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

Area of Science:

• Rehabilitation Medicine
• Outcome Measurement
• Psychometrics

Background:

• Community integration is crucial for individuals with limb trauma or amputation.
• Existing measures for assessing community integration in these populations vary widely in focus and quality.

Purpose of the Study:

• To systematically review community integration measures for limb trauma/amputation populations.
• To evaluate the psychometric properties and content of these measures.

Main Methods:

• Systematic literature search of PubMed and CINAHL using terms related to social participation and amputation.
• Inclusion of English-language articles with ≥20 adult participants; measures focused on International Classification of Functioning, Disability and Health (ICF) participation construct.
• Extraction and rating of psychometric properties including reliability, validity, and responsiveness.

Main Results:

• 156 articles and 34 measures/94 subscales were reviewed.
• Scant evidence for psychometric properties of most measures.
• Eight scales from five instruments (TAPES, CRIS, SF-36, SIP, WHODAS-II) exhibited the strongest measurement properties.

Conclusions:

• The Trinity Amputation and Prosthesis Experience (TAPES), Community Reintegration of Injured Service Members (CRIS), SF-36, Sickness Impact Profile (SIP), and WHODAS-II 12-item measure possess the most robust measurement properties.
• These selected scales are recommended for assessing community integration in populations with limb trauma or amputation.
• Further research is needed to develop and validate additional measures for this population.