A comparison of three measures of progress in early lower limb amputee rehabilitation.
OBJECTIVE
To assess the responsiveness to change and validity of three established outcome measures in relation to early lower limb vascular amputee rehabilitation: the Functional Independence Measure (FIM), the Office of Population Censuses and Surveys Scale (OPCS) and the Amputee Activity Score (AAS).


METHODS
Prospective observational study.


METHODS
Inpatient amputee rehabilitation unit.


METHODS
Fifty-one consecutive patients admitted for rehabilitation following lower limb amputation for vascular disease.


METHODS
To study the responsiveness to change differences between total scores and between subsection scores at different times were analysed. To assess validity, comparisons of the total scores of the measures were made with each other, and the total scores for each measure were compared with other outcomes.


RESULTS
Complete scores were obtained on 34 subjects. All measures showed significant change between admission and discharge (p < 0.00001) but only the AAS showed change between discharge and follow-up (p < 0.0001). Subsection analysis revealed expected improvements in mobility. During the inpatient stage progress was also detected in certain activities of daily living in the FIM and OPCS. The measures correlated with each other (p < 0.001). All of the measures' admission scores correlated with duration of stay (OPCS p < 0.005, AAS p < 0.006, FIM p < 0.009) and admission OPCS also correlated with discharge placement (p < 0.036).


CONCLUSIONS
The FIM and OPCS are suitable for the inpatient stage but the AAS would appear to be the best measure at time of discharge and thereafter, and further studies are justified.
Panesar
B S
BS
Astley Ainslie Hospital, Edinburgh, Scotland.
Morrison
P
P
Hunter
J
J
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000009:adverse effects / Q000523:psychology* / Q000534:rehabilitation*; D001186:Artificial Limbs; D017281:Cost of Illness; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007866:Leg / Q000601:surgery*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D016743:Mental Competency; D008875:Middle Aged; D010351:Patient Discharge; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome