Outcome measurement for vascular amputee patients: a scoping survey of UK clinical practice

Objective: Currently it is unknown whether Physical Performance Based Outcome Measures (PerBOMs) are used in clinical practice with patients who have undergone an amputation due to peripheral arterial disease. This study aims to explore the clinical use and usefulness for healthcare professionals (HCPs) and to look at the types of rehabilitation interventions being provided to amputees. Methods: An anonymised scoping survey published online at https://www.onlinesurveys.ac.uk was used. The survey consisted of 17 questions, and all data collected were non-identifiable. Ethical approval was obtained from the University of Leicester ethics committee. Statistical analysis was completed with descriptive statistics. Results: A total of 125 HCPs responded, of which more than half had ≥10 years’ experience working with vascular amputees (51.2%). Timed Up and Go was the most used ambulatory PerBOM by HCPs (89%) and the Basic Ambulatory Mobility Scale (45%) was the most commonly used non-ambulatory PerBOM. PerBOMs were least used before amputation (15%) and were used most frequently 6 months after amputation (59%). HCPs rated PerBOMs for ambulatory patients as being of greater usefulness than non-ambulatory PerBOMs. The most common rehabilitation interventions for non-ambulatory amputees include transfer practice (85.5%) and wheelchair training (69.6%); few provided group exercise therapy (23.2%). Conclusions: Ambulatory PerBOMs are well known and used more frequently than non-ambulatory PerBOMs. PerBOMs for vascular amputees are not used within clinical practice due to the limited number and inadequate options of PerBOMs for non-ambulatory vascular amputees. Further research is needed in understanding the limited clinical use of existing PerBOMs. Pending further research, a new PerBOM for non-ambulatory patients may be supported to assess the physical function of amputees throughout the patient journey of vascular amputees and for goal setting in the short and longer term.