Development and reliability of the rating of compensatory movements in upper limb prosthesis wearers during work-related tasks

Study Design: Reliability study.

Introduction: Quantifying compensatory movements during work-related tasks may help to prevent musculoskeletal complaints in individuals with upper limb absence.

Purpose of the Study: (1) To develop a qualitative scoring system for rating compensatory shoulder and trunk movements in upper limb prosthesis wearers during the performance of functional capacity evaluation tests adjusted for use by 1-handed individuals (functional capacity evaluation-one handed [FCE-OH]); (2) to examine the interrater and intrarater reliability of the scoring system; and (3) to assess its feasibility.

Methods: Movement patterns of 12 videotaped upper limb prosthesis wearers and 20 controls were analyzed. Compensatory movements were defined for each FCE-OH test, and a scoring system was developed, pilot tested, and adjusted. During reliability testing, 18 raters (12 FCE experts and 6 physiotherapists/gait analysts) scored videotapes of upper limb prosthesis wearers performing 4 FCE-OH tests 2 times (2 weeks apart). Agreement was expressed in % and kappa value. Feasibility (focus area's "acceptability", "demand," and "implementation") was determined by using a questionnaire.

Results: After 2 rounds of pilot testing and adjusting, reliability of a third version was tested. The interrater reliability for the first and second rating sessions were kappa = 0.54 (confidence interval [CI]: 0.520.57) and kappa = 0.64 (CI: 0.61-0.66), respectively. The intrarater reliability was kappa = 0.77 (CI: 0.72-0.82). The feasibility was good but could be improved by a training program.

Discussion: It seems possible to identify compensatory movements in upper limb prosthesis wearers during the performance of FCE-OH tests reliably by observation using the developed observational scoring system.

Conclusions: Interrater reliability was satisfactory in most instances; intrarater reliability was good. Feasibility was established. (C) 2018 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved.