A study published in the recent issue of the Journal of Rehabilitation Research & Development (JRRD) presents a new high-level mobility outcome measure to assess progress toward high-level mobility during and after rehabilitation of lower-limb loss. The researchers have concluded that it is a reliable assessment of progress toward high-level mobility in people with traumatic lower-limb amputations.
The test, dubbed the Comprehensive High-Level Activity Mobility Predictor (CHAMP), is a combination of four physical performance tests: the Single-Limb Stance Test, the Edgren Side Step Test (ESST), the T-Test, and the Illinois Agility Test (IAG). The tests measure balance, postural stability, coordination, power, speed, and agility. The criteria for designing the CHAMP were to identify the minimal number of test items that would assess coordination, power, speed, and agility in multiple planes, without hopping or jumping, yielding a single composite score, and ensure that all tests could be performed safely in a clinical setting after a moderate level of mobility was achieved.
The study’s participants were active duty or retired service men between 18-40 years of age with high-level mobility-defined by the researchers as a “change in body position or location by moving from one place to another by rapidly walking and/or running.” The researchers first collected the test data from 97 active duty service men without lower-limb amputations. (In another study in this same issue of JRRD, the ESST, The T-Test, and IAG were all established to be reliable mobility measures of agility in nondisabled, fit active duty service members between the ages of 18-40 years.)
The second phase tested 118 active duty or retired service men with a unilateral or bilateral lower-limb amputation whose recovery ranged from recently completing rehabilitation to fully rehabilitated and returning to active duty. The testing data was ranked to produce a composite score ranging from zero to 40, with higher scores indicating better performance; scores of ≥33 points were equivalent to active duty services member without a lower-limb amputation.
A convergent construct validity of the CHAMP was also established in yet another separate study published in this issue of JRRD using the six-minute walk test (6MWT) as a measure of overall mobility and physical function and the Amputee Mobility Predictor (AMP) as a measure of basic prosthetic mobility. The CHAMP score demonstrated a strong positive relationship between 6MWT distance (r = 0.80, p < 0.001) and AMP score (r = 0.87, p < 0.001), respectively. In addition, the CHAMP can discriminate between different levels of lower-limb amputation, the researchers said.
