title: Prosthesis donning and doffing questionnaire: Development and validation.
abstract: OBJECTIVE
  To develop a questionnaire that specifically evaluates the ability of trans-tibial amputees to don and doff a prosthesis and to investigate the psychometric properties of the newly developed questionnaire.
  
  
  BACKGROUND
  Prosthesis should be donned and doffed few times during the day and night; thus, it is important to measure ease of donning and doffing.
  
  
  METHODS
  A cross-sectional study.
  
  
  METHODS
  The questionnaire was designed and evaluated by a group of experts. The final questionnaire was administered to 50 individuals with trans-tibial amputation. A test-retest study was also conducted on 20 amputees to assess the repeatability of questionnaire items.
  
  
  RESULTS
  The prosthesis donning and doffing questionnaire was developed and tested through a pilot study. Based on Kappa index, the questionnaire items showed correlation coefficients greater than 0.7, which indicate good reliability and repeatability. The majority of the participants had good hand dexterity (80%) and could perform all types of grasps. The mean satisfaction scores with donning and doffing were 69.9 and 81.4, respectively. Most of the respondents needed to don and doff the prosthesis 3.44 times per day. Based on a 7-point score, the total scores ranged between 3 and 7.
  
  
  CONCLUSIONS
  The prosthesis donning and doffing questionnaire items showed good psychometric properties. A scoring method was suggested based on the pilot sample, which requires further evaluation to be able to differentiate between more suspension types. A larger international multicenter evaluation is required in the future to measure the responsiveness of the scales. This questionnaire will be useful in the evaluation of the ability of amputees to don and doff a trans-tibial limb prosthesis. Clinical relevance Donning and doffing of prostheses are challenging tasks for many lower limb amputees. The prosthesis donning and doffing questionnaire, on its own or combined with other prosthetic evaluation questionnaires, has the potential to help manufacturers, clinicians, and researchers gain knowledge and improve the donning and doffing qualities of prostheses.
authors.affiliation: 1 Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Noor Azuan
authors.initials: NA
authors.lastname: Abu Osman
authors.affiliation: 1 Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia.|2 Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.
authors.forename: Arezoo
authors.initials: A
authors.lastname: Eshraghi
authors.affiliation: 1 Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia.|3 Ottawa Hospital Research Institute, Centre for Rehabilitation Research and Development, Ottawa, Canada.
authors.forename: Hossein
authors.initials: H
authors.lastname: Gholizadeh
authors.affiliation: 1 Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Wan Abu Bakar
authors.initials: WAB
authors.lastname: Wan Abas
authors.affiliation: 4 Ossur ehf, R&D Medical Office, Reykjavik, Iceland.
authors.forename: Knut
authors.initials: K
authors.lastname: Lechler
mesh_terms: D000328:Adult; D000671:Amputation, Surgical; D000674:Amputees / Q000523:psychology; D001186:Artificial Limbs; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011474:Prosthesis Design; D011594:Psychometrics; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
keywords: Amputation; disability evaluation; prosthesis; psychometrics; questionnaires; rehabilitation