Normative data for the lower extremity functional scale (LEFS)

Dingemans, Siem A.; Kleipool, Suzanne C.; Mulders, Marjolein A. M.; Winkelhagen, Jasper; Schep, N.W.L.; Goslings, J. Carel; Schepers, Tim

doi:10.1080/17453674.2017.1309886

Cited by 86 publications

(88 citation statements)

References 21 publications

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“…Items are summed to give a score from 0 to 80 where 80 is the best possible score. The mean of the completed items is used when up to four items are missing [ 8 , 13 ] and normative data is available to aid the interpretation of LEFS scores [ 14 ]. Two studies have assessed the measurement properties of LEFS in patients with ankle fracture and there is evidence for reliability, validity and responsiveness in Australian patients [ 15 ] and in Finnish patients undergoing surgery due to musculoskeletal pathology of the foot and ankle [ 16 ].…”

Section: Methodsmentioning

confidence: 99%

Evaluation of three patient reported outcome measures following operative fixation of closed ankle fractures

Garratt

Naumann

Sigurdsen

et al. 2018

BMC Musculoskelet Disord

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BackgroundSeveral patient reported outcome measures (PROMs) are available for assessing the outcomes of ankle fracture but few have been compared for recommended measurement properties. This study compares the measurement properties of the Lower Extremity Function Scale (LEFS), Olerud Molander Ankle Score (OMAS) and Self-Reported Foot and Ankle Score (SEFAS) following ankle surgery.MethodsThe retrospective cohort study included 959 patients aged 18 years and over who underwent surgical treatment (ORIF) for unstable and closed ankle fractures in SE Norway. The PROMs were included in a postal questionnaire sent to patients’ homes in 2015, three years after surgery. Missing data, structural validity, internal consistency, test-retest reliability and validity were assessed.ResultsConfirmatory factor analysis results showed model fit for the SEFAS and a bi-dimensional LEFS with scales of easy and difficult items. The OMAS performed less satisfactorily. Cronbach’s alpha and test-retest correlations ranged from 0.82 to 0.96 and 0.91 to 0.93 respectively. The smallest detectable differences for group and individual comparisons were 14.1 to 20.6 and 0.93 to 1.55; SEFAS performed best. As hypothesised, instrument scores were highly correlated and with those for the EQ-5D and SF-36 physical functioning. Mean imputation where half or more items are completed increased usable scores by 1.4–15.7% without affecting measurement properties.ConclusionsThe three instruments largely performed satisfactorily in relation to important measurement properties but the LEFS had evidence for two dimensions relating to easier and more difficult aspects of function. Mean imputation where half or more items are completed increased the number of usable responses for all three instruments. The three instruments represent different approaches to measuring outcomes and their content should be considered carefully when choosing between them. The SEFAS is designed for a range of foot disorders including ankle fractures and has the best measurement properties in this population.

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Section: Methodsmentioning

confidence: 99%

Evaluation of three patient reported outcome measures following operative fixation of closed ankle fractures

Garratt

Naumann

Sigurdsen

et al. 2018

BMC Musculoskelet Disord

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“…We speculated that the difference might result from the different disease severity of the participants involved in the different studies [29]. The disease severity of participants in this study was lower than that in the previous samples, and thus, activity limitations of the participants did not lead to significant changes in role emotional [30].…”

Section: Discussionmentioning

confidence: 73%

Cross-Cultural Adaptation and Validation of the Simplified Chinese Version of the Lower Extremity Functional Scale

