To evaluate the criterion and construct validity of the 7-category Amputee Single Item Mobility Measure (AMPSIMM) in a large contemporary dysvascular lower limb amputation population and propose an abbreviated 4-category version (AMPSIMM-4) whose mobility categories parallel the Medicare Functional Classification Levels (K-levels).
Design
Cohort study retrospectively identifying persons with their first lower limb amputation then prospectively collecting their self-reported mobility.
Setting
National cohort identified through a large Veterans’ Administration dataset.
Participants
Six hundred and ninety-two participants aged 30 years and older, undergoing their first diabetes and/or peripheral artery disease-related amputation at the transmetatarsal, transtibial, or transfemoral level, with a subset of 60 consecutive participants with a self-reported K-level.
Main measures
AMPSIMM, Locomotor Capability Index-5 (LCI-5), K-levels, and PROMIS Global-10 Physical (PROMIS-P), at one year post amputation.
Results
The strength of the correlation between AMPSIMM and LCI-5 scores was large (Spearman's rho = .88; p < .0001). The correlation with PROMIS-P scores was 0.67 (p < .0001). The strength of the correlation between the AMPSIMM-4 and self-reported K-levels was large (Spearman's rho = .82; p < .0001).
Conclusions
The AMPSIMM is a clinician-friendly single-item patient-reported measure that can capture a broad range of lower limb amputation mobility, from wheelchair to advanced community ambulation, with or without a prosthesis, and with or without ambulation aids. It demonstrates strong criterion and construct validity. The AMPSIMM-4 can be generated directly from the AMPSIMM with descriptors that are very similar to and are highly correlated with self-reported K-levels.
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