Houghton Scale of prosthetic use in people with lower-extremity amputations: Reliability, validity, and responsiveness to change.

OBJECTIVE

To evaluate the responsiveness to change and the floor and ceiling effects of the Houghton Scale.

DESIGN

One-week and 3-month test-retest to evaluate reliability, validity, and responsiveness to change.

SETTING

Amputee rehabilitation program.

PARTICIPANTS

Persons (N=125) with unilateral or bilateral lower-extremity amputation who were wearing a prostheses: 1 group (n=49) for the reliability component and another group (n=76) for the responsiveness and validity component.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Responsiveness to change, ceiling and floor effects, and reliability and convergent validity.

RESULTS

Evaluation of responsiveness to change (n=76) showed that the total score increased from a mean +/- standard deviation of 6.14+/-2.40 at discharge to 7.70+/-2.62 (P<.001) at follow-up 3 months later. Floor and ceiling effects were not detected for the overall score but were noted for the individual subscales. The internal consistency was moderate at discharge (Cronbach alpha=.71) and follow-up (Cronbach alpha=.70). The Houghton Scale correlated significantly, although moderately, with the physical composite score of the Medical Outcomes Study 36-Item Short-Form Health Survey (r=.393, P<.01) and the 2-minute walk test at admission (r=.620, P<.01) and discharge (r=.653, P<.01). The reliability (intraclass correlation coefficient=.96) of the Houghton Scale was high (n=49).

CONCLUSIONS

The Houghton Scale is appropriately responsive to change in prosthetic use in individuals with lower-limb amputation after rehabilitation.