IS A NEW ACUTE FUNCTIONAL OUTCOME MEASURE ASSOCIATED WITH LONG-TERM OUTCOME IN TRAUMATIC BILATERAL LOWER LIMB AMPUTEES AND DOES IT DEMONSTRATE INTER-RATER RELIABILITY?
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Objectives This study explored a new functional outcome measure known as the Pre Prosthetic Functional Outcome Measure (PPFOM). The PPFOM was analysed regarding its relationship with long-term outcome in traumatic bilateral lower limb amputees and its inter-rater reliability. Method Part one studied the relationship between the PPFOM and a validated long-term outcome measure, the Amputee Mobility Predictor Questionnaire (AMP). Part two studied the inter-rater reliability of the PPFOM by two physiotherapists assessing the same participants at the same time. Participants Part one: 21 traumatic bilateral lower limb amputees. Part two: 12 with varying levels and numbers of amputations. Results Part one found that there was a linear relationship between the PPFOM and the AMP. The inter-class correlation coefficient is 0.584 (p=0.005), with the outliers removed this was 1.0. Even without removing the outliers this indicates a statistically significant correlation between the two outcome measures. The coefficient of determination (R2) is 34.1% and therefore there may be other factors that would account for the rest of the variability (65.9%). This would need to be explored from a clinical perspective. 3 Part two’s results were plotted with a ‘Bland Altman plot’. The 95% limits of agreement (LoA; bias ±(1.96 x sdiff) of the actual scores were 0.42 ± (3.96). Clinicians within amputee rehabilitation felt that this was an acceptable level of error. Conclusions Overall there is good correlation between the PPFOM and the AMP and therefore the PPFOM may be useful to predict the AMP. However, with the amount of variability unexplained by the PPFOM calibration model other factors need to be investigated. The PPFOM also demonstrated good inter-rater reliability and therefore could be used as an accepted clinical tool in the pre-prosthetic stage of amputee rehabilitation for all levels of amputation. Furthermore, there is such a vast variation within the amputee population in regard to function (from the cosmetic prosthetic user to the mountaineer) that it is an impossible task to ensure that one outcome measure fits all. An algorithm to guide clinicians towards the most appropriate outcome measures to use with the individual amputee would be a valuable tool for the patient, healthcare professionals and healthcare providers alike.
- Masters Degrees (Sport) 
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