Determining Reliability of a Dual-task Functional Mobility Protocol for Individuals with Lower Extremity Amputations

Publication date: Available online 6 January 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Courtney Frengopoulos, Michael WC. Payne, Jeffrey Holmes, Ricardo Viana, Susan W. Hunter
ObjectivesTo determine the relative and absolute reliability of a dual-task functional mobility assessment.DesignCross-sectional study.SettingAcademic Rehabilitation Hospital.ParticipantsSixty individuals with lower extremity amputation (LEA) attending an outpatient amputee clinic (age= 58.21±12.59; 80.0% male). Subjects were stratified into three groups: 1) transtibial amputations of vascular etiology (TTA-vas), transtibial amputations of non-vascular etiology (TTA-nonvas); transfemoral or bilateral amputees (TFA/bilat) of any etiology.InterventionsN/AMain Outcome MeasuresTime to complete the L Test measured functional mobility under single- and dual-task conditions. Addition of a cognitive task (serial subtractions by 3s) created dual-task conditions. Single task performance on the cognitive task was also reported. Intra-class correlation coefficients (ICC) measured relative reliability; standard error of measurement (SEM) and minimal detectable change with a 95% confidence interval (MDC95) measured absolute reliability. Bland and Altman plots measured agreement between assessments.ResultsRelative reliability results were excellent for all three groups. Values for the dual-task L Test for those with TTA-vas (n=20, age=60.36±7.84, 90.0% male) were ICC=0.98 (95% CI, 0.94-0.99), with SEM=1.36s and MDC95 of 3.76s; for those with TTA-nonvas (n=20, age=55.85±14.08, 85.0% male), were ICC=0.93 (95% CI, 0.80-0.98), SEM=1.34s and MDC95 of 3.71s; and for those with TFA/bilat group (n=20, age=58.21±14.88, 65.0% male) were ICC=0.998 (95% CI, 0.996-0.999), SEM=1.03s and an MDC95 of 2.85s. Bland-Altman plots indicated that assessments did not vary systematically for each group.ConclusionsThis dual-task assessment protocol achieved approved levels of relative reliability values for the three groups tested. This protocol may be used clinically or in research settings to assess the interaction between cognition and functional mobility in the LEA population.



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