The Locomotor Capabilities Index; validity and reliability of the Swedish version in adults with lower limb amputation

Brita Larsson, Anton Johannesson, Ingemar H Andersson, Isam Atroshi, Brita Larsson, Anton Johannesson, Ingemar H Andersson, Isam Atroshi

Abstract

Background: The Locomotor Capabilities Index (LCI) is a validated measure of lower-limb amputees' ability to perform activities with prosthesis. We have developed the LCI Swedish version and evaluated its validity and reliability.

Methods: Cross-cultural adaptation to Swedish included forward/backward translations and field testing. The Swedish LCI was then administered to 144 amputees (55 women), mean age 74 (40-93) years, attending post-rehabilitation prosthetic training. Construct validity was assessed by examining the relationship between the LCI and Timed "Up-and-Go" (TUG) test and between the LCI and EQ-5D health utility index in 2 subgroups of 40 and 20 amputees, respectively. Discriminative validity was assessed by comparing scores in different age groups and in unilateral and bilateral amputees. Test-retest reliability (1-2 weeks) was evaluated in 20 amputees (14 unilateral).

Results: The Swedish LCI showed good construct convergent validity, with high correlation with the TUG (r = -0.75) and the EQ-5D (r = 0.84), and discriminative validity, with significantly worse mean scores for older than younger and for bilateral than unilateral amputees (p < 0.01), and high internal consistency (Cronbach alpha 0.95). In test-retest reliability the intraclass correlation coefficient was 0.91 (95% CI 0.79-0.96) but for the unilateral amputees was 0.83 (95% CI 0.56-0.94). Ceiling effect occurred in 23%.

Conclusion: The Swedish version of the LCI demonstrated good validity and internal consistency in adult amputees. Test-retest reliability in a small subsample appears to be acceptable. The high ceiling effect of the LCI may imply that it would be most useful in assessing amputees with low to moderate functional abilities.

Figures

Figure 1
Figure 1
Flow diagram of the participants in the validity and reliability analyses.
Figure 2
Figure 2
Distribution of the LCI scores (N = 144).

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