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The Assessment of Capacity for Myoelectric Control: Psychometric evidence and comparison with upper limb prosthetic outcome measures
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Evaluation of outcomes using validated prosthetic outcome measures (OMs) is a current priority in upper limb (UL) prosthetics, and OMs with psychometric evidence toward UL prosthesis users are thus necessary. The “Assessment of Capacity for Myoelectric Control” (ACMC) is a tool that assesses the ability to control a myoelectric prosthetic hand. Some psychometric aspects of the ACMC have been previously investigated, but others are still lacking. A major part of this thesis was thus to search and assess the psychometric evidence of the ACMC. Data were collected from prosthesis users of different ages, prosthetic sides, and sexes. Rasch analysis was used to search for validity evidence and activity influence on the users’ ACMC ability measures, while reliability statistics was used to search for reliability evidence. Overall, the validity evidence was satisfactory in terms of unidimensionality, item technical quality, item difficulty, and relation to prosthetic wearing time. In terms of activity influence, the majority of prosthesis users received similar ability measures in different activities. Reliability evidence was also satisfactory in terms of test-retest reliability and rater agreements (intra- and interrater).

Besides the ACMC, several other prosthetic OMs have been developed in recent years. A comparison of these OMs would help professionals to select appropriate tools for clinical practice. Thus, a comparison of the validated UL prosthetic OMs was performed with an emphasis on what health aspects they cover. Eight OMs were chosen, and their contents were linked to the “International Classification of Functioning, Disability and Health” (ICF). The results showed that the contents from different OMs were linked to the ICF categories in “Body functions,” “Activity and Participation,” and “Environmental Factors.”

In conclusion, the use of a mixture of OMs is recommended to cover different aspects of health. Based on the evidence in this thesis, the ACMC can be recommended to measure the ability to control a myoelectric hand.

Place, publisher, year, edition, pages
Örebro: Örebro universitet , 2013. , p. 85
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 48
Keyword [en]
capacity, comparison, icf, myoelectric control, psychometric evidence, upper limb prosthesis
National Category
Nursing
Identifiers
URN: urn:nbn:se:oru:diva-30071ISBN: 978-91-7668-963-9 (print)OAI: oai:DiVA.org:oru-30071DiVA, id: diva2:638531
Public defence
2013-10-18, Hörsal P2, Prismahuset, Örebro universitet, Fakultetsgatan 1, 701 82 Örebro, 13:00
Opponent
Supervisors
Available from: 2013-07-31 Created: 2013-07-30 Last updated: 2017-10-17Bibliographically approved
List of papers
1. Assessment of capacity for myoelectric control: evaluation of construct and rating scale
Open this publication in new window or tab >>Assessment of capacity for myoelectric control: evaluation of construct and rating scale
2009 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, no 6, p. 467-474Article in journal (Refereed) Published
Abstract [en]

Objective: To examine the construct and rating scale of the Assessment of Capacity for Myoelectric Control, an assessment to evaluate ability in using a prosthetic hand.

Design: Cross-sectional study. Subjects: Upper limb prosthesis users with different prosthetic levels/sides and prosthetic experience were included (n=96).

Methods: Subjects' assessments with the Assessment of Capacity for Myoelectric Control were collected by 6 raters during their regular hospital visits. Rasch analysis was used, since it allowed an analysis of the data at the item and category levels. Dimension, item hierarchy and item fit statistics were used to examine the construct. Different Rasch parameters were used to examine rating scale structure and its use.

Results: The consistency of item difficulties with clinical knowledge and the unidimensionality confirmed that the construct is valid. Two items functioned unexpectedly (misfit), but the misfit was idiosyncratic to the sample, not systematic to the items. The 4-point rating scale usefully differentiated the subjects on the basis of their abilities. The use of category 2 was somewhat redundant.

Conclusion: The Assessment of Capacity for Myoelectric Control is a valid assessment that evaluates ability in using a prosthetic hand. Revision of the category 2 definition would improve the functioning of the rating scale.

Keyword
Ability, Arm prosthetics, Assessment, Rasch analysis
National Category
Nursing Other Medical Sciences not elsewhere specified
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-14200 (URN)10.2340/16501977-0361 (DOI)000266490300011 ()2-s2.0-66349121104 (Scopus ID)
Available from: 2011-01-25 Created: 2011-01-25 Last updated: 2017-12-11Bibliographically approved
2. Influence of standardized activities on validity of Assessment of Capacity for Myoelectric Control
Open this publication in new window or tab >>Influence of standardized activities on validity of Assessment of Capacity for Myoelectric Control
2013 (English)In: Journal of rehabilitation research and development, ISSN 0748-7711, E-ISSN 1938-1352, Vol. 50, no 10, p. 1391-1400Article in journal (Refereed) Published
Abstract [en]

The Assessment of Capacity for Myoelectric Control (ACMC) is an observation-based clinical tool that evaluates ability to control a myoelectric prosthetic hand during bimanual activities. Two validity aspects were investigated: potential bias interaction between prosthesis users and activities performed during assessment, and potential bias interaction between activities and different user characteristics (sex or prosthetic side). Six activities were standardized for the ACMC. Upper-limb myoelectric prosthesis users (47 congenital, 11 acquired; 31 male, 27 female, average age 19.9 yr) performed three standardized activities, each on one occasion. Bias-interaction analysis in the many-facet Rasch model identified inconsistent patterns in the interactions of individual users and activity facets and between activities and user characteristics. The standardized activities had no significant influence on measures of user ability. The activities functioned similarly across both sexes (p-value greater than or equal to 0.12) and across both prosthetic sides in persons with upper-limb reduction deficiency (p-value greater than or equal to 0.50) and persons with acquired amputation (p-value greater than or equal to 0.13). The results provide evidence for the validity of the ACMC across the standardized activities and support use of the ACMC in prosthesis users of both sexes and prosthetic sides. The newly standardized activities are recommended for future ACMC use.

Keyword
activities, amputation, assessment, bimanual, instrument validation, myoelectric control, prostheses, rehabilitation, upper-limb reduction deficiency, upper limb
National Category
Nursing
Research subject
Caring sciences
Identifiers
urn:nbn:se:oru:diva-41681 (URN)10.1682/JRRD.2012.12.0231 (DOI)000333658300010 ()24699974 (PubMedID)2-s2.0-84896351017 (Scopus ID)
Note

Funding Agencies:

Health Care Sciences Postgraduate School, Karolinska Institute, Solna, Sweden

Research Committee of Orebro County Council, Orebro, Sweden

Available from: 2015-01-15 Created: 2015-01-15 Last updated: 2017-12-05Bibliographically approved
3. Test-retest reliability and rater agreements of assessment of capacity for myoelectric control version 2.0
Open this publication in new window or tab >>Test-retest reliability and rater agreements of assessment of capacity for myoelectric control version 2.0
2014 (English)In: Journal of rehabilitation research and development, ISSN 0748-7711, E-ISSN 1938-1352, Vol. 51, no 4, p. 635-644Article in journal (Other academic) Published
Abstract [en]

The Assessment of Capacity for Myoelectric Control (ACMC) is an observation-based tool that evaluates ability to control a myoelectric prosthetic hand. Validity evidence led to ACMC version 2.0, but the test-retest reliability and minimal detectable change (MDC) of the ACMC have never been evaluated. Investigation of rater agreements in this version was also needed because it has new definitions in certain rating categories and items. Upper-limb prosthesis users (n = 25, 15 congenital, 10 acquired; mean age 27.5 yr) performed one standardized activity twice, 2 to 5 wk apart. Activity performances were video-recorded and assessed by two ACMC raters. Data were analyzed by weighted kappa, intraclass correlation coefficient (ICC), and Bland-Altman method. For test-retest reliability, weighted kappa agreements were fair to excellent (0.52 to 1.00), ICC2,1 was 0.94, and one user was located outside the limits of agreement in the Bland-Altman plot. MDC95 was less than or equal to 0.55 logits (1 rater) and 0.69 logits (2 raters). For interrater reliability, weighted kappa agreements were fair to excellent in both sessions (0.44 to 1.00), and ICC2,1 was 0.95 (test) and 0.92 (retest). Intrarater agreement (rater 1) was also excellent (ICC3,1 0.98). Evidence regarding the reliability of the ACMC is satisfactory and MDC95 can be used to indicate change.

Place, publisher, year, edition, pages
Rehibilitation Research & Development Service, 2014
Keyword
ACMC, assessment, capacity, myoelectric con - trol, myoelectric prosthetic hand, prosthesis, prosthetic hand control, rater agreement, test-retest, upper limb
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-32494 (URN)10.1682/JRRD.2013.09.0197 (DOI)000340895400012 ()25144176 (PubMedID)2-s2.0-84905671717 (Scopus ID)
Note

Funding Agency:

Health Care Sciences Postgraduate School, Karolinska Institute, Solna, Sweden

Available from: 2013-11-22 Created: 2013-11-22 Last updated: 2018-06-04Bibliographically approved
4. Upper limb prosthetic outcome measures: Review and content comparison based on International Classification of Functioning, Disability and Health
Open this publication in new window or tab >>Upper limb prosthetic outcome measures: Review and content comparison based on International Classification of Functioning, Disability and Health
2010 (English)In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 34, no 2, p. 109-128Article, review/survey (Refereed) Published
Abstract [en]

The International Classification of Functioning, Disability and Health (ICF) has been recommended as a framework for evaluation of aspects of health. The aim of this study was to compare the contents of outcome measures for upper limb prosthesis users by using the ICF. Measurement focus and psychometric properties of these measures were also investigated. Outcome measures that used upper limb prosthesis users as subjects in their development and psychometric evaluations were selected. The psychometric studies (n - 14) were reviewed and scored and the items in the measures were linked to the ICF. One measure for all ages (ACMC), five paediatric measures (CAPP-FSI, CAPP-PSI, PUFI, UBET and UNB) and two adult measures (OPUS and TAPES) were selected. The concepts extracted (n - 393) were linked to 54 categories in the ICF. The ACMC, CAPP-FSI, UBET, UNB and PUFI measure categories mostly under the ICF component 'Activity and participation'. The TAPES and OPUS also measure ICF categories that describe the emotional and social status of a person. The main conclusion is that the use of a mixture of outcome measures would give a better picture on the aspects of our clients. Measures that focus on the social interaction in paediatric users are required.

Keyword
Upper limb prosthetics, outcome measures, upper limb, prosthetics
National Category
Nursing Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-12848 (URN)10.3109/03093641003776976 (DOI)000283117200001 ()20470058 (PubMedID)2-s2.0-77952471108 (Scopus ID)
Available from: 2011-01-10 Created: 2011-01-03 Last updated: 2018-04-23Bibliographically approved

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