Comparing the Effects of Dual‐Task Gait Testing in New and Established Ambulators With Lower Extremity Amputations

Frengopoulos, Courtney; Payne, Michael; Holmes, Jeffrey D.; Viana, Ricardo; Hunter, Susan

doi:10.1016/j.pmrj.2018.03.018

Cited by 22 publications

(27 citation statements)

References 53 publications

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“…24 The dual-task L Test has demonstrated reliability in PLEA. 25 No instructions were given to the participant regarding task prioritization during dual-task testing.…”

Section: Measure Of Functional Mobilitymentioning

confidence: 99%

Reliability, validity, and agreement of the short-form Activities-specific Balance Confidence Scale in people with lower extremity amputations

Fuller

Omaña

Frengopoulos

et al. 2019

Prosthetics &Amp; Orthotics International

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Background: Clinicians use the Activities-specific Balance Confidence Scale to understand balance confidence. A short-form Activities-specific Balance Confidence scale, was developed using the six most difficult tasks from the original Activities-specific Balance Confidence scale; however, short-form the short-form scale psychometrics and agreement with the original scale have yet to be explored in people with lower extremity amputations. Objective: To determine the relative and absolute reliability, construct validity, and agreement of the short-form Activities-specific Balance Confidence scale. Study design: Test–retest with a 2-week interval. Methods: Analysis for relative reliability and internal consistency was intraclass correlation coefficient and Cronbach’s α, respectively. Absolute reliability was measured using standard error of measurement and minimal detectable change. Bland–Altman plots measured agreement between scales. Construct validity was evaluated against the L Test using a Pearson-product moment correlation. Results: The short-form Activities-specific Balance Confidence (intraclass correlation coefficient = 0.92) and Activities-specific Balance Confidence (intraclass correlation coefficient = 0.91) scales had excellent relative reliability. Both scales demonstrated good internal consistency. Worse absolute reliability was observed in the short-form Activities-specific Balance Confidence scale. Construct validity against the L Test was confirmed. Bland–Altman plots indicated poor agreement between scales. Conclusion: Both scales exhibit excellent relative reliability and good internal consistency and construct validity. Poor agreement between short-form Activities-specific Balance Confidence and Activities-specific Balance Confidence indicates the scales should not be used interchangeably. Inadequate absolute reliability of the short-form Activities-specific Balance Confidence scale suggests the Activities-specific Balance Confidence should be the balance confidence scale of choice. Clinical relevance: Balance confidence is an important metric for our understanding of rehabilitation and community re-integration in people with lower extremity amputations. Due to inferior absolute reliability and a lack of appropriate items composing the short-form Activities-specific Balance Confidence scale, the full-scale Activities-specific Balance Confidence is recommended for the assessment of balance confidence in this population.

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“…24 The dual-task L Test has demonstrated reliability in PLEA. 25 No instructions were given to the participant regarding task prioritization during dual-task testing.…”

Section: Measure Of Functional Mobilitymentioning

confidence: 99%

Reliability, validity, and agreement of the short-form Activities-specific Balance Confidence Scale in people with lower extremity amputations

Fuller

Omaña

Frengopoulos

et al. 2019

Prosthetics &Amp; Orthotics International

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“…Many persons with lower limb amputation have reported the need to "concentrate on every step" and this may reflect increased use of cognitive resources [11]. Cognition has an impact on walking performance, and the current literature on lower limb amputation recognises this relationship [12,13,14,15,16]. Hence, it is important that outcome measures reflect the complexity of mobility in daily life by including both cognitive and environmental dimensions, and at the same time are easy and quick to administer in a clinical setting [6].…”

Section: Introductionmentioning

confidence: 99%

“…Various cognitive tasks like serial subtractions or the Stroop test have been used together with walking tasks in dual-task assessments among persons with lower limb amputation [6,7,20,21,22]. The results indicate that adding a concurrent cognitive task decreases performance in both walking and cognitive performance [22] and a decrease is observed regardless of level of amputation, or time since amputation [13]. However, to our knowledge, these dual-task tests have not been validated in persons with lower limb amputation.…”

Section: Introductionmentioning

confidence: 99%

Assessing mobility for persons with lower limb amputation: the Figure-of-Eight Walk Test with the inclusion of two novel conditions

