Colorado Limb Donning-Timed Up and Go (COLD-TUG) Test in Lower-Extremity Amputation: Less Donning Time with Osseointegrated Bone-Anchored Prosthetic Limb.

BACKGROUND Osseointegration of a bone-anchored limb (BAL) establishes a direct skeletal interface for prosthesis attachment, simplifying the donning/doffing process. The Timed Up and Go (TUG) test reliably assesses mobility in individuals with lower-extremity amputation who use socket prostheses, but it does not account for the time required to don a prosthetic limb. The aim of this study was to develop and examine the reliability and validity of the Colorado Limb Donning-Timed Up and Go (COLD-TUG) test. This test combines the time required for donning a prosthesis with the time to complete the TUG test in lower-extremity amputees using a prosthesis. METHODS Participants with a unilateral lower-extremity amputation were enrolled in this study; participants were divided into 2 groups: socket prosthesis users (n = 15) and BAL users (n = 22). The COLD-TUG test measured the time (in seconds) required to don the prosthesis, get up from a standard chair, walk 3 m, turn around, walk back to the chair, and sit down again. Group differences as well as the intrarater reliability and concurrent validity of the test were analyzed. RESULTS There were no significant differences between the 2 groups in terms of baseline characteristics. The intrarater reliability of the COLD-TUG test was excellent (intraclass correlation coefficient [ICC] = 0.94; p = 0.001). The concurrent validity between the COLD-TUG test and the TUG test in BAL patients was good (r = 0.712; p = 0.006). Participants in the BAL group had a significantly shorter mean COLD-TUG time (16.6 ± 5.6 seconds) compared with participants in the socket-prosthesis group (85.3 ± 61.4 seconds) (p < 0.001). CONCLUSIONS The COLD-TUG test accurately measures prosthesis-donning burden in the context of functional mobility, thus providing valuable insights into functional abilities and quality of life. Use of a BAL was associated with a shorter donning time compared with use of a socket prosthesis. LEVEL OF EVIDENCE Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.