Validity and Reliability of the German Version of the Locomotor Capabilities Index-5 (LCI-5)

Abstract

Background Before foreign language questionnaires, such as patient reported outcome measures (PROMs), can be scientifically used in the national language, guideline-based translation, cultural adaptation and comprehensive verification of their validity and reliability are needed. The aim of this study was to assess the psychometric properties of the German version of the LCI-5 (LCI-5-D) on a sample of people with lower limb amputation (LLA). Methods The LCI-5 was translated into German (LCI-5-D) based on the ISPOR guidelines for cross-cultural adaptation following pilot testing. The final LCI-5-D was administered to n = 52 lower limb amputees in order to determine the validity and reliability of both the total score and the subscores (“basic items” and “advanced items”). Internal consistency (Cronbachʼs alpha), test-retest reliability (ICC2,1), standard error of the mean (SEM), minimal detectable change (MDC), item-to-total correlation, and item-to-subscale correlation were calculated. Floor and ceiling effects were checked. For construct validity, the Rivermead Mobility Index (RMI) and timed up and go (TUG) test were correlated, and differences of defined subgroups (amputation height and prosthesis user type) were calculated. Results On average, the score of the LCI-5-D was 40.13 ± 16.64 points. High ceiling effects were present for the subscale “basic items” (57.7% maximum score). Internal consistency showed excellent results (Cronbachʼs α = 0.97). A strong correlation to the RMI (r = 0.863; p < 0.001) and to the TUG (r = − 0.714; p < 0.001) demonstrated construct validity. Test-rest reliability was measured after an averaged time span of 5.3 ± 2.47 days and resulted in very high reliability [ICC (2,1) = 0.97; p < 0.001]. MDC was 7.57 points for the total score. Conclusion The LCI-5-D is a valid and reliable PROM for measuring mobility with prostheses in German-speaking lower limb amputees, which is rather suitable for people with low to moderate mobility abilities. It can be used in a German-speaking population.

Rasch validation and comparison of the German versions of the Locomotor Capabilities Index-5 and Prosthetic Mobility Questionnaire 2.0 in lower-limb prosthesis users

“…Higher scores reflect greater locomotor capability with the prosthesis and less dependence on assistance. The main psychometric properties of the German version of LCI-5 have been demonstrated [15].…”

“…Two validated PROMs for measuring mobility with the prosthesis in people with LLA are the Locomotor Capabilities Index (LCI-5) [10,11] and the Prosthetic Mobility Questionnaire (PMQ 2.0) [12–14], which are available also in German versions: the former already published [15], while the latter submitted for publication (Ranker et al ., 2021, unpublished material). They are both promising tools but, so far, no head-to-head comparison of them has been performed.…”

“…As most of the PROMs were originally created in English, cross-cultural translations and validations have to be performed according to standardized guidelines to ensure that their metric quality is maintained [8,9]. Two validated PROMs for measuring mobility with the prosthesis in people with LLA are the Locomotor Capabilities Index (LCI-5) [10,11] and the Prosthetic Mobility Questionnaire (PMQ 2.0) [12][13][14], which are available also in German versions: the former already published [15], while the latter submitted for publication (Ranker et al, 2021, unpublished material). They are both promising tools but, so far, no head-to-head comparison of them has been performed.…”

Übersetzung und transkulturelle Adaptation des Prosthesis Mobility Questionnaire 2.0 (PMQ) ins Deutsche und dessen Reliabilität und Validität bei Patienten mit Majoramputation der unteren Extremität

“…Trotz seiner hohen Deckeneffekte bei Patienten mit hohen Mobilitätsklassen, ist er doch ein sehr nützlicher Fragebogen und wird international häufig verwendet [18]. Die deutsche validierte Version wurde verwendet (Cronbachs Alpha = 0,97) [19].…”

“…Die hohe Korrelation mit dem Prothesenmobilitätsscore LCI-5 belegt die Konstruktvalidität. Der LCI-5 ist ebenso ein sehr verlässlicher und international deutlich häufiger verwendeter Score als der PMQ, zeigt aber hohe Deckeneffekte der Gesamtscores bei Patienten mit hohen Mobilitätsgraden [17,19]. Da gemäß epidemiologischen Daten die Mehrheit der Amputationen in Deutschland bei geriatrischen, mobilitätsgeminderten und gefäßerkrankten Patienten stattfindet [3,4], sollte die fehlende Diskriminationsfähigkeit im hohen Mobilitätsniveau des LCI-5 in der Realität nicht wirklich ins Gewicht fallen.…”