Outcome measures in amputation rehabilitation: ICF body functions

Abstract

Purpose: To identify and evaluate the lower limb amputation rehabilitation outcome measurement instruments that quantify those outcomes classified within the International classification of functioning, disability and health (ICF) category of body function or structure. This was done to summarise the current evidence base for the most commonly used outcome measurement tools and to provide clinicians with recommendations on how specific tools might be selected for use.

Method: A systematic review of the literature associated with outcome measurement in lower limb amputation rehabilitation was conducted. Only articles containing data related to metric properties (reliability, validity or responsiveness) for an instrument were included. Articles were identified by electronic and hand-searching techniques and were subsequently classified according to the ICF.

Results: Sixteen instruments were identified that were classified into one of Global mental function (12), Sensory and pain (1), Cardiovascular and respiratory (1) and Neuromusculoskeletal and movement (2). Evidence about metric properties and clinical utility was summarised in tables, which formed the basis for conclusions.

Conclusions: Few well-validated body function tools exist in the amputee literature, which may explain their lack of widespread use. For all scales, responsiveness to intervention has not been well established and should be the focus of future studies along with continued establishment of validity and reliability.