Balkman G, Morgan S, Gaunaurd I, Kristal A, Amtmann D, Gailey R, Hafner B.J. PERFORMANCE TESTING IN PEOPLE WITH LOWER LIMB AM PUTATION: INTERVIEWS WITH PROSTHETISTS, PHYSICAL THERAPISTS, AND PHYSICIANS. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, POSTER PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.32018 1 OPEN ACCESS AOPA’S 101 ST NATIONAL ASSEMBLY ABSTRACTS, SEPTEMBER 26-29, VANCOUVER, CANADA, 2018 ABSTRACT (POSTER PRESENTATION) PERFORMANCE TESTING IN PEOPLE WITH LOWER LIMB AMPUTATION: INTERVIEWS WITH PROSTHETISTS, PHYSICAL THERAPISTS, AND PHYSICIANS Geoffrey Balkman1*, Sara Morgan1, Ignacio Gaunaurd2, Anat Kristal2, Dagmar Amtmann1, Robert Gailey2, Brian J. Hafner1 1 Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA. 2 Department of Physical Therapy, University of Miami, Miami, FL, USA. * Email: gbalkman@uw.edu DOI: https://doi.org/10.33137/cpoj.v1i2.32018 INTRODUCTION A variety of performance-based tests are available to assess mobility in people with lower limb amputation (LLA)1. Selection of a specific test is likely to be guided by the clinical value of tasks patients perform; the space and equipment available to administrator the test; and/or the time required to set up, administer, score, and interpret the test results. The aim of this study was to collect information about the clinical value of performance tests, and the space, equipment, and time available to rehabilitation specialists who provide care to people with LLA (i.e., prosthetists, physical therapists (PTs), and physical medicine and rehabilitation (PM&R) physicians). METHODS Cross-sectional semi-structured telephone interviews were conducted to gather information about the type of performance tasks administered to people with LLA, the clinical environment in which tests may be administered, and the resources available (e.g. time, space, and equipment). A convenience sample of prosthetists, PTs, and PM&R physicians was recruited through investigators’ professional contacts. Interviews were conducted by phone, recorded, and transcribed. An interview guide2 was used to ask participants about tasks with clinical value; space, equipment, time available for administration; and general barriers or facilitators to performance testing. Qualitative data were reviewed for themes and quantitative data were tabulated to compare results across and within professional groups.3 RESULTS Prosthetists, PTs, and PM&R physicians (n=8, 9, and 8, respectively) from 12 US states participated in the interviews. Walking (in parallel bars and the hallway) and moving from sit-to-stand were tasks used by all participants to assess people with LLA. Other tasks included standing (n=20/25), stair climbing (n=16/25), transfers (n=14/25), navigating obstacles (n=13/25), variable cadence walking (n=12/25), and single limb stance (n=11/25). Most participants stated that they had access to more than one room for patient evaluation and all participants had a corridor at least 25 feet long. The majority (n=8/9) of PTs had access to a therapy gym, whereas fewer physicians (n=5/8) and prosthetists (n=2/8) had access to larger indoor spaces. All participants reported that they had the equipment (e.g., stopwatch and tape measure) necessary to conduct timed or distance tests. Most (n=16/25) had a meter or yardstick that could be used to conduct select tests. Only about half (n=12/25) of the clinicians interviewed had a treadmill. Most physicians (n=5/8) reported they wished to spend 10 minutes or less on performance assessment, whereas the majority of prosthetists (n=5/8) and PTs (n=7/9) were willing to spend 21 minutes or more (Figure 1). Figure 1. Maximum time clinicians reported to be willing to spend on performance testing during one appointment CONCLUSION Participants interviewed in this study identified a variety of factors that can promote or inhibit performance testing of people with LLA in clinical practice. Differences in space, equipment, and time resources available to different rehabilitation specialists may inform which tests can be conducted in which settings, or suggest the need for referrals when additional time, space, or equipment is necessary. Results of this study may also mailto:*%20Email:%20gbalkman@uw.edu https://doi.org/10.33137/cpoj.v1i2.32018 Balkman G, Morgan S, Gaunaurd I, Kristal A, Amtmann D, Gailey R, Hafner B.J. PERFORMANCE TESTING IN PEOPLE WITH LOWER LIMB AM PUTATION: INTERVIEWS WITH PROSTHETISTS, PHYSICAL THERAPISTS, AND PHYSICIANS. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, POSTER PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.32018 2 OPEN ACCESS AOPA’S 101 ST NATIONAL ASSEMBLY ABSTRACTS, SEPTEMBER 26-29, VANCOUVER, CANADA, 2018 ABSTRACT (POSTER PRESENTATION) inform development of new performance tests. Similarities in basic equipment and frequently used tasks imply that performance tests intended for use across disciplines and settings should include tasks with clinical value (i.e., sit to stand and walking) that require only basic equipment (i.e., tape measure and stopwatch). SIGNIFICANCE Knowledge of tasks with value and resources available to rehabilitation specialists can help improve selection, administration, and development of performance tests. REFERENCES 1. Condie, E, et al. Lower Limb Prosthetic Outcome Measures: A Review of the Literature 1995 to 2005. 2006; J Prosthet Orthot, 18, P13-45. DOI: 10.1097/00008526-200601001- 00004 2. Kallio H, et al. Systematic methodological review: developing a framework for a qualitative semi-structured interview guide. J Adv Nurs. 2016; 72: 2954-65. DOI:10.1111/jan.13031 3. Turner III DW. Qualitative Interview Design: A Practical Guide for Novice Investigators. Qual Rep. 2010; 15: 754-60. DISCLOSURE This research was supported by a grant from the National Institutes of Health (Award number R01HD065340). https://doi.org/10.1111/jan.13031