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Houghton Scale of prosthetic use in people with lower-extremity amputations: Reliability, validity, and
Michael Devlin1, Tim Pauley, Kris Head
1Division of Physiatry, Department of Medicine, University of Toronto, Toronto, ON, Canada. mdevlin@westpark.org
Objective:
To evaluate the responsiveness to change and the floor and ceiling effects of the Houghton Scale.
Design:
One-week and 3-month test-retest to evaluate reliability, validity, and responsiveness to change.
Setting:
Amputee rehabilitation program.
Participants:
Persons (N=125) with unilateral or bilateral lower-extremity amputation who were wearing a prostheses: 1 group (n=49) for the reliability component and another group (n=76) for the responsiveness and validity component.
Interventions:
Not applicable.
Main Outcome Measures:
Responsiveness to change, ceiling and floor effects, and reliability and convergent validity.
Results:
Evaluation of responsiveness to change (n=76) showed that the total score increased from a mean +/- standard deviation of 6.14+/-2.40 at discharge to 7.70+/-2.62 (P<.001) at follow-up 3 months later. Floor and ceiling effects were not detected for the overall score but were noted for the individual subscales. The internal consistency was moderate at discharge (Cronbach alpha=.71) and follow-up (Cronbach alpha=.70). The Houghton Scale correlated significantly, although moderately, with the physical composite score of the Medical Outcomes Study 36-Item Short-Form Health Survey (r=.393, P<.01) and the 2-minute walk test at admission (r=.620, P<.01) and discharge (r=.653, P<.01). The reliability (intraclass correlation coefficient=.96) of the Houghton Scale was high (n=49).
Conclusions:
The Houghton Scale is appropriately responsive to change in prosthetic use in individuals with lower-limb amputation after rehabilitation.
