Identifying Prosthetic Capabilities That Define Functionality of Individuals With Amputation

ABSTRACT Introduction Although the physical abilities associated with activity, exercise, and fitness within the general population of individuals without disabilities have been well established, it is unclear if these abilities define the physical function of individuals with lower-limb amputations (LLAs) who use a prosthesis. A multidimensional definition of the physical function of people with LLA must consider what abilities are necessary and relevant. Objectives This literature review aimed to identify common abilities used to evaluate the physical function of people with LLA. A secondary aim was to evaluate if each identified ability had been indirectly addressed by existing questionnaires and performance-based tests. Study Design Literature Review. Methods Ten common physical abilities associated with measuring the physical function of LLA were identified through literature review. These identified abilities were used to assess what aspects had been indirectly addressed by existing questionnaires and performance-based evaluations of LLA physical function. Results and Conclusions Abilities identified through literature review included agility, balance, comfort, endurance, flexibility, load, maneuverability, power, strength, and symmetry. These 10 abilities are important and commonly used as outcome measures associated with the physical function of people with LLA. Although each ability was addressed by multiple assessments, no assessment addressed all 10 identified abilities. The Prosthetic Limb Users Survey of Mobility, Prosthetic Profile of the Amputee, Rivermead Mobility Index, and the Amputee Mobility Predictor addressed most (8–9 of 10) of the identified abilities. There were clear differences and gaps in the abilities addressed by current assessments, possibly because they rely on an incomplete definition of what is required for LLA physical function. We propose that these 10 abilities are unique and underlie the definition of LLA physical function. However, future work must assess the validity of this proposed framework. Clinical Relevance A multidimensional definition of LLA physical function is necessary to enable more appropriate prosthetic design, prescription, and use. Promoting greater mobility and physical activity levels within this population will improve health of people with LLA.