Abstract
Objectives
(1) To develop a performance-based measure for adult upper limb (UL) prosthetic functioning
through broad (ie, overall performance) and functional domain-specific (eg, control
skills) assessment of commonplace activities; (2) to conduct initial psychometric
evaluation of the Capacity Assessment of Prosthetic Performance for the Upper Limb
(CAPPFUL).
Design
Internal consistency of CAPPFUL and interrater reliability for task, functional domain,
and full-scale (sub)scores among 3 independent raters were estimated. Known-group
validity was examined comparing scores by amputation level. Convergent validity was
assessed between CAPPFUL and 2 hand dexterity or function tests; discriminant validity
was assessed against self-reported disability.
Setting
Six prosthetic rehabilitation centers across the United States.
Participants
Subjects (N=60) with UL amputation using a prosthesis.
Interventions
Not applicable.
Main Outcome Measures
Not applicable.
Results
Interrater reliability was excellent for scoring on the task, domain, and full-scale
scores (intraclass correlation coefficients=.88-.99). Internal consistency was good
(α=.79-.82). Generally, subjects with higher UL amputation levels scored lower (worse)
than subjects with lower UL amputation levels. CAPPFUL demonstrated strong correlations
with measures of hand dexterity or functioning (rs=−.58 to .72) and moderate correlation with self-reported disability (r=−.35).
Conclusions
CAPPFUL was designed as a versatile, low-burden measure of prosthesis performance
for any UL functional prosthetic device type and any UL amputation level. CAPPFUL
assesses overall performance and 5 functional performance domains during completion
of 11 tasks that require movement in all planes while manipulating everyday objects
requiring multiple grasp patterns. Psychometric evaluation indicates good interrater
reliability, internal consistency, known-group validity, and convergent and discriminant
validity.
Keywords
List of abbreviations:
AM-ULA (Activities Measure for Upper Limb Amputees), BBT (Box and Block Test), CAPPFUL (Capacity Assessment of Prosthetic Performance for the Upper Limb), DASH (Disability of the Arm, Shoulder, and Hand), ICC (intraclass correlation coefficient), ICF (International Classification of Functioning, Disability and Health), JTHF (Jebsen-Taylor Hand Function Test), UL (upper limb), WHO (World Health Organization)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 17, 2018
Footnotes
Disclosures: Nathan T. Kearns and Warren T. Jackson received personal fees from Advanced Arm Dynamics, both during the conduct of the study and outside the submitted work. Jennifer K. Peterson, Lisa Smurr Walters, John M. Miguelez, and Tiffany Ryan hold positions as salaried employees of Advanced Arm Dynamics, outside the submitted work.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
