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Two-handed task performance in upper limb prosthesis users: rethinking measurement approaches.

Linda Resnik1,2, Matthew Borgia1, Allen W Heinemann3

  • 1Providence VA Medical Center, Providence, Rhode Island, USA.

Disability and Rehabilitation
|September 26, 2025
PubMed
Summary
This summary is machine-generated.

A new scoring method for the UEFS-P Two-Handed Task scale improves physical function assessment for upper limb prosthesis users. This revised approach offers greater clinical relevance and accuracy in evaluating prosthesis performance.

Keywords:
Upper limb amputationactivity performancedisability evaluationpatient reported outcomeupper limb prosthesis

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Area of Science:

  • Rehabilitation Engineering
  • Prosthetics and Orthotics
  • Clinical Measurement

Background:

  • The Upper Extremity Functional Scale-Prosthesis (UEFS-P) Two-Handed Task scale is used to measure physical function in upper limb prosthesis users.
  • Original scoring methods had limitations, including collapsing response categories and assumptions about task difficulty.
  • This study aimed to explore and validate alternative scoring approaches for the UEFS-P scale.

Purpose of the Study:

  • To investigate and compare alternative scoring models for the UEFS-P Two-Handed Task scale.
  • To enhance the clinical relevance and validity of physical function assessment in upper limb prosthesis users.
  • To identify a scoring strategy that better reflects the construct of prosthesis task performance.

Main Methods:

  • A sample of 423 upper limb prosthesis users was analyzed.
  • Scoring approaches included a partial credit model (PCM) and six generalized linear mixed models.
  • Model fit, reliability, and known-group validity were compared; item fit and concurrent validity were also assessed.

Main Results:

  • A Poisson and PCM model demonstrated the best fit and was selected.
  • The new scoring method showed significant differences based on amputation level and had a reliability of 0.78.
  • Concurrent validity with the original scoring was high, with a Pearson correlation of 0.82.

Conclusions:

  • The revised scoring strategy addresses concerns regarding face validity and clinical relevance.
  • Incorporating the number of tasks performed with a prosthesis provides additional valuable information.
  • This new approach offers a more comprehensive assessment of prosthesis task performance.