Development and reliability of the rating of compensatory movements in upper limb prosthesis wearers during work-related tasks

• Published in: Journal of hand therapy Vol. 32; no. 3; pp. 368 - 374
• Main Authors: van der Laan, Tallie M.J., Postema, Sietke G., Reneman, Michiel F., Bongers, Raoul M., van der Sluis, Corry K.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2019; Elsevier Limited
• Subjects: Adaptation, Physiological; Artificial Limbs; Compensatory movements; Confidence intervals; Evaluation; Feasibility studies; Gait; Humans; Musculoskeletal pain; Physical Functional Performance; Prostheses; Prosthesis; Questionnaires; Rehabilitation; Reliability analysis; Reproducibility of Results; Risk factors; System reliability; Upper Extremity - physiopathology; Upper limb; Video tapes; Work Capacity Evaluation; Canada; United States > US; Netherlands; Work capacity evaluation; Musculoskeletal pain; Upper limb; Prosthesis; Compensatory movements
• ISSN: 0894-1130; 1545-004X
• DOI: 10.1016/j.jht.2017.12.003

Reliability study. Quantifying compensatory movements during work-related tasks may help to prevent musculoskeletal complaints in individuals with upper limb absence. (1) To develop a qualitative scoring system for rating compensatory shoulder and trunk movements in upper limb prosthesis wearers during the performance of functional capacity evaluation tests adjusted for use by 1-handed individuals (functional capacity evaluation-one handed [FCE-OH]); (2) to examine the interrater and intrarater reliability of the scoring system; and (3) to assess its feasibility. Movement patterns of 12 videotaped upper limb prosthesis wearers and 20 controls were analyzed. Compensatory movements were defined for each FCE-OH test, and a scoring system was developed, pilot tested, and adjusted. During reliability testing, 18 raters (12 FCE experts and 6 physiotherapists/gait analysts) scored videotapes of upper limb prosthesis wearers performing 4 FCE-OH tests 2 times (2 weeks apart). Agreement was expressed in % and kappa value. Feasibility (focus area's “acceptability”, “demand,” and “implementation”) was determined by using a questionnaire. After 2 rounds of pilot testing and adjusting, reliability of a third version was tested. The interrater reliability for the first and second rating sessions were к = 0.54 (confidence interval [CI]: 0.52-0.57) and к = 0.64 (CI: 0.61-0.66), respectively. The intrarater reliability was к = 0.77 (CI: 0.72-0.82). The feasibility was good but could be improved by a training program. It seems possible to identify compensatory movements in upper limb prosthesis wearers during the performance of FCE-OH tests reliably by observation using the developed observational scoring system. Interrater reliability was satisfactory in most instances; intrarater reliability was good. Feasibility was established. •Functional capacity tests should not only be evaluated quantitatively but also qualitatively.•Compensatory shoulder and trunk movements can be assessed reliably using the developed scoring system.•The feasibility of scoring compensatory shoulder and trunk movements was established.