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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                                                                            

 

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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 AMPUTATION: 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

