Objective To assess construct validity of the Prosthetic Limb Users Survey of Mobility (PLUS-M), a self-report mobility measure for people with lower limb amputation (LLA). Design Cross-sectional study. Setting Private prosthetic clinics (n=37). Participants Current lower limb prosthesis users (n=199, mean age=55.4±14.3 years, 71.4% male) were assessed before receiving a replacement prosthesis, prosthetic socket, and/or prosthetic knee. Intervention Not applicable. Main Outcome Measure(s) Convergent construct validity was examined using correlations between participants’ PLUS-M T-scores and measures of physical function, mobility, and balance, including the Amputee Mobility Predictor (AMP), Timed Up and Go (TUG), Patient Reported Outcomes Measurement Information System-Physical Function (PROMIS-PF), Prosthesis Evaluation Questionnaire-Mobility Subscale (PEQ-MS), and Activities-Specific Balance Confidence Scale (ABC). Known-groups construct validity was evaluated by comparing differences in PLUS-M T-scores among participants grouped by Medicare Functional Classification Level (MFCL). Results PLUS-M T-scores demonstrated a moderate positive relationship with AMP scores (rho=0.54, p<0.001) and a moderate negative relationship with TUG times (rho=- 0.56, p<0.001). The PLUS-M also showed a strong positive relationship with PEQ-MS scores (rho=0.78, p<0.001), ABC scores (rho=0.81, p<0.001), and PROMIS-PF T-scores (rho=0.81, p<0.001). Significant differences (p<0.05) in PLUS-M T-scores were found among groups of people classified by different MFCLs. Conclusion Study results support validity of the PLUS-M as a self-report measure of prosthetic mobility. Correlations between PLUS-M and measures of physical function, mobility, and balance indicate convergent construct validity. Similarly, significant differences in PLUS-M T-scores across MFCL groups provide evidence of known-groups construct validity. In summary, evidence indicates that PLUS-M has good construct validity among people with LLA.

Abstract-Performance-based outcomes such as the T-Test, Edgren SideStep Test (ESST), and Illinois Agility Test (IAT) have been used to assess agility in athletes and nonathletes; however, the reliability and validity of these tests have not been established. The purpose of this study was to establish the reliability and convergent construct validity of the ESST, TTest, and IAT in young, nondisabled, physically active male servicemembers (SMs). Ninety-seven male Active Duty U.S. Army SMs completed the study. Statistically significant differences were not found between the ESST (p = 0.10), T-Test (p = 0.09), and IAT (p = 0.23) when administered twice within a 24 to 48 h period. These tests were found to have excellent interrater reliability and moderate to good test-retest reliability. A good positive relationship exists between the IAT and T-Test (r = 0.76, p < 0.001) and a moderate negative relationship exists between the ESST and both the T-Test (r = 0.69, p < 0.001) and IAT (r = 0.65, p < 0.001). The results suggest that these tests are valid measures of agility that uniquely assess movement in different planes, thus providing a comprehensive assessment of high-level mobility.

INTRODUCTION: Pulmonary rehabilitation is effective for patients with COPD, but its benefit is less clearly established in idiopathic pulmonary fibrosis (IPF), especially in regard to levels of physical activity and health-related quality of life. The objectives were to determine whether pulmonary rehabilitation increased physical activity as assessed by the International Physical Activity Questionnaire (IPAQ), and improved quality of life and symptoms as assessed by the St George respiratory questionnaire for IPF (SGRQ-I) and the Borg dyspnea index (BDI). METHODS: Subjects who met current criteria for IPF were randomized to a 3-month pulmonary rehabilitation program (n ‫؍‬ 11) or to a control group (n ‫؍‬ 10). The rehabilitation group participated in twiceweekly, 90-min exercise sessions (24 total sessions). The control group maintained its preceding, normal physical activity. All subjects underwent 6-min walk tests to assess the postexertion BDI. The SGRQ-I and a 5-point self-assessment of health were completed at baseline, after 3 months of intervention or observation, and after 3-month follow-up. All subjects completed the IPAQ weekly. RESULTS: Subjects in the rehabilitation group maintained significantly higher levels of physical activity throughout the 3-month rehabilitation program (rehabilitation: 51,364 ؎ 57,713 [mean ؎ SD] metabolic equivalent of task-minutes; control: 20,832 ؎ 37,155, P ‫؍‬ .027 by 2-tailed Mann-Whitney test). SGRQ-I symptom domain scores improved considerably by ؊9 ؎ 22 in the rehabilitation group, whereas in the control group they worsened (16 ؎ 12 rehabilitation compared with control, P ‫؍‬ .013 by 2-tailed Mann-Whitney test). During the 3-month follow-up, self-reported physical activity levels in the rehabilitation group were 14,428 ؎ 8,884 metabolic equivalent of task-minutes and in the control group 16,923 ؎ 32,620 (P ‫؍‬ .17 by 2-tailed Mann-Whitney test), demonstrating substantial reversal of activity in the rehabilitation group. BDI scores after 6-min walk tests did not change significantly. CONCLUSIONS: A 3-month rehabilitation program significantly improved symptoms (SGRQ-I) and physical activity levels (IPAQ) in subjects with IPF while they participated actively in the program. (ClinicalTrials.gov registration NCT01118221.) Key words: idiopathic pulmonary fibrosis; pulmonary rehabilitation; exercise; quality of life.

Pulmonary rehabilitation effectively maintained exercise oxygen uptake over 3 months and lengthened constant load exercise time in patients with moderately severe IPF. Exercise endurance on cycle ergometry testing was limited by dyspnea and severe hypoxemia associated with systemic oxidant stress.

Background Outcome measures can be used in prosthetic practices to evaluate interventions, inform decision making, monitor progress, document outcomes, and justify services. Strategies to enhance prosthetists' ability to use outcome measures are needed to facilitate their adoption in routine practice. Objective To assess prosthetists' use of outcome measures and evaluate the effects of training on their confidence administering performance-based measures. Design Cross-sectional and single group pretest-posttest survey Methods Seventy-nine certified prosthetists (mean of 16.0 years of clinical experience) were surveyed about their experiences with 20 standardized outcome measures. Prosthetists were formally trained by the investigators to administer the Timed Up and Go and Amputee Mobility Predictor. Prosthetists’ confidence in administering the Timed Up and Go and Amputee Mobility Predictor was measured before and after training. Results The majority (62%) of prosthetists were classified as non-routine outcome measure users. Confidence administering the TUG and AMP prior to training was low-to-moderate across the study sample. Training significantly (p<0.0001) improved prosthetists' confidence administering both instruments. Conclusion Prosthetists in this study reported limited use of and confidence with standardized outcome measures. Interactive training resulted in a statistically significant increase of prosthetists' confidence in administering the TUG and AMP and may facilitate use of outcome measures in clinical practice.