Enhancing the Prosthetic Limb Users Survey of Mobility (PLUS-M) to Improve Measurement of Service Members, Veterans, and Civilians With High Mobility
Abstract
Objective: The goal of this project is to improve measurement of mobility for highly active Service members, Veterans, and civilians with lower limb amputation. The Prosthetic Limb Users Survey of Mobility (PLUS-M) was developed previously by the investigators to measure prosthetic mobility from the perspective of people with lower limb amputation. While PLUS-M is increasingly used in clinical practice and research, its ability to measure mobility in highly functional individuals is limited by a lack of questions pertaining to high-performance activities, such as running, playing sports, and carrying heavy loads. To address this limitation, we will identify and develop new questions that can be integrated into the PLUS-M instrument, thereby enhancing its ability to quickly and accurately measure people with high mobility. The proposed research will result in a brief, valid, and reliable measure appropriate for clinical administration or use in research studies. Rationale: Patient-reported outcome measures are survey instruments developed to measure important health outcomes from the patient’s perspective. As such, surveys like PLUS-M contribute valuable information toward a clinical assessment and complement information obtained from physical examination, diagnostic tests, and measures of physical performance. Use of patient-report surveys is widely advocated in both clinical care and research for measuring outcomes, like prosthetic mobility, that are challenging to measure in a clinic or laboratory. Although a number of surveys have been developed to assess mobility in people with lower limb amputation, none are suitable for measuring people with very high mobility. This critical limitation in patient-reported mobility measures inhibits their ability to guide clinical care of people with lower limb amputation or to be used as primary outcome measures in comparative effectiveness research studies. Efforts are therefore needed to improve patient-reported measurement of people with high mobility. Applicability and Impact of Research: The proposed research is directly relevant to the care and treatment of Veterans and Service members who have experienced lower limb amputation. Accurate and reliable measurement of mobility outcomes in people with limb amputation is critical for guiding clinical decisions, informing selection of prosthetic componentry, evaluating the effectiveness of rehabilitation interventions, and improving standardization of outcomes assessment. PLUS-M is currently used by researchers and clinicians worldwide, including those at U.S. Department of Veterans Affairs (VA) Regional Amputation Centers (RACs) and Polytrauma/Amputation Network Sites (PANs). Enhancing PLUS-M for high mobility measurement will further increase its use by those who serve highly active amputees. Patients Who Will Be Aided by the Research: Service members and Veterans with lower limb amputation exhibit a broad range of mobility capabilities, from those who are unable to walk short distances without assistance to those who run ultra-marathons. Availability of and access to instruments capable of measuring prosthesis users with both low and high mobility is therefore important to the more than 40,000 people with lower limb amputation currently receiving care in the Military and Veteran healthcare systems. Clinical Applications, Benefits, and Risks: Improved measurement of key health outcomes, like mobility, will help clinicians and researchers to monitor Service members and Veterans as they progress through rehabilitation, transition between healthcare systems, and experience changes in function over the course of their lives. Risks to study participants are minimal; as a part of these studies, they will be asked to complete surveys and perform tests that are routinely used in the clinical care of people who are highly active. Projected Timeline: We anticipate that the enhanced PLUS-M measure will be availa
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Oct 29, 2018
- Source ID
- W81XWH1710551
Entities
People
- Brian J Hafner
Organizations
- United States Army
- University of Washington