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DOS Kongressen 2016 ·
153
Development and inter-rater reliability of the Basic
Amputee Mobility Score (BAMS) for use in patients
with a major lower limb amputation
Morten Tange Kristensen, Annie Østergaard Nielsen, Peter Gebuhr
Physical Medicine and Rehabilitation Research – Copenhagen (PMR-C),
Departments of Physical Therapy and Orthopedic Surgery, Copenhagen
University Hospital Hvidovre; Physical Medicine and Rehabilitation Research –
Copenhagen (PMR-C), Department of Physical Therapy, Copenhagen University
Hospital Hvidovre; Department of Orthopedic Surgery, Copenhagen University
Hospital Hvidovre
Background:
Early in-hospital rehabilitation following major lower limb ampu-
tation is mainly focused at patient’s independence in basic mobility activities.
Thus, an easily applicable measure for daily assessment of these skills, planning
of training, and communication between health care professionals is of great
importance.
Purpose / Aim of Study:
To develop and examine inter-rater reliability of the
Basic Amputee Mobility Score (BAMS) in patients with a lower limb amputation.
Materials and Methods:
Four essential basic amputee activities; 1.supine in
bed to sitting on the side of the bed and return, 2.bed to chair transfer and
return, 3.indoor wheelchair manoeuvring, and 4. One-leg sit-to-stand-to-sit
from a chair with arms, were chosen through consensus meetings with expe-
rienced amputee physical therapists. Each activity is scored from 0-2 (0=not
able to, 1=able to with assistance, and 2=independent), and cumulated to a
daily score of 0-8. Inter-rater reliability and agreement was established by 1
experienced and 1 un-experienced user of BAMS, using standardized instruc-
tions. Raters were blinded to each others ratings and in charge of sessions in a
randomized order.
Findings / Results:
Assessments were conducted within the first week of
a major dysvascular lower limb amputation in 30 Patients. The mean (SD) of
BAMS was 5.6 (2.3) points, while the ICC1.1, the standard error of measure-
ment, and the minimal detectable change were 0.98 (95%CI, 0.96-0.99), 0.32
and 0.89 points, respectively. No systematic between-rater bias was seen
(p=0.3). BAMS is fully implemented in the capital region.
Conclusions:
The inter-rater reliability of BAMS is excellent, and changes of 1
point (group and individual level) indicate a real change in BAMS. We suggest the
score be further used for communication between different groups of health
care professionals and settings.
No conflicts of interest reported
104.