Resnik Linda, Borgia Matthew, Heinemann Allen W, Stevens Phillip, Clark Melissa A, Ni Pengsheng
Providence VA Medical Center, Providence, RI, USA.
Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI, USA.
Disabil Rehabil. 2023 Nov;45(22):3768-3778. doi: 10.1080/09638288.2022.2138572. Epub 2022 Nov 10.
To develop a self-report measure of activity performance for upper limb prosthesis users that quantifies outcomes by level of amputation and prosthesis type.
Telephone survey of 423 adults with major upper limb amputation (ULA) who used a prosthesis. Item generation, cognitive, and pilot testing were followed by field testing. Items were categorized as one- or two-handed. Factor and Rasch analyses evaluated unidimensionality, monotonicity, item fit, differential item functioning (DIF), and reliability. Test-retest reliability was evaluated with intraclass correlation coefficients (ICCs). Known group validity was assessed with ANOVAs.
Respondents with unilateral ULA utilized prosthesis for 24% of unilateral and 38% of bilateral tasks. Those with bilateral ULA utilized prostheses for 64% of unilateral and 46% of bilateral tasks. Factor analyses identified a One-handed Task factor (CFI = 0.963, TLI = 0.950, and RMSEA = 0.064) and a Two-Handed Task factor (CFI = 0.958, TLI = 0.953, and RMSEA = 0.053). Response categories were collapsed to address monotonicity. After DIF adjustment, person reliability was 0.49 and 0.82 for One-handed and Two-handed Task scales, respectively, and ICCs were 0.88 and 0.91. Both scales differed by amputation level ( < 0.001).
The Upper Extremity Functional Scale for Prosthesis Users (UEFS-P) measure of upper limb function of prosthesis users has promising psychometric properties.Implications for rehabilitationMeasurement of upper limb function in persons with amputation is challenging, given currently available measures which do not explicitly grade activity performance with a prosthesis.The Upper Extremity Functional Scale for Prosthesis Users (UEFS-P) builds upon the original Orthotics and Prosthetics User Survey (OPUS) UEFS Scale with modified instructions, a revised item set, response categories and scoring algorithm.The UEFS-P consists of two unidimensional scales, the One-handed Tasks scale and the Two-handed Tasks scale.The UEFS-P scales have clear advantages over existing self-report measures of upper limb function that ask about difficulty with performing functional activities without accounting for prosthesis use, and do not differentiate persons who use and do not use a prosthesis.
开发一种针对上肢假肢使用者的活动表现自我报告测量方法，该方法可根据截肢水平和假肢类型对结果进行量化。
对423名使用假肢的上肢主要截肢（ULA）成年人进行电话调查。在进行项目生成、认知测试和预测试之后进行现场测试。项目分为单手或双手类别。因子分析和拉施分析评估了单维度性、单调性、项目拟合度、项目功能差异（DIF）和信度。使用组内相关系数（ICC）评估重测信度。通过方差分析评估已知组效度。
单侧ULA受访者在24%的单侧任务和38%的双侧任务中使用假肢。双侧ULA受访者在64%的单侧任务和46%的双侧任务中使用假肢。因子分析确定了一个单手任务因子（CFI = 0.963，TLI = 0.950，RMSEA = 0.064）和一个双手任务因子（CFI = 0.958，TLI = 0.953，RMSEA = 0.053）。为解决单调性问题，对响应类别进行了合并。在进行DIF调整后，单手和双手任务量表的个人信度分别为0.49和0.82，ICC分别为0.88和0.91。两个量表在截肢水平上均存在差异（<0.001）。
上肢假肢使用者功能量表（UEFS-P）对上肢假肢使用者上肢功能的测量具有良好的心理测量学特性。对康复的意义鉴于目前可用的测量方法未明确根据假肢对活动表现进行分级，因此对截肢者上肢功能的测量具有挑战性。上肢假肢使用者功能量表（UEFS-P）在原始矫形器和假肢使用者调查（OPUS）UEFS量表的基础上进行了改进，包括修改了说明、修订了项目集、响应类别和评分算法。UEFS-P由两个单维度量表组成，即单手任务量表和双手任务量表。与现有的上肢功能自我报告测量方法相比，UEFS-P量表具有明显优势，现有方法询问执行功能活动的难度时未考虑假肢使用情况，也未区分使用和未使用假肢的人群。
