Researchers set out to determine if differences in physical function exist between K3 and K4 functional level individuals who use a lower-limb prosthesis. The cross-sectional study was conducted at the University of Delaware Physical Therapy Amputee Clinic and published online February 3 in the Archives of Physical Medicine and Rehabilitation. Based on the study’s conclusions, the research team suggested that prosthetists consider using the Timed Up and Go (TUG), ten-meter walk test, Amputee Mobility Predictor (AMPPRO), and six-minute walk test (6MWT) to help differentiate between individuals of higher functional mobility. The Locomotor Capabilities Index (LCI) and Prosthetic Evaluation Questionnaire-Mobility Section (PEQ-MS) may be less useful in classifying individuals as K3 versus K4 due to a ceiling effect, according to the study.
The 55 participants were over 18 years old, had a unilateral transfemoral or transtibial amputations, were classified as K3 or K4 functional level, completed all relevant outcome measures, and were using a prosthesis. K-level was determined by group consensus based on a standardized clinical evaluation. Assessment was conducted via self-report questionnaires and physical performance tests.
According to the authors, after controlling for covariates, the K3 participants had slower TUG times and self-selected and fast gait speeds, lower AMPPRO scores, and walked shorter distances during the 6MWT when compared to patients classified as K4. No significant between-group differences for the LCI or PEQ-MS were found.
This data was presented, in part, at the American Orthotic & Prosthetic Association National Assembly in Boston on September 10, 2016, as a platform presentation titled “Differences in Physical Performance Measures among Patients with Unilateral Limb Amputations Classified as Functional Level K3 versus K4.”