amputees: A systematic review - 21/10/23

Doi : 10.1016/j.rehab.2023.101756 
Amirah Essop-Adam a, c, , Enya Daynes c, e, f , John S.M. Houghton a, b, c , Andrew T.O. Nickinson a, b, c , Robert D.S. Sayers a, b, c , Victoria J. Haunton a , Coral Pepper d , Sally J. Singh c, e, f
a Department of Cardiovascular Sciences, College of Life Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, United Kingdom 
b Leicester Vascular Institute, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Groby Road, Leicester LE3 9QP, United Kingdom 
c National Institute for Health Research Leicester Biomedical Research Centre, The Glenfield Hospital, Leicester, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, United Kingdom 
d Library Service, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Groby Road, Leicester, LE3 9QP, United Kingdom 
e Centre of Exercise and Rehabilitation Sciences, Leicester NIHR Biomedical Research Centre-Respiratory, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom 
f Department of Respiratory Sciences, University of Leicester, Groby Road, Leicester, LE3 9QP, United Kingdom 

Corresponding author at: Department of Cardiovascular Sciences, College of Life Sciences, University of Leicester, Glenfield Hospital, Groby Road, Leicester LE3 9QP, United Kingdom.Department of Cardiovascular Sciences, College of Life SciencesUniversity of Leicester, Glenfield HospitalGroby RoadLeicesterLE3 9QPUnited Kingdom

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Abstract

Background

Objective physical performance-based outcome measures (PerBOMs) are essential tools for the holistic management of people who have had an amputation due to vascular disease. These people are often non-ambulatory, however it is currently unclear which PerBOMs are high quality and appropriate for those who are either ambulatory or non-ambulatory.

Research question

Which PerBOMs have appropriate clinimetric properties to be recommended for those who have had amputations due to vascular disease (‘vascular amputee’)?

Data sources

MEDLINE, CINAHL, EMBASE, EMCARE, the Cochrane Library, Cochrane Central Register of Controlled Trials (CENTRAL) and Scopus databases were searched for the terms: “physical performance” or “function”, “clinimetric properties”, “reliability”, “validity”, “amputee” and “peripheral vascular disease” or “diabetes”.

Review methods

A systematic review of PerBOMs for vascular amputees was performed following COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology and PRISMA guidelines. The quality of studies and individual PerBOMs was assessed using COSMIN risk of bias and good measurement properties. Overall PerBOM quality was evaluated with a modified GRADE rating. Key clinimetric properties evaluated were reliability, validity, predictive validity and responsiveness.

Results

A total of 15,259 records were screened. Forty-eight studies (2650 participants) were included: 7 exclusively included vascular amputees only, 35 investigated validity, 20 studied predictive validity, 23 investigated reliability or internal consistency and 7 assessed responsiveness. Meta-analysis was neither possible nor appropriate for this systematic review in accordance with COSMIN guidelines, due to heterogeneity of the data. Thirty-four different PerBOMs were identified of which only 4 are suitable for non-ambulatory vascular amputees. The Amputee Mobility Predictor no Prosthesis (AMPnoPro) and Transfemoral Fitting Predictor (TFP) predict prosthesis use only. PerBOMs available for assessing physical performance are the One-Leg Balance Test (OLBT) and Basic Amputee Mobility Score (BAMS).

Conclusion

At present, few PerBOMs can be recommended for vascular amputees. Only 4 are available for non-ambulatory individuals: AMPnoPro, TFP, OLBT and BAMS.

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Keywords : Clinimetrics, Physical performance, Vascular amputee, Outcome measures, Physiotherapy, Rehabilitation

Abbreviations : 2MWT, 6MWT, 10MWT, AMPnoPro, AUC, BAMS, BBS, CINAHL, CLTI, COSMIN, CROM, ECW, FFST, F8W, FRT, GDI, GRADE, K Levels, LEMCOT, MCID, NBWT, OLBT, PAD, PAM, PerBOM, PRISMA, PROM, PROSPERO, RMI, R, SMART goals, TFP, TUGT


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Vol 66 - N° 6

Article 101756- septembre 2023 Retour au numéro
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