Zhang

Lin

Yuan

et al. 2020

BioMed Research International

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Purpose. The purpose of this study was to cross-culturally adapt and validate the Simplified Chinese version of the Lower Extremity Functional Scale (SC-LEFS). Methods. The original English version of the Lower Extremity Functional Scale was translated and cross-culturally adapted into Simplified Chinese according to international guidelines. The SC-LEFS and 36-Item Short-Form Health Survey were administered to 213 patients with lower extremity musculoskeletal disorders. Psychometric properties including internal consistency, test-retest reliability, content validity, and construct validity were tested. Results. There were no floor or ceiling effects for the SC-LEFS. The scale had high values for internal consistency (Cronbach α=0.97) and test-retest reliability (intraclass correlation coefficient=0.97). Corrected item-total correlations for every item ranged from 0.67 to 0.89. And the item-level content validity index (I-CVI) for each item ranged from 0.78 to 1.00. Principal component analysis revealed a one-factor structure. Nine of ten prior hypotheses were confirmed, which further supports good construct validity within the SC-LEFS. Conclusion. The SC-LEFS has high internal consistency, good test-retest reliability and content validity, convergent construct validity, and a one-factor structure. Thus, it could be regarded as a reliable and valid tool to assess activity limitations in Chinese patients with lower extremity musculoskeletal disorders.

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“…Another limitation is that the use of QuickDASH and LEFS questionnaires in this context may be inappropriate. Both questionnaires were validated for patients with musculoskeletal disorders (Binkley et al, ; Gummesson et al, ) and have also been tested on the general population (Aasheim & Finsen, ; Dingemans et al, ), and these assignments were apprehended to be sufficient without a pretest on this category of patients. For QuickDASH, several studies show varying distinct cut‐off points to reflect severity (Angst et al, ), but the purposed use in this study was to detect any differences between baseline and follow‐ups in both questionnaires.…”

Section: Discussionmentioning

confidence: 99%

“…The minimal clinical relevant change over time has been set to ±9 scale points (Binkley et al, ). The median score for the LEFS for the general population has previously been set to 77 points (Dingemans et al, ). The LEFS questionnaire was translated into Swedish for this study and was pretested for understanding and accuracy with three nurses, and no revisions were needed.…”

Section: Methodsmentioning

confidence: 99%

Patient‐reported extremity symptoms after robot‐assisted laparoscopic cystectomy

Johansson

Vogelsang

2019

Journal of Clinical Nursing

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Aims and objectives To describe patient‐reported extremity symptoms after robot‐assisted laparoscopic cystectomy in patients with bladder cancer. Background Preventive activities for remaining patient safety due to correct positioning play an important part in perioperative nursing care.Extremity injuries are well‐known after prolonged surgery, especially in robot‐assisted urologic surgery in the steep Trendelenburg position. The risk of injury increases due to patient‐related and operative risk factors. Methods A quantitative prospective observational study was conducted. Patients were followed up with the QuickDASH (Disabilities in the Arm, Shoulder and Hand), Lower Extremity Functional Scale (LEFS) and a study‐specific questionnaire 7–10 days and monthly, up to six months after surgery in patients with extremity symptoms. The study adheres to STROBE (strengthening the reporting of observational studies in epidemiology) guidelines, see Supporting information File S1. Results Out of the 94 included participants, 46.8% (n = 44) experienced extremity symptoms 7–10 days after surgery. Pain, numbness and weakness were the most frequent symptoms. There was a discrepancy between the patients reported symptoms and the documentation in the patient records. Only 13.6% (n = 3) of the reported pain was documented, respectively 27.5% (n = 11) of other symptoms. Conclusion A large proportion of the patients report postoperative extremity symptoms after robot‐assisted laparoscopic cystectomy. Prevention of complications in the perioperative setting, are together with follow‐ups, important nursing activities for maintaining patient safety and may both prevent and detect postoperative extremity symptoms and injuries. Relevance to clinical practice This study reveals the need of accurate documentation regarding extremity symptoms in digital patient records, as well as continuous follow‐ups during the hospital stay and after hospital discharge to enable detection of treatable extremity injuries. The result of this study also indicates the importance of nursing activities such as evidence‐based positioning guidelines in the operating theatre for optimal positioning.

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Normative data for the lower extremity functional scale (LEFS)

Cited by 86 publications

References 21 publications

Evaluation of three patient reported outcome measures following operative fixation of closed ankle fractures

Evaluation of three patient reported outcome measures following operative fixation of closed ankle fractures

Cross-Cultural Adaptation and Validation of the Simplified Chinese Version of the Lower Extremity Functional Scale

Patient‐reported extremity symptoms after robot‐assisted laparoscopic cystectomy

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