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Abstract-The Amputee Mobility Predictor (AMP) is an outcome measure designed to assess mobility and functional capabilities for people with unilateral lower-limb amputation. No comparable measure exists for those with bilateral lower-limb amputation (BLLA). The purpose of this study was to examine the utility of the AMP-Bilateral (AMP-B) to measure the ability to perform functional tasks related to participation in advanced skill activities in those with BLLA and to determine whether AMP-B scores correlated with 6-minute walk test (6MWT) performance. Twenty-six male servicemembers (SMs) completed the study: 12 with bilateral transtibial amputation(BTTA), 7 with bilateral transfemoral amputation (BTFA), and 7 with combination transtibial and transfemoral amputation (TTA/TFA). Significant differences existed between the AMP-B scores (p < 0.001), AMP scores (p < 0.001), and 6MWT distance (p < 0.05) for SMs with BTTA and TTA/TFA and SMs with BTTA and BTFA but not between those with BTFA and TTA/TFA. Scoring of five AMP items was modified because they necessitate at least one intact knee joint to generate the necessary torque requirements to perform the activity without upper-limb assistance. Minor modifications in scoring of the AMP do not alter total score and allow clinicians to determine the mobility and functional capabilities of SMs with BTFA and TFA/TTA.
Key words: 6-minute walk test, Amputee Mobility Predictor, Amputee Mobility Predictor-Bilateral, bilateral amputation, mobility, New Injury Severity Score, outcome measure, servicemembers, traumatic amputation, veterans.
Abbreviations: 6MWT = 6-minute walk test, AIS = Abbreviated Injury Scale, AMP = Amputee Mobility Predictor, AMPB = AMP-Bilateral, ANOVA = analysis of variance, BLLA = bilateral lower-limb amputation, BTFA = bilateral transfemoral amputation, BTTA = bilateral transtibial amputation, IRB = Institutional Review Board, NISS = New Injury Severity Score, SF-36 = 36-Item Short Form Health Survey, SM = servicemember, TTA/TFA = combination transtibial/transfemoral amputation, WRAMC = Walter Reed Army Medical Center.
INTRODUCTION
Approximately 185,000 amputations occur annually in the United States [1]. Although the actual incidence of bilateral amputation has not been reported, it has been established that 30 to 50 percent of people who have an amputation related to diabetes will undergo amputation of the contralateral limb 3 to 5 yr after the primary amputation [2-3]. Moreover, with the increase in world conflict over the past decade with Operation Iraqi Freedom/Operation Enduring Freedom, coupled...