Abstract-The opportunity for wounded servicemembers (SMs) to return to high-level activity and return to duty has improved with advances in surgery, rehabilitation, and prosthetic technology. As a result, there is now a need for a high-level mobility outcome measure to assess progress toward high-level mobility during and after rehabilitation. The purpose of this study was to develop and determine the reliability of a new outcome measure called the Comprehensive High-Level Activity Mobility Predictor (CHAMP). The CHAMP consists of the Single Limb Stance, Edgren Side Step Test, T-Test, and Illinois Agility Test. CHAMP reliability was determined for SMs with lower-limb loss (LLL) (interrater: n = 118; test-retest: n = 111) and without LLL (n = 97). A linear system was developed to combine the CHAMP items and produce a composite score that ranges from 0 to 40, with higher scores indicating better performance. Interrater and test-retest intraclass correlation coefficient values for the CHAMP were 1.0 and 0.97, respectively. A CHAMP score equal to or greater than 33 points is within the range for SMs without LLL. The CHAMP was found to be a safe and reliable measure of high-level mobility in SMs with traumatic LLL.Key words: agility, high-level activity, lower-limb loss, military personnel, mobility, OIF/OEF, outcome measures, reliability, traumatic amputation, Veterans.

The high frequency of static and dynamic palpation methods used during evaluation of SIJ problems in clinical practice demands an understanding of the factual quantity of movement at the SIJ. The objective of this systematic literature review was to synthesize three-dimensional (3-D) motion of the sacroiliac joint (SIJ) during various functional static postures and movements and to determine the clinical utility of movement during examination. A computer-based search was performed by means of OVID, which included Medline (February 1966 to April 2007) and CINAHL (February 1982 to April 2007) using the key words Pelvis, Kinematics, Imaging, Three-dimensional, and Stereophotogrammetric. Articles included in-vivo or in-vitro studies that investigated human SIJs with 3-D analysis. Three-dimensional analyses conducted using mathematical modeling, computerized modeling, and/or skin markers were not included because of concerns of transferability and validity. Studies that failed to report standard error of measurement (SEM) or defined tabulated values for translations or rotations using the Cartesian coordinate system were not considered for this study. Studies included for review were analyzed by the SBC biomechanical checklist to measure the quality of procedural design. Seven manuscripts were eligible for inclusion in this study. Rotation ranged between -1.1 to 2.2 degrees along the X-axis, -0.8 to 4.0 degrees along the Y-axis, and -0.5 to 8.0 degrees along the Z-axis. Translation ranged between -0.3 to 8.0 millimeters (mm) along the X-axis, -0.2 to 7.0 mm along the Y-axis, -0.3 to 6.0 mm along the Z-axis. Motion of the SIJ is limited to minute amounts of rotation and of translation suggesting that clinical methods utilizing palpation for diagnosing SIJ pathology may have limited clinical utility.

Abstract-Adding active power to a prosthetic knee unit may improve function and reduce the potential for overuse injuries in persons with transfemoral amputation (TFA). Servicemembers who have sustained a TFA are often young and motivated to perform at high functional levels. The goal of this article is to compare the biomechanics of ramp and stair descent and ascent for participants using the C-Leg and the Power Knee (PK). Subjects were asked to ascend and descend an instrumented staircase and 12 degree ramp at their comfortable pace while equipped with retroreflective markers. Temporal-spatial and kinetic data were collected. Knee power generated by the nondisabled limb during stair ascent for subjects wearing the C-Leg was significantly greater than for those wearing the PK. Knee power generated by prosthetic knee units was significantly greater for subjects while wearing the PK. Although the PK reduced the power required from the nondisabled knee during stair climbing, it does not appear to be superior to the CLeg for other tasks. Adding power to a prosthetic knee may reduce wear on the nondisabled limb; however, there are still limitations that require improvement.

Abstract-This study examined the convergent construct validity of a new performance-based assessment instrument called the Comprehensive High-Level Activity Mobility Predictor (CHAMP) as a measure of high-level mobility in servicemembers (SMs) with traumatic lower-limb loss (LLL). The study was completed by 118 SMs. Convergent construct validity of the CHAMP was established using the 6-minute walk test (6MWT) as a measure of overall mobility and physical function and the Amputee Mobility Predictor (AMP) as a measure of basic prosthetic mobility. The known group methods construct validity examined disparities in high-level mobility capability among SMs with different levels of LLL. The CHAMP score demonstrated a strong positive relationship between 6MWT distance (r = 0.80, p < 0.001) and AMP score (r = 0.87, p < 0.001), respectively. In addition, the CHAMP can discriminate between different levels of LLL. Study findings support the CHAMP as a valid performance-based assessment instrument of high-level mobility for SMs with traumatic LLL.

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