Houghton Scale of prosthetic use in people with lower-extremity amputations: Reliability, validity, and responsiveness to change.
OBJECTIVE
To evaluate the responsiveness to change and the floor and ceiling effects of the Houghton Scale.


METHODS
One-week and 3-month test-retest to evaluate reliability, validity, and responsiveness to change.


METHODS
Amputee rehabilitation program.


METHODS
Persons (N=125) with unilateral or bilateral lower-extremity amputation who were wearing a prostheses: 1 group (n=49) for the reliability component and another group (n=76) for the responsiveness and validity component.


METHODS
Not applicable.


METHODS
Responsiveness to change, ceiling and floor effects, and reliability and convergent validity.


RESULTS
Evaluation of responsiveness to change (n=76) showed that the total score increased from a mean +/- standard deviation of 6.14+/-2.40 at discharge to 7.70+/-2.62 (P<.001) at follow-up 3 months later. Floor and ceiling effects were not detected for the overall score but were noted for the individual subscales. The internal consistency was moderate at discharge (Cronbach alpha=.71) and follow-up (Cronbach alpha=.70). The Houghton Scale correlated significantly, although moderately, with the physical composite score of the Medical Outcomes Study 36-Item Short-Form Health Survey (r=.393, P<.01) and the 2-minute walk test at admission (r=.620, P<.01) and discharge (r=.653, P<.01). The reliability (intraclass correlation coefficient=.96) of the Houghton Scale was high (n=49).


CONCLUSIONS
The Houghton Scale is appropriately responsive to change in prosthetic use in individuals with lower-limb amputation after rehabilitation.
Division of Physiatry, Department of Medicine, University of Toronto, Toronto, ON, Canada. mdevlin@westpark.org
Michael
M
Devlin
Tim
T
Pauley
Kris
K
Head
Susan
S
Garfinkel
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000368:Aged; D000671:Amputation, Surgical / Q000523:psychology* / Q000534:rehabilitation; D000674:Amputees / Q000523:psychology*; D001186:Artificial Limbs / Q000706:statistics & numerical data*; D016009:Chi-Square Distribution; D016002:Discriminant Analysis; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D018579:Patient Selection; D011446:Prospective Studies; D011475:Prosthesis Failure; D011594:Psychometrics; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards*; D013997:Time Factors