Systematic Review of Measures of Impairment and Activity Limitation for Persons With Upper Limb Trauma and Amputation

Arch Phys Med Rehabil. 2017 Sep;98(9):1863-1892.e14. doi: 10.1016/j.apmr.2017.01.015. Epub 2017 Feb 14.

Abstract

Objective: (1) To identify outcome measures used in studies of persons with traumatic upper limb injury and/or amputation; and (2) to evaluate focus, content, and psychometric properties of each measure.

Data sources: Searches of PubMed and CINAHL for terms including upper extremity, function, activities of daily living, outcome assessment, amputation, and traumatic injuries.

Study selection: Included articles had a sample of ≥10 adults with limb trauma or amputation and were in English. Measures containing most items assessing impairment of body function or activity limitation were eligible.

Data extraction: There were 260 articles containing 55 measures that were included. Data on internal consistency; test-retest, interrater, and intrarater reliability; content, structural, construct, concurrent, and predictive validity; responsiveness; and floor/ceiling effects were extracted and confirmed by a second investigator.

Data synthesis: The mostly highly rated performance measures included 2 amputation-specific measures (Activities Measure for Upper Limb Amputees and University of New Brunswick Test of Prosthetic Function skill and spontaneity subscales) and 2 non-amputation-specific measures (Box and Block Test and modified Jebsen-Taylor Hand Function Test light and heavy cans tests). Most highly rated self-report measures were Disabilities of the Arm, Shoulder and Hand; Patient Rated Wrist Evaluation; QuickDASH; Hand Assessment Tool; International Osteoporosis Foundation Quality of Life Questionnaire; and Patient Rated Wrist Evaluation functional recovery subscale. None were amputation specific.

Conclusions: Few performance measures were recommended for patients with limb trauma and amputation. All top-rated self-report measures were suitable for use in both groups. These results will inform choice of outcome measures for these patients.

Keywords: Amputation; Disability evaluation; Rehabilitation; Upper extremity; Wounds and injuries.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Activities of Daily Living
  • Amputation, Surgical / methods
  • Amputation, Surgical / psychology
  • Amputation, Surgical / rehabilitation*
  • Amputees / psychology
  • Amputees / rehabilitation*
  • Arm Injuries / physiopathology
  • Arm Injuries / psychology
  • Arm Injuries / rehabilitation*
  • Disability Evaluation*
  • Humans
  • Patient Reported Outcome Measures*
  • Psychometrics
  • Quality of Life
  • Reproducibility of Results
  • Treatment Outcome
  • Upper Extremity / injuries
  • Upper Extremity / physiopathology