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

Abstract

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