Use of the Houghton Scale to Classify Community and Household Walking Ability in People With Lower-Limb Amputation: Criterion-Related Validity

Wong, Chi Song; Gibbs, William Brooks; Chen, Elizabeth Sell

doi:10.1016/j.apmr.2016.01.022

Cited by 40 publications

(66 citation statements)

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“…Third, the definition of fall-related injury in this study did not capture injuries for which self- or home-care was sufficient and thus may have underestimated the injury rate. For a person with limb loss, a simple abrasion or bruise to the amputated limb can limit prosthetic wear and functional ability and in the presence of diabetes or peripheral artery disease can lead to ulceration or subsequent reamputation (Wong et al 2016b ). Furthermore, the self-report questionnaire did not control for recall bias.…”

Section: Discussionmentioning

confidence: 99%

“…The 4-question HS quantifies daily prosthetic use and function in indoor and outdoor walking conditions (Houghton et al 1992 ). Total scores range from 0 to 12 with higher scores indicating better function (Houghton et al 1992 ) without appreciable ceiling or floor effects (Devlin et al 2004 ; Wong et al 2016b ).…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…Although numeric HS scores have good to excellent test-retest reliability (ICC = 0.85–0.96) and moderate internal consistency (Cronbach’s alpha > 0.70) (Devlin et al 2004 ) and concurrent validity ( r > .62) with self-reported functional scales and performance-based walking ability measures (Wong et al 2016b ; Miller et al 2001b ), items like hours of wear that may vary for other reasons than functional ability and the non-parametric nature of the self-report scale may make score ranges more meaningful to report. Subjects were classified into the three HS score categories corresponding to distinct walking abilities; limited household walker (5 > HS), limited community/independent household walker (6 > HS > 8), and independent community walker (HS > 9) (Wong et al 2016b ). The 12-question mobility subscale of the PEQ (Legro et al 1998 ) has demonstrated reliability in a multisite study (ICC = 0.85) (Resnik and Borgia 2011 ) and good person- and item-separation reliability (> 0.95) and construct validity ( r = 0.78) on Rasch analysis for measuring mobility in both visual analog scale and 5-level response formats used in this study (Franchignoni et al 2007 ).…”

Section: Methodsmentioning

confidence: 99%

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Factors associated with the likelihood of fall-related injury among people with lower limb loss

Chihuri

Wong

2018

Inj. Epidemiol.

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BackgroundPeople with lower limb loss that live in the community fall at a rate that exceeds that of other vulnerable populations such as hospitalized elderly people. Past research in a small single state study has identified factors associated with fall-related injury. The purpose of this study was to use a larger multistate sample of people with lower limb loss living in community settings to evaluate factors associated with fall-related injury in a multivariable model.MethodThis retrospective cohort study included community-dwelling people with lower limb loss participating in wellness-walking programs in 6 states within the United States. Fall-related injury was considered injury sustained during a fall to the ground that required medical care. Pearson’s Chi-squared test and student’s t-test were used for descriptive statistics. Odds ratios and 95% confidence intervals from multivariable logistic regression modelling were used to estimate the likelihood of fall-related injuries.ResultsOf the 303 subjects recruited, 257 (84.8%) were included in the analyses. Overall, 45 subjects (17.5%) reported at least a single fall-related injury. Most subjects reported two or more falls within the previous 12 months (N = 161, 63.1%), were male (N = 177, 68.9%), and were White (N = 212, 83.8%). Most falls were associated with gait (44.5%), activities of daily living (ADL, 15.7%), or ramps and/or stairs (12%). The likelihood of fall-related injury was elevated among females versus males (OR = 2.90, 95% CI 1.35, 6.24), people of non-White versus White race (OR = 4.79, 95% CI 1.06, 21.76), people with vascular amputations due to peripheral artery disease or diabetes versus non-vascular amputations (OR = 2.22, 95% CI 1.04, 4.73) and people with transtibial versus transfemoral amputations (OR = 2.32, 95% CI 1.01, 4.89).DiscussionResults of this study show that the likelihood of fall-related injury was significantly higher among women, non-White race, people with vascular and transtibial amputations. The results from this study were largely consistent with results from the prior multivariable fall-related injury model.ConclusionThe results highlight the association of female sex, non-White race, vascular and transtibial amputations with the likelihood of fall-related injury. Future studies may use the study findings to develop educational fall prevention programs for women, minorities, and people with vascular etiology and transtibial amputations.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Factors associated with the likelihood of fall-related injury among people with lower limb loss

