The Locomotor Capabilities Index; validity and reliability of the Swedish version in adults with lower limb amputation.
BACKGROUND
The Locomotor Capabilities Index (LCI) is a validated measure of lower-limb amputees' ability to perform activities with prosthesis. We have developed the LCI Swedish version and evaluated its validity and reliability.


METHODS
Cross-cultural adaptation to Swedish included forward/backward translations and field testing. The Swedish LCI was then administered to 144 amputees (55 women), mean age 74 (40-93) years, attending post-rehabilitation prosthetic training. Construct validity was assessed by examining the relationship between the LCI and Timed "Up-and-Go" (TUG) test and between the LCI and EQ-5D health utility index in 2 subgroups of 40 and 20 amputees, respectively. Discriminative validity was assessed by comparing scores in different age groups and in unilateral and bilateral amputees. Test-retest reliability (1-2 weeks) was evaluated in 20 amputees (14 unilateral).


RESULTS
The Swedish LCI showed good construct convergent validity, with high correlation with the TUG (r = -0.75) and the EQ-5D (r = 0.84), and discriminative validity, with significantly worse mean scores for older than younger and for bilateral than unilateral amputees (p < 0.01), and high internal consistency (Cronbach alpha 0.95). In test-retest reliability the intraclass correlation coefficient was 0.91 (95% CI 0.79-0.96) but for the unilateral amputees was 0.83 (95% CI 0.56-0.94). Ceiling effect occurred in 23%.


CONCLUSIONS
The Swedish version of the LCI demonstrated good validity and internal consistency in adult amputees. Test-retest reliability in a small subsample appears to be acceptable. The high ceiling effect of the LCI may imply that it would be most useful in assessing amputees with low to moderate functional abilities.
Larsson
Brita
B
Department of Clinical Sciences, Lund University, Lund, Sweden. brita.larsson@adaptus.se
Johannesson
Anton
A
Andersson
Ingemar H
IH
Atroshi
Isam
I
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000534:rehabilitation*; D001186:Artificial Limbs; D004185:Disability Evaluation; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D008124:Locomotion; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D011597:Psychomotor Performance; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D013548:Sweden; D014177:Translations