Development and reliability testing of the Comprehensive High-Level Activity Mobility Predictor (CHAMP) in male servicemembers with traumatic lower-limb loss

Gailey, Robert; Gaunaurd, Ignacio; Raya, Michele A.; Roach, Kathryn E.; Linberg, Alison; Campbell, Stephen; Jayne, Daniel M.; Scoville, Charles R.

doi:10.1682/jrrd.2012.05.0099

Cited by 48 publications

(56 citation statements)

References 31 publications

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“…A satisfactory level of prosthetic use on the self-report Houghton scale can be obtained easily in a variety of settings but should not be construed as representing optimal use. For instance, most high performing servicemembers with lower-limb loss, who would score at the top of the Houghton scale, did not yet perform at the ability of their nondisabled peers [40]. Regardless, obtaining prognostic information about a person's ability to use his or her prosthesis for mobility with easily accessible medical history data, a self-report scale completed in a clinic waiting room, and physical assessment of three simple physical tasks is an important development.…”

Section: Discussionmentioning

confidence: 99%

Role of balance ability and confidence in prosthetic use for mobility of people with lower-limb loss

et al. 2014

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Abstract-For people with lower-limb loss, impaired balance is common and limits prosthetic function within the community. This cross-sectional study (1) analyzed relationships among prosthetic use for mobility, balance ability and confidence, and amputation-related variables and (2) determined multivariate models to identify level of prosthetic use. Subjects included 46 community-dwelling adults (mean age 56.2 yr) with limb loss (91.3% unilateral) of varied levels (52.2% transtibial) and etiologies (69.6% vascular). A three-variable linear regression model including balance ability, balance confidence, and years since amputation explained 63.7% of variance in the Houghton scale of prosthetic use score. A logistic regression model including the 14-task Berg Balance Scale, balance confidence, years since amputation, age, and number of comorbidities correctly differentiated between people who had reached a satisfactory level of prosthetic use or not 89.1% of the time. The first three variables demonstrated moderate accuracy with positive likelihood ratios from 2.34 to 4.35. The regression model was further reduced to correctly classify 87.0% of cases with three balance ability tasks (retrieving objects from floor, turning to look behind, and placing alternate foot on stool), balance confidence, and numbers of comorbidities. Logistic models that include balance ability, balance confidence, and numbers of comorbidities can identify level of prosthetic use in people with lower-limb loss. Increased balance confidence and ability when retrieving objects from floor, turning to look behind, and placing alternate foot on stool were most indicative of successful prosthetic use for mobility.

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Section: Discussionmentioning

confidence: 99%

Role of balance ability and confidence in prosthetic use for mobility of people with lower-limb loss

et al. 2014

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“…To be useful as an outcome measure for this unique population, the CHAMP had to quantify and measure change in function throughout the rehabilitation process and provide information relevant in determining readiness to return to high-level activity. In a previously reported study, the CHAMP demonstrated excellent test-retest and interrater reliability in a population of SMs with traumatic LLL [20]. Having established the CHAMP's reliability, it was necessary to validate the CHAMP to establish the degree of confidence that can be placed on inferences made about SMs with amputation's high-level mobility performance [21].…”

Section: Introductionmentioning

confidence: 99%

“…The AMP has been shown to be a measure of basic mobility in people with LLL [20]. Both the 6MWT and the AMP have excellent reliability for people with LLL and can differentiate between Medicare Functional Classification Levels (MFCLs) [20].…”

Section: Introductionmentioning

confidence: 99%

Construct validity of Comprehensive High-Level Activity Mobility Predictor (CHAMP) for male servicemembers with traumatic lower-limb loss

Gailey

Scoville

Gaunaurd³

et al. 2013

J Rehabil Res Dev

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Abstract-This study examined the convergent construct validity of a new performance-based assessment instrument called the Comprehensive High-Level Activity Mobility Predictor (CHAMP) as a measure of high-level mobility in servicemembers (SMs) with traumatic lower-limb loss (LLL). The study was completed by 118 SMs. Convergent construct validity of the CHAMP was established using the 6-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 known group methods construct validity examined disparities in high-level mobility capability among SMs with different levels of LLL. 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 LLL. Study findings support the CHAMP as a valid performance-based assessment instrument of high-level mobility for SMs with traumatic LLL.

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“…The Comprehensive High-Level Activity Mobility Predictor (CHAMP) was created to quantify the ability of SMs with limb loss to perform high-level mobility activities. The CHAMP assesses balance, postural stability, coordination, power, speed, and agility in multiple planes of motion and has been demonstrated to be a reliable and valid measure of high-level mobility in SMs with limb loss [4][5]. By using the CHAMP to measure high-level mobility, it may be possible to identify factors that are related to ability to perform high-level mobility activities.…”

Section: Introductionmentioning

confidence: 99%

Factors related to high-level mobility in male servicemembers with traumatic lower-limb loss

et al. 2013

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The purpose of this study was to examine the possible relationship between factors modifiable by rehabilitation interventions (rehabilitation factors), other factors related to lower-limb loss (other factors), and high-level mobility as measured by the Comprehensive High-Level Activity Mobility Predictor (CHAMP) in servicemembers (SMs) with traumatic lower-limb loss. One-hundred eighteen male SMs with either unilateral transtibial amputation (TTA), unilateral transfemoral amputation (TFA), or bilateral lower-limb amputation (BLLA) participated. Stepwise regression analysis was used to develop separate regression models of factors predicting CHAMP score. Regression models containing both rehabilitation factors and other factors explained 81% (TTA), 36% (TFA), and 91% (BLLA) of the variance in CHAMP score. Rehabilitation factors such as lower-limb strength and dynamic balance were found to be significantly related to CHAMP score and can be enhanced with the appropriate intervention. Further, the findings support the importance of salvaging the knee joint and its effect on high-level mobility capabilities. Lastly, the J-shaped energy storage and return feet were found to improve high-level mobility for SMs with TTA. These results could help guide rehabilitation and aid in developing appropriate interventions to assist in maximizing high-level mobility capabilities for SMs with traumatic lower-limb loss.

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Development and reliability testing of the Comprehensive High-Level Activity Mobility Predictor (CHAMP) in male servicemembers with traumatic lower-limb loss

Cited by 48 publications

References 31 publications

Role of balance ability and confidence in prosthetic use for mobility of people with lower-limb loss

Role of balance ability and confidence in prosthetic use for mobility of people with lower-limb loss

Construct validity of Comprehensive High-Level Activity Mobility Predictor (CHAMP) for male servicemembers with traumatic lower-limb loss

Factors related to high-level mobility in male servicemembers with traumatic lower-limb loss

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