Rushton Paula W, Miller William C, Deathe A Barry
Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada.
Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
Prosthet Orthot Int. 2015 Dec;39(6):470-6. doi: 10.1177/0309364614545418. Epub 2014 Aug 18.
The L Test is a reliable/valid clinical evaluation of mobility that measures walking speed in seconds. It can be used with individuals with lower limb amputation. Responsiveness of the L Test is not yet determined.
The purpose of this pilot study was to determine how well the L Test identified individuals with a lower limb amputation who have/have not undergone a minimal clinically important difference.
Prospective follow-up study.
In total, 33 individuals with lower limb amputation, deemed to require a major intervention, were recruited consecutively from a follow-up clinic. Participants completed the L Test at baseline and follow-up. A Global Rating Change scale was also completed at follow-up.
The participants had a mean age ± standard deviation of 60 ± 13.0 years, and 81.8% had a transtibial amputation. The mean ± standard deviation for the L Test change scores was 6.0 ± 13.9. The area under the curve was 0.67, and the minimal clinically important difference was 4.5 s.
The L Test identified individuals as having an important clinical change. Results must be interpreted with caution, as the accuracy, based on the Global Rating Change scale, is low. Further inquiry into the L Test is encouraged.
The L Test can guide the clinical management of individuals with lower limb amputation. Results from this pilot study indicate that individuals with a lower limb amputation who improve by at least 4.5 s on the L Test after an intervention have likely undergone an important change. This result must be interpreted with caution given that the ability of the L Test to correctly identify individuals, who have and have not undergone an important change, using the Global Rating Change scale as the gold standard, is limited because this is a pilot study. It is plausible that the precision of the cut-point threshold could increase or decrease given a larger sample or when using a different method of identifying important clinical change.
L测试是一种可靠/有效的运动能力临床评估方法，以秒为单位测量步行速度。它可用于下肢截肢患者。L测试的反应性尚未确定。
本初步研究的目的是确定L测试在识别下肢截肢且有/无经历最小临床重要差异的个体方面的效果如何。
前瞻性随访研究。
总共从一家随访诊所连续招募了33名被认为需要进行重大干预的下肢截肢患者。参与者在基线和随访时完成L测试。随访时还完成了全球评分变化量表。
参与者的平均年龄±标准差为60±13.0岁，81.8%为经胫骨截肢。L测试变化分数的平均值±标准差为6.0±13.9。曲线下面积为0.67，最小临床重要差异为4.5秒。
L测试可识别有重要临床变化的个体。由于基于全球评分变化量表的准确性较低，结果必须谨慎解读。鼓励对L测试进行进一步研究。
L测试可指导下肢截肢患者的临床管理。本初步研究结果表明，干预后L测试成绩至少提高4.5秒的下肢截肢患者可能经历了重要变化。鉴于本初步研究中，以全球评分变化量表为金标准时，L测试正确识别有/无经历重要变化个体的能力有限，该结果必须谨慎解读。考虑到样本量更大或使用不同的识别重要临床变化的方法时，切点阈值的精度可能会提高或降低，这是合理的。
