Differences in Physical Performance Measures among Patients with Unilateral Lower-Limb Amputations Classified as Functional Level K3 versus K4

Publication date: Available online 1 February 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Jaclyn Megan Sions, Emma Haldane Beisheim, Tara Jo Manal, Sarah Carolyn Smith, John Robert Horne, Frank Bernard Sarlo
ObjectiveTo determine if differences in physical function, assessed via self-report questionnaires and physical performance tests, exist between individuals with lower-limb loss using a prosthetic device classified as a K3 versus a K4 functional level.DesignCross-sectional study.SettingUniversity of Delaware Physical Therapy Amputee Clinic.ParticipantsParticipants (n=55) were included if they were aged ≥18 years with a unilateral transfemoral or transtibial amputation, classified as K3 or K4 functional level, completed all relevant outcome measures, and currently were using a prosthesis.InterventionsNot applicable.Main Outcome MeasuresLocomotor Capabilities Index (LCI), Prosthetic Evaluation Questionnaire-Mobility Section (PEQ-MS), Timed Up and Go (TUG), 10-Meter Walk Test (10MWT), Amputee Mobility Predictor (AMPPRO), and 6 Minute Walk Test (6MWT). K-level was determined by group consensus based on a standardized clinical evaluation.ResultsAfter controlling for covariates, patients classified as K3 had slower TUG times (p=.002) and self-selected and fast gait speeds (p<.001), lower AMPPRO scores (p<.001), and walked shorter distances during the 6MWT (p=.003) when compared to patients classified as K4. No significant between-group differences for the LCI or PEQ-MS were found.ConclusionsClinicians involved in prosthetic prescription may consider including the TUG, 10MWT, AMPPRO, and 6MWT during their clinical evaluations to help differentiate between individuals of higher functional mobility. The LCI and PEQ-MS may be less useful in classifying individuals as K3 versus K4 due to a ceiling effect.



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