Chihuri

Wong

2018

Inj. Epidemiol.

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“…Total scores range from 0-12 with higher scores indicating better function; test-retest reliability (ICC total score = 0.96; 95% confidence interval [CI] = 0.92-0.97), as well as convergent and discriminant validity, have been established [24,25]. Scores of 9 or greater suggest independent, community walking ability, scores between 6 and 8 suggest limited community and household walking ability, and scores less than or equal to 5 suggest limited household walking ability [26].…”

Section: Methodsmentioning

confidence: 99%

Retracted: Test‐Retest Reliability of Dynamic Balance Performance‐Based Measures Among Adults With a Unilateral Lower‐Limb Amputation

Cardoso

Beisheim

Horne³

et al. 2019

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Body image and perception among adults with and without phantom limb pain

Beisheim‐Ryan

Hicks

Pohlig

et al. 2022

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Background Following lower‐limb amputation, phantom limb pain (i.e., pain perceived as coming from the amputated portion of the limb) is common. Phantom limb pain may be associated with impaired body image and perception, which may be targets for rehabilitative intervention. Objective To compare measures of body image and perception between adults with and without phantom limb pain post amputation and evaluate associations between measures of body image and perception and phantom limb pain. Design Survey. Setting Online, remote assessment. Participants Seventy‐two adults ≥1 year post unilateral lower‐limb loss (n = 42 with phantom limb pain, n = 30 without phantom limb pain or pain in the remaining portion of the limb). Interventions Not applicable. Main Outcome Measures Self‐reported outcome measures assessing body image (i.e., Amputee Body Image Scale‐Revised), perceptual disturbances associated with the phantom limb (i.e., a modified Bath Complex Regional Pain Syndrome Body Perception Disturbance Scale), and prosthesis satisfaction (i.e., Trinity Amputation and Prosthesis Experience Scale) were administered; participants with phantom limb pain reported pain interference via the Brief Pain Inventory‐Short Form. Between‐group comparisons of self‐reported outcome measure scores were conducted using Mann Whitney U or chi‐square tests, as appropriate (a = .05). Results Compared to peers without phantom limb pain, adults with phantom limb pain reported more negative body image; increased phantom limb ownership, attention, and awareness; and reduced prosthesis satisfaction and embodiment (U = 175.50–364.00, p < .001 to .034). Disturbances in phantom limb perception (i.e., size, weight, pressure, temperature) were similar between groups (p = .086 to >.999). More negative body image was associated with increased phantom limb pain interference (τb = .25, p = .026). Conclusions Adults with phantom limb pain demonstrate more negative body image and hypervigilance of the phantom limb as compared to peers with nonpainful phantom sensations. Mind‐body treatments that target impaired body image and perception may be critical interventions for adults with phantom limb pain.

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Use of the Houghton Scale to Classify Community and Household Walking Ability in People With Lower-Limb Amputation: Criterion-Related Validity

Cited by 40 publications

References 31 publications

Factors associated with the likelihood of fall-related injury among people with lower limb loss

Factors associated with the likelihood of fall-related injury among people with lower limb loss

Retracted: Test‐Retest Reliability of Dynamic Balance Performance‐Based Measures Among Adults With a Unilateral Lower‐Limb Amputation

Body image and perception among adults with and without phantom limb pain

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