title: PSYCHOMETRIC EVALUATION OF THE HILL ASSESSMENT INDEX (HAI) AND STAIR ASSESSMENT INDEX (SAI) IN HIGH-FUNCTIONING TRANSFEMORAL AMPUTEES.
abstract: The hill assessment index (HAI) and stair assessment index (SAI) were developed to objectively evaluate ramp and stair gait. This study's purpose was to determine the validity and reliability of these tests in a sample of persons with unilateral transfemoral amputation (TFA) using microprocessor prosthetic knee systems. All subjects were fit with a microprocessor knee system. After accommodation, subjects performed three trials ascending and descending a 5° ramp and a flight of stairs while being recorded on video. Sensitivity and specificity for the HAI was calculated against degree of asymmetry in step length using Dartfish video analysis software. Reliability was assessed using intraclass correlational coefficients calculated using Spearman's Rho (rs).A priorisignificance level was set atp≤ 0.05. Twenty (n= 20) individuals with TFA completed the study protocol. Sensitivity and specificity of the HAI were calculated at 88.0% and 75.0% during ascending conditions and 94.0% and 67.0% during descending conditions, respectively. Significant correlations for the HAI included rs= 0.87 and rs= 0.73 within raters uphill and downhill, respectively. Corresponding coefficients of rs= 0.80 and rs= 0.67 were calculated between raters. For the SAI, significant correlations included rs= 1.00 for both comparisons within raters and in the comparison between raters in the ascending condition. A correlation of rs= 0.89 was calculated for the between-rater comparison in the descending condition. The HAI showed moderate to excellent sensitivity and specificity but good to adequate reliability. The SAI showed excellent to good reliability.
authors.affiliation: School of Physical Therapy & Rehabilitation Sciences, University of South Florida, Tampa, FL, USA; Extremity Trauma & Amputation Center of Excellence (EACE), U.S. Department of Veterans Affairs, Tampa, FL, USA; 319 Minimal Care Detachment, U.S. Army Reserves, Pinellas Park, FL, USA.
authors.forename: M Jason
authors.initials: MJ
authors.lastname: Highsmith
authors.affiliation: OP Solutions, Tampa, FL, USA; Prosthetic Design + Research, Tampa, FL, USA.
authors.forename: Jason T
authors.initials: JT
authors.lastname: Kahle
authors.affiliation: Ability Prosthetics and Orthotics, Greenville, SC, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Kaluf
authors.affiliation: School of Physical Therapy & Rehabilitation Sciences, University of South Florida, Tampa, FL, USA.
authors.forename: Rebecca M
authors.initials: RM
authors.lastname: Miro
authors.affiliation: Doctor of Physical Therapy Program, University of St. Augustine for Health Sciences, St. Augustine, FL, USA.
authors.forename: Larry J
authors.initials: LJ
authors.lastname: Mengelkoch
authors.affiliation: Prosthetics and Sensory Aids Service, James A. Haley Veterans' Hospital, Tampa, FL, USA.
authors.forename: Tyler D
authors.initials: TD
authors.lastname: Klenow
keywords: Gait evaluation; Observational gait assessment; Outcome measures; Physical therapy; Ramps; Rehabilitation; Step