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- Jarl, Gustav M., 1978-, et al.
(author)
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Validity evidence for a modified version of the Orthotics and Prosthetics Users' Survey
- 2012
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In: Disability and Rehabilitation. - Philadelphia, USA : Taylor & Francis. - 1748-3107 .- 1748-3115. ; 7:6, s. 469-478
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Journal article (peer-reviewed)abstract
- Purpose: To evaluate the validity of a modified version of the Orthotics and Prosthetics Users' Survey (OPUS) with persons using different prosthetic and orthotic (P&O) devices.Method: Two-hundred-and-eighty-two adults using prosthesis, orthosis, shoe insoles or orthopaedic shoes completed OPUS. OPUS comprises five modules - Lower and Upper Extremity Functional Status, respectively (LEFS and UEFS), Client Satisfaction with Device and Services, respectively (CSD and CSS), and, Health-Related Quality of Life (HRQoL). Eight new items were added to LEFS and six to UEFS. Rasch analysis was used for data analyses.Results: Rating scales functioned satisfactory after some modifications. All modules demonstrated a ceiling effect. Unidimensionality was satisfactory after deleting some items and dividing HRQoL into two subscales, although somewhat weak on CSD and CSS. Item reliability was excellent for all modules and person reliability good for all but CSD and CSS. Some items demonstrated differential item functioning related to sex and age, but the impact on person measures was small.Conclusions: This study supports the validity of a modified version of OPUS for persons using different P&O devices, but also reveals limitations to be addressed in future studies. OPUS could be useful in clinical rehabilitation and research to evaluate P&O outcomes.
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- Postema, Sietke, et al.
(author)
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Musculoskeletal complaints in major upper limb defects in the Netherlands : prevalence, influence on health status and work and risk factors
- 2014
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In: MEC'14. - Frederiction, Canada : University of New Brunswick, Fredericton, Canada. - 9781551311760
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Conference paper (peer-reviewed)abstract
- Objectives: (1) To compare the prevalence of self-reported musculoskeletal complaints (MSC) in individuals with major upper limb defects (ULD) in the Netherlands with a control group, (2) to explore the influence of MSC on health status and work and (3) to assess predictors of MSC, disability and work productivity in ULD.Methods: A national survey among individuals with ULD and controls was performed, using the databases of rehabilitaA national survey among individuals with ULD and controls was performed, using the databases of rehabilitation centers and orthopedic workshops in the Netherlands. A questionnaire was designed based on known risk factors for MSC, and it included validated (subscales of) existing questionnaires, such as SF36 and the Pain Disability Index (PDI). Inclusion criteria were ≥ 18 years and major ULD at or proximal to the carpal level. Controls were recruited by convenience and matched on age and sex.Results: Of the 263 individuals with ULD that completed the questionnaire, 42% had a congenital transversal defect and 58% had an amputation. The mean age was 50.7±16.7 years and 60% was male. A prosthesis was used by 79%. In total 108 controls were included (mean age 50.6±15.7; 65% male). Year prevalence of MSC (lasting for at least four consecutive weeks) was 65% in individuals with ULD, compared to 34% in controls. The most common location of MSC was the dominant or non-affected limb (46% in patients and 17% in controls), followed by upper back/neck (43% in patients and 19% in controls). Presence of MSC was associated with lower scores on scales of general health perception, mental health, work productivity and higher scores on disability. Prosthesis use did not differ between individuals with and without MSC. Predictors for presence of MSC were deficiency of the right limb, higher upper extremity work demands and being divorced or widowed. More pain, lower mental health and higher age were associated with a more severe disability. Predictors for lower work productivity were presence of MSC and more pain.Discussion: Presence of MSC is a common problem in individuals with ULD. Mostly affected were the non-affected limb and upper back/neck. More research on employment of the affected and non-affected limb, and its relation with MSC, is therefore warranted. Interestingly, presence of MSC was not related to prosthesis use. Associations with disability and work productivity add extra relevance to the study results, because of its relevance for individuals and society.Conclusion: Prevention and treatment of MSC deserves an important role in rehabilitation medicine of individuals with ULD.
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- Jarl, Gustav, 1978-, et al.
(author)
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Cross-cultural validity and differential item functioning of theOrthotics and Prosthetics Users’ Survey with Swedish and Americanusers of lower limb prosthesis
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Other publication (other academic/artistic)abstract
- Objective: To investigate the cross-cultural validity of the Orthotics and Prosthetics Users’ Survey (OPUS), to investigate differential item functioning (DIF) in the OPUS related to sex, age, amputation level and amputated sides (unilateral or bilateral), and to determine the known-group validity of the OPUS.Design: Cross-sectional study design.Setting: 2 outpatient clinics in Sweden and 7 outpatient clinics in the United States.Participants: A total of 195 Swedish and 126 American adults using lower limb prosthesis.Interventions: Not applicable.Main Outcome Measure: 4 modules from the OPUS were used in this study, including the Lower extremity functional status (LEFS), Client satisfaction with device (CSD), Client satisfaction with services (CSS), and Health-related quality of life (HRQoL) modules. Items were scored on 4- or 5-level Likert scales, and a Rasch measure was calculated for each person and module.Results: The cross-cultural validity was satisfactory. Many items demonstrated DIF related to country and demographic characteristics, but the impact on mean person measures was negligible. The rating scales of the CSD and CSS needed adjustments, and the unidimensionality of the CSD and CSS was weak. The differences between the mean measures of known patient groups were statistically significant for age in the LEFS and for the level of amputation in the CSD.Conclusions: This study supports the validity of comparing OPUS measures between Sweden and USA and between patient groups with different demographic characteristics. The OPUS can, to some extent, discriminate between patient groups known to be different. The unidimensionality of the CSD and CSS modules is weaker than the other modules and these need further development and evaluation.
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