Systematic Review of Measures of Impairment and Activity Limitation for Persons With Upper Limb Trauma and Amputation

Abstract

OBJECTIVE: (1) To identify outcome measures used in studies of persons with traumatic upper limb injury and/or amputation; and (2) to evaluate focus, content, and psychometric properties of each measure.

DATA SOURCES: Searches of PubMed and CINAHL for terms including upper extremity, function, activities of daily living, outcome assessment, amputation, and traumatic injuries.

STUDY SELECTION: Included articles had a sample of ≥10 adults with limb trauma or amputation and were in English. Measures containing most items assessing impairment of body function or activity limitation were eligible.

DATA EXTRACTION: There were 260 articles containing 55 measures that were included. Data on internal consistency; test-retest, interrater, and intrarater reliability; content, structural, construct, concurrent, and predictive validity; responsiveness; and floor/ceiling effects were extracted and confirmed by a second investigator.

DATA SYNTHESIS: The mostly highly rated performance measures included 2 amputation-specific measures (Activities Measure for Upper Limb Amputees and University of New Brunswick Test of Prosthetic Function skill and spontaneity subscales) and 2 non-amputation-specific measures (Box and Block Test and modified Jebsen-Taylor Hand Function Test light and heavy cans tests). Most highly rated self-report measures were Disabilities of the Arm, Shoulder and Hand; Patient Rated Wrist Evaluation; QuickDASH; Hand Assessment Tool; International Osteoporosis Foundation Quality of Life Questionnaire; and Patient Rated Wrist Evaluation functional recovery subscale. None were amputation specific.

CONCLUSIONS: Few performance measures were recommended for patients with limb trauma and amputation. All top-rated self-report measures were suitable for use in both groups. These results will inform choice of outcome measures for these patients.