Schack

Mirtaheri

Steen

et al. 2019

Disability and Rehabilitation

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Purpose: To investigate the internal consistency, convergent and known-groups construct validity of the Figure-of-Eight Walk Test with two novel conditions in persons with lower limb amputation, and to examine differences in walking performance between the three conditions within a group of persons with transtibial amputation and transfemoral amputation/knee disarticulation. Materials and methods: 50 adults with unilateral amputation participated, 28 of whom had undergone a transtibial amputation and 22 a transfemoral amputation/knee disarticulation. Three Figure-of-Eight Walk Test Conditions were investigated: 1) walking at a self-selected walking speed, 2) walking while carrying a tray with two cups of water and 3) walking on uneven terrain. Internal consistency was evaluated using Cronbach's alpha. Convergent construct validity was examined by analysing the relationship between the Figure-of-Eight Walk Test parameters and performance-based parameters (Amputee Mobility Predictor, Ten-Meter Walk Test, Six-Minute Walk Test) and self-report measures (Prosthetic Limb Users Survey of Mobility, Activities-specific Balance Confidence Scale) using Spearman's rankorder correlations. Known-groups construct validity was assessed by comparing the Figureof-Eight Walk Test parameters based on anatomical level of amputation. Friedman's test and posthoc analysis was used to examine differences between the walking conditions within each group. Results: Cronbach's alpha coefficients of the Figure-of-Eight Walk Test parameters for all three conditions ranged from .89 to .99. The Figure-of-Eight Walk Test time and steps parameters demonstrated moderate to good correlation (r = -.50 to -.77) for performance-

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“…The relative change in the performance between single‐task and dual‐task conditions is known as the dual‐task cost 23 . In PLLA, dual‐task testing leads to worse mobility, 24 deteriorated gait parameters, and increased instability 25 . Only one review on this topic has been published, reporting that the magnitude of the effect of dual‐task on the balance, but not gait, was greater in PLLA relative to healthy adults 26 .…”

Section: Introductionmentioning

confidence: 99%

The effect of dual‐task testing on the balance and gait of people with lower limb amputations: A systematic review

Omaña

Madou

Montero‐Odasso

et al. 2021

PM&R

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Objective: To systematically review the literature on the effect of dual-task testing on the balance and gait of people with lower limb amputations (PLLA). Literature Survey: Databases MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, and Scopus were searched in duplicate (inception to December 1, 2020). Methodology: Inclusion criteria: participants were adults with transtibial, kneedisarticulation, transfemoral, or bilateral lower limb amputations; balance or gait was paired with a secondary task; and studies were peer-reviewed and published in English. Two authors independently reviewed articles and consensus was required. A standardized data extraction sheet was used to gather study relevant information in duplicate. Methodological quality of reporting was examined using the Downs and Black Scale. A meta-analysis was unable to be performed owing to substantial participant and protocol heterogeneity among the studies included. Synthesis: Of 3950 articles screened, 22 met inclusion criteria. Four assessed dual-task balance and 18 dual-task gait. During single-task standing, PLLA demonstrated higher sway distance and sway velocity than controls (CN); however, a greater dual-task effect was observed only for sway velocity. Gait pace, rhythm, variability, asymmetry, and postural control were observed to be worse in PLLA relative to CN during single-task. Dual-task gait testing resulted in a disproportionally reduced pace and rhythm and increased asymmetry in PLLA compared to CN. Conclusions: People with lower limb amputations have impaired balance and gait, which is affected by dual-task to a greater degree compared to healthy adults. An examination of how PLLA-specific factors such as level of amputation, reason for amputation, and experience with a prosthesis affect dual-task performance has not yet been thoroughly explored. Future research should continue to characterize the cognitive-mobility link to better understand the challenges associated with the use of a prosthesis.

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Comparing the Effects of Dual‐Task Gait Testing in New and Established Ambulators With Lower Extremity Amputations

Abstract: II.

Cited by 22 publications

References 53 publications

Reliability, validity, and agreement of the short-form Activities-specific Balance Confidence Scale in people with lower extremity amputations

Reliability, validity, and agreement of the short-form Activities-specific Balance Confidence Scale in people with lower extremity amputations

Assessing mobility for persons with lower limb amputation: the Figure-of-Eight Walk Test with the inclusion of two novel conditions

The effect of dual‐task testing on the balance and gait of people with lower limb amputations: A systematic review

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