Validity and Reliability of the German Version of the Locomotor Capabilities Index-5 (LCI-5)

Abstract

Background Before foreign language questionnaires, such as patient reported outcome measures (PROMs), can be scientifically used in the national language, guideline-based translation, cultural adaptation and comprehensive verification of their validity and reliability are needed. The aim of this study was to assess the psychometric properties of the German version of the LCI-5 (LCI-5-D) on a sample of people with lower limb amputation (LLA).

Methods The LCI-5 was translated into German (LCI-5-D) based on the ISPOR guidelines for cross-cultural adaptation following pilot testing. The final LCI-5-D was administered to n = 52 lower limb amputees in order to determine the validity and reliability of both the total score and the subscores (“basic items” and “advanced items”). Internal consistency (Cronbachʼs alpha), test-retest reliability (ICC2,1), standard error of the mean (SEM), minimal detectable change (MDC), item-to-total correlation, and item-to-subscale correlation were calculated. Floor and ceiling effects were checked. For construct validity, the Rivermead Mobility Index (RMI) and timed up and go (TUG) test were correlated, and differences of defined subgroups (amputation height and prosthesis user type) were calculated.

Results On average, the score of the LCI-5-D was 40.13 ± 16.64 points. High ceiling effects were present for the subscale “basic items” (57.7% maximum score). Internal consistency showed excellent results (Cronbachʼs α = 0.97). A strong correlation to the RMI (r = 0.863; p < 0.001) and to the TUG (r = − 0.714; p < 0.001) demonstrated construct validity. Test-rest reliability was measured after an averaged time span of 5.3 ± 2.47 days and resulted in very high reliability [ICC (2,1) = 0.97; p < 0.001]. MDC was 7.57 points for the total score.

Conclusion The LCI-5-D is a valid and reliable PROM for measuring mobility with prostheses in German-speaking lower limb amputees, which is rather suitable for people with low to moderate mobility abilities. It can be used in a German-speaking population.

Zusammenfassung

Hintergrund Bevor fremdsprachige Fragebögen, wie z. B. patient reported outcome measures (PROMs), in der Landessprache wissenschaftlich eingesetzt werden können, sind leitfadengestützte Übersetzungen, eine kulturelle Adaptation und eine umfassende Überprüfung ihrer Validität und Reliabilität erforderlich. Ziel dieser Studie war es, die psychometrischen Eigenschaften der deutschen Version des LCI-5 (LCI-5-D) an einer Stichprobe von Personen mit Majoramputation der unteren Extremitäten zu überprüfen.

Methoden Der LCI-5 wurde in Anlehnung an die ISPOR-Richtlinie ins Deutsche übersetzt (LCI-5-D) und in einer Pilot-Studie getestet. Der endgültige LCI-5-D wurde an n = 52 Unterschenkelamputierten auf Validität und Reliabilität untersucht, und zwar sowohl der LCI-5-D-Gesamtscore als auch der daraus berechenbaren Teilscores („Basis-Items“ und „Advanced Items“). Es wurden die interne Konsistenz (Cronbachs Alpha), die Test-Retest-Reliabilität (ICC2,1), der Standardfehler des Mittelwertes (SEM) und die minimal detektierbare Differenz (MDC), sowie die Trennschärfe der Items berechnet. Boden- und Decken-Effekte wurden ebenfalls überprüft. Für das Messen der Konstruktvalidität wurden der parallel erhobene Rivermead Mobility Index (RMI) und der Timed Up and Go Test (TUG) korreliert und Differenzen definierter Untergruppen (Amputationshöhe und Prothesenträger-Typ) berechnet.

Ergebnisse Im Durchschnