title: Selecting a test for the clinical assessment of balance and walking capacity at the definitive fitting state after unilateral amputation: a comparative study.
abstract: BACKGROUND
  There is a lack of data and consensus concerning the most appropriate functional evaluation in clinical practice at the definitive prosthetic phase after lower limb amputation.
  
  
  OBJECTIVE
  To determine among several selected functional tests the most pertinent to evaluate balance and prosthetic walking.
  
  
  METHODS
  Validation of a diagnostic procedure.
  
  
  METHODS
  Sixty-four patients were included.
  
  
  METHODS
  Timed Up and Go test, Functional Reach test (FRT), one-leg balance, tandem test, Modified Houghton Scale, Berg Balance Scale, two-minute walk test (2MW test). Correlations were assessed with the Pearson correlation coefficient and the Principal Component Analysis. Score distribution was analyzed with the Shapiro-Wilk W normality test. Receiver operating characteristic curves were drawn to identify the best predictor for the function.
  
  
  RESULTS
  The clinical tests correlated highly with each other. Only 2MW test and FRT did not have either a floor/ceiling effect, or a bi-modal distribution. The 2MW test was the best predictor of prosthetic walking limitations (area under the curve 0.93 (0.83-0.97), the best threshold was between 130 and 150 meters), and FRT was best for balance.
  
  
  CONCLUSIONS
  2MW test can be proposed as the first-line clinical test. The FRT can be indicated for the specific assessment of balance disorders. Clinical relevance This validation of a clinical evaluation of balance and walking capacity after lower limb amputation may be useful in everyday practice to ensure in a simple and standardized way the follow-up of patients and adapt treatments--especially prosthetics--at the definitive prosthetic phase.
authors.affiliation: Centre d'Investigation Clinique Plurithématique INSERM 803, CHU Dijon, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Gremeaux
authors.forename: Sabeur
authors.initials: S
authors.lastname: Damak
authors.forename: Odile
authors.initials: O
authors.lastname: Troisgros
authors.forename: Amine
authors.initials: A
authors.lastname: Feki
authors.forename: Davy
authors.initials: D
authors.lastname: Laroche
authors.forename: Dominic
authors.initials: D
authors.lastname: Perennou
authors.forename: Charles
authors.initials: C
authors.lastname: Benaim
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Casillas
mesh_terms: D000328:Adult; D000674:Amputees / Q000534:rehabilitation; D006305:Health Status Indicators; D006801:Humans; D017063:Outcome Assessment, Health Care; D004856:Postural Balance; D025341:Principal Component Analysis; D011594:Psychometrics; D012372:ROC Curve; D020127:Recovery of Function; D012680:Sensitivity and Specificity; D016138:Walking; D055815:Young Adult