Evaluation of the validity of the prosthetic upper extremity functional index for children

Abstract

Objective: To evaluate the validity of the Prosthetic Upper Extremity Functional Index (PUFI), a parent- and older child-report measure that evaluates the extent of Prosthetic limb use, ease of task performance with and without the prosthesis, and its usefulness.

Design: Evaluation of discriminant validity (the PUFI's ability to detect differences between children), construct validity (between the parent-report PUFI and University of New Brunswick Test of Prosthetic Function [UNB Test]), and criterion validity (comparison of parent-report PUFI responses with an assessor's scores of a child's performance of PUFI activities).

Setting: Four pediatric amputee clinics.

Participants: Thirty-eight children, ages 3 to 18 years, with unilateral upper-extremity amputation and a prosthesis.

Interventions: Not applicable.

Main outcome measures: The PUFI and the UNB Test.

Results: The PUFI differentiated between children in high and low UNB Test score categories, and between younger and older children's functional abilities. The extent of correlation between PUFI ratings and UNB skill of performance scores was moderate for "ease of performance" and "usefulness of prosthesis" categories (r>.47, P<.05). The level of agreement between parent report and observational assessment of PUFI skills was acceptable (weighted kappa range,.44-.65).

Conclusions: The PUFI showed acceptable validity and showed promise in identifying prosthetic skill and use in children of different ages and abilities.