The Walter Reed Experience: Current Issues in the Care of the Traumatic Amputee

Pasquina, Paul F.; Fitzpatrick, Kevin F.

doi:10.1097/00008526-200601001-00015

Cited by 21 publications

(14 citation statements)

References 6 publications

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“…Since the model of care of our amputee program is very different from that followed at civilian hospitals, we could only capture WRAMC's unique aspects by using a site-specific assessment rather than a generalized measure. Also, since these data are commonly used to assess the quality of the program, specific components that reflect the actual care but are not currently available in other standardized measurements had to be included in this survey [24]. A third limitation of the study may be the pressure perceived by military personnel to positively rate a DOD service, because of possible fear that a bad rating may reflect badly on them.…”

Section: Variablementioning

confidence: 99%

Quality of medical care provided to service members with combat-related limb amputations: Report of patient satisfaction

Pasquina

Tsao

Collins

et al. 2008

JRRD

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Abstract-A group of 158 service members who sustained major limb amputations during the global war on terrorism were surveyed on their satisfaction with the quality of care received from the Walter Reed Army Medical Center (WRAMC) Amputee Clinic from the time of their injury to their inpatient discharge. Of these participants, 96% were male, 77% were Caucasian, 89% were enlisted personnel, and 68% had sustained lower-limb amputations. WRAMC inpatient therapy, peer visitors, overall medical care, and pain management received particularly high satisfaction ratings. Age, race, rank, and level and side of amputation had little effect on overall satisfaction ratings. Significant differences, however, were found by location of injury (Iraq vs Afghanistan, Cuba, and Africa) regarding satisfaction with care received while in Europe and with the education process at WRAMC. Study findings strongly support the rehabilitation-based, integrative care approach designed by the U.S. military to care for service members with amputations.

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Section: Variablementioning

confidence: 99%

Quality of medical care provided to service members with combat-related limb amputations: Report of patient satisfaction

Pasquina

Tsao

Collins

et al. 2008

JRRD

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“…The clinical value of functional outcome measures is to allow the clinician to achieve these objectives. Pasquina and Fitzpatrick observed that SMs with LLL receiving rehabilitation postinjury at WRAMC were achieving maximum scores on the standard outcome measures shortly after being fit with their initial prosthesis [5]. They concluded that the available outcome measures of mobility following LLL were subject to a ceiling effect and could not measure the effect of the high-level rehabilitation provided to this new generation of SMs with traumatic LLL.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2013

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Abstract-The opportunity for wounded servicemembers (SMs) to return to high-level activity and return to duty has improved with advances in surgery, rehabilitation, and prosthetic technology. As a result, there is now a need for a high-level mobility outcome measure to assess progress toward high-level mobility during and after rehabilitation. The purpose of this study was to develop and determine the reliability of a new outcome measure called the Comprehensive High-Level Activity Mobility Predictor (CHAMP). The CHAMP consists of the Single Limb Stance, Edgren Side Step Test, T-Test, and Illinois Agility Test. CHAMP reliability was determined for SMs with lower-limb loss (LLL) (interrater: n = 118; test-retest: n = 111) and without LLL (n = 97). A linear system was developed to combine the CHAMP items and produce a composite score that ranges from 0 to 40, with higher scores indicating better performance. Interrater and test-retest intraclass correlation coefficient values for the CHAMP were 1.0 and 0.97, respectively. A CHAMP score equal to or greater than 33 points is within the range for SMs without LLL. The CHAMP was found to be a safe and reliable measure of high-level mobility in SMs with traumatic LLL.Key words: agility, high-level activity, lower-limb loss, military personnel, mobility, OIF/OEF, outcome measures, reliability, traumatic amputation, Veterans.

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“…However, as rehabilitation strategies and prosthetic components improved over time, so did the expectations of physical performance for people with limb loss. At Walter Reed Army Medical Center (WRAMC), the majority of SMs with limb loss were achieving high scores on the AMP early in the rehabilitation process after receiving a prosthesis, and a ceiling was observed [24]. The physical capabilities of SMs has improved to the level that approximately 17 percent of those with limb loss either qualified for Continuation on Active Duty or Continuation on Active Reserve, or were determined to be Fit for Duty [25][26].…”

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 Walter Reed Experience: Current Issues in the Care of the Traumatic Amputee

Cited by 21 publications

References 6 publications

Quality of medical care provided to service members with combat-related limb amputations: Report of patient satisfaction

Quality of medical care provided to service members with combat-related limb amputations: Report of patient satisfaction

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

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

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