Measuring long-term outcome in people with lower limb amputation: cross-validation of the Italian versions of the Prosthetic Profile of the Amputee and Prosthesis Evaluation Questionnaire.

AIM

Recently 2 questionnaires have been developed for people with lower limb amputation to determine, in follow-up studies, the level of function and extent of prosthetic use, to measure major life domains connected with prosthesis function, and to study the factors potentially related to prosthetic use the Prosthetic Profile of the Amputee (PPA) and the Prosthesis Evaluation Questionnaire (PEQ). The purpose of the present study was: a) to produce Italian versions of both PPA (PPA-it) and PEQ (PEQ-it), using a validated procedure of cross-cultural translation; b) to analyse and discuss the internal consistency and construct validity of the main sections of the 2 questionnaires, in an Italian population.

METHODS

The PPA questionnaire consists of 44 questions arranged in 6 sections. The PEQ is composed of 82 questions subdivided into 9 scales related to 4 sectors. In order to produce the Italian versions of the PPA and PEQ the forward/backward translation method was used. The final versions of the questionnaires were mailed to 110 patients and 95 of them returned the questionarries.

RESULTS

The Cronbach's alpha of Locomotor Capabilities Index (LCI/5), part of the PPA, was 0.97, and those of the 9 PEQ-it scales ranged from 0.64 (appearance) to 0.95 (mobility, MO). The LCI/5 and MO correlated highly with each other (rs=0.81) and with the variables related to prosthesis use. There was a significant correlation among the PEQ-it domains concerning MO, prosthesis function, psycho-social aspects and well-being.

CONCLUSION

Unfortunately, the acceptability and feasibility of both questionnaires (rather low completion rate, visual analogue scale format of PEQ, demanding scoring procedures) were sub-optimal, and their structure (item selection, response format, scaling properties, etc.) would need some refinement and simplification in order to facilitate a broader clinical use. On the other hand, findings for the LCI/5 (PPA) and MO (PEQ) are encouraging (particularly regarding the first scale) and confirm their sound practical and psychometric features.