Lower Extremity Assessment Scale: A Simple Patient-Reported Tool Validated Against Patient-Reported Outcomes Measurement Information System Physical Function

Accurate assessment of recovery after lower extremity trauma is critical in orthopaedics. The Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF) scale is widely used but may introduce ambiguity for lower limb-related impairments. To address this limitation, the Lower Extremity Assessment (LEA) scale was developed. It is a brief patient-reported tool focused on assessing pain, mobility, and gait. The aim of this study was to validate LEA by comparing it with PROMIS in postoperative trauma patients.

An IRB-approved prospective cross-sectional study of 232 patients was conducted among patients who had undergone surgery for lower extremity fractures, joint pathology, or soft-tissue injuries at a level I US trauma center. Participants completed the eight-item PROMIS Physical Function form (T-scores) and the three-question LEA survey (0-7 scale). Correlations were analyzed using Spearman ρ and Pearson r, with subgroup analyses by injury type and postoperative intervals.

PROMIS-PF T-scores ranged from 22.7 to 56.9 (median 40.2), while LEA scores ranged from 0 to 7 (median 4). LEA demonstrated a strong correlation with PROMIS (Spearman ρ = 0.701; P < 0.001; Pearson r = 0.68; P < 0.001). Correlations were not different across recovery phases (<3 months vs. > 6 months; P = 0.93).

The LEA is a valid, efficient, and patient-friendly outcome measure for postoperative lower extremity trauma. It correlates strongly with PROMIS-PF while providing insight into limb-specific function, supporting its integration into clinical practice and research.