Measuring Community Integration in Persons with Limb Trauma and Amputation: A Systematic Review

Publication date: Available online 6 September 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Linda Resnik, Matthew Borgia, Benjamin Silver
ObjectiveThe study purpose was to conduct a systematic review of community integration measures used with populations with limb trauma and/or amputation and evaluate each measure's focus, content, and psychometric properties.Data SourcesSearches of PubMed and CINAHL for terms social participation, community integration, social function, outcome assessment, wounds and injuries, and amputation/rehabilitation.Study SelectionIncluded English language articles with a sample size of at least 20 adults with limb trauma or amputation Measures were deemed eligible if they contained a majority of items related to construct of participation as defined by the International Classification of Functioning, Disability and Health (ICF).Data ExtractionData on internal consistency; test-retest, inter-rater, and intra-rater reliability; content, structural, construct, concurrent, and predictive validity; responsiveness; and floor/ceiling effects was extracted from each manuscript and confirmed by a second investigator.Data SynthesisOne hundred fifty six papers containing 36 measures and 94 sub-scales were reviewed. Psychometric properties were rated and an overall score was calculated for each measure. Content of highest scoring measures were examined. Scant evidence was found regarding the psychometric properties of most measures. Eight scales from five instruments had the strongest measurement properties: the Trinity Amputation and Prosthetics Experience (TAPES) social restriction and adjustment to limitation scales; Community Reintegration of Service Members (CRIS) extent of participation and perceived limitations, scales; SF-36 role-physical and social functioning scales; the 136-item Sickness Impact Profile (SIP) psychosocial domain scale, and the WHODAS-II 12-item total score.ConclusionsEights scales from 5 instruments: the TAPES, CRIS, SF-36, the 136-item SIP, and the WHODAS-II 12-item measure, had the strongest measurement properties.



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