Development and measurement properties of the Orthotics and Prosthetics Users’ Survey (OPUS)

Abstract

The need to measure and evaluate orthotics and prosthetics (O&P) practice has received growing recognition in the past several years. Reliable and valid self-report instruments are needed that can help facilities evaluate patient outcomes. The objective of this project was to develop a set of self-report instruments that assess functional status, quality of life, and satisfaction with devices and services that can be used in an orthotics and prosthetics clinic. Selecting items from a variety of existing instruments, the authors developed and revised four instruments that differentiate patients with varying levels of lower limb function, quality of life, and satisfaction with devices and services. Evidence of construct validity is provided by hierarchies of item difficulty that are consistent with clinical experience. For example, with the lower limb function instrument, running one block was much more difficult than walking indoors. The instruments demonstrate adequate internal consistency (0.88 for lower limb function, 0.88 for quality of life, 0.74 for service satisfaction, 0.78 for device satisfaction). The next steps in their research programme are to evaluate sensitivity and construct validity. The Orthotics and Prosthetics Users' Survey (OPUS) is a promising self-report instrument which may, with further development, allow orthotic and prosthetic practitioners to evaluate the quality and effectiveness of their services as required by accreditation standards such as those of the American Board for Certification in Orthotics and Prosthetics that mandate quality assessment.

The i-LIMB Hand and the DMC Plus Hand Compared

“…A score of 27 reflects zero logits and a moderate level of upper extremity function. 8,9 Visual analogue scale (VAS) scores were used to determine the patient's subjective opinion on strength, appearance, sound, precision grip, power grip and robustness of the prosthetic hands (lowest score 0, highest score 10). The patient also scored the relevance of these prosthetic characteristics.…”

Impact of Michelangelo prosthetic hand: Findings from a crossover longitudinal study

“…Orthotics and Prosthetics User Survey-Upper Extremity Functional Status module (OPUS-UEFS) [21] was administered only at T1 and asks participants to separately complete the same form about the TD and M; the sequence was balanced within the sample. In the present study, we used the Resnick and Borgia scoring method, calculating person-level summary scores [22].…”

Rasch analysis of the Locomotor Capabilities Index-5 in people with lower limb amputation

“…An expert review suggested also that this item does not seem to exactly belong to the construct 'locomotion' but to a wider category of mobility/transfer tasks, that not necessarily are unidimensional in these subjects (as Rasch models require); (b) 'Walk outside in inclement weather', a task depending on various personal and environmental confounding factors, that could induce some subjects to respond with an idiosyncratic answer (Streiner and Norman 1995). As an alternative, items like 'Walk on slippery surfaces' (the hardest item in PEQ-MS), 'Walk for up to two hours', 'Climb a flight of stairs without rail' (two challenging items from the Orthotics and Prosthetics Users' Survey [Heinemann et al 2003]), or 'Climb a steep slope' might be checked. In fact, if subjects with high locomotor ability were the target group for this test, the test would need to have at least one new question representing a high difficulty (3 or more logits), so as to estimate more precisely the abilities of the top subjects and raise the ceiling of the test (Bond and Fox 2001).…”