Repeatability and Validity of the Prosthetic Observational Gait Scale in Patients with Bilateral Lower Limb Amputations 4345

Abstract

Objectives

To investigate the repeatability and validity of the Prosthetic Observational Gait Scale (POGS) in individuals with bilateral lower limb amputations. Establishing its repeatability and validity underscored the significance of POGS in clinical practice, providing a simple yet reliable means of quantitative gait assessment accessible to a broad range of clinicians.

Design

Prospective observational cohort study on the interrater and intrarater validation and repeatability of POGS.

Setting

The study participants were obtained from the Superhumans Center (Vynnyky, Lviv, Ukraine)—a medical center for prosthetics, reconstructive surgery, and the rehabilitation of people affected by the war. Outpatient rehabilitation and follow-up post discharge.

Participants

In the current study were observed 12 male patients (N=12), who had bilateral lower limb amputees due to combat actions: 4 TF bilateral, 4 TT bilateral, 3 hip disarticulation+TF, and 1 TF+TT. The average age of participants was 37±11 years.

Interventions

Six observers, all of whom were physiotherapists, scored the patients’ videos using the observational gait scale. All had access to video playback facilities, enabling pause and slow-motion viewing. These videos were then reassessed in a new, randomly selected order at least 1 week after the initial analysis.

Main Outcome Measures

The study aimed to investigate the consistency of gait assessments made by different observers (interrater) and the same observer over time (intrarater).

Results

The intraobserver (COR) had an average coefficient of 8.7 (range, 6.1-11.7), indicating poor repeatability over time. Observers: 1 COR, 6.9; 2 COR, 7.2; 3 COR, 10.4; 4 COR, 6.1; 5 COR, 9.6; and 6 COR, 11.7. Two-way analysis of variance for the factor “observer,” P=.0009. The overall percentage agreement ranged from 43% to 93%. Kappa statistics for the 26 items, 5 showed good agreement, 11 moderate agreement, 6 fair agreement, and 4 poor agreement.

Conclusions

In summary, the study reveals concerns regarding the scale's (POGS) reliability in individuals with bilateral lower limb amputations. Intraobserver repeatability demonstrated significant variability over time, with each observer showing varying levels of consistency. The interobserver repeatability also raised concerns, indicating poor agreement among different observers. Given these limitations, it is advisable to integrate instrumental video analysis into clinical practice for individuals with bilateral lower limb amputations.

Disclosures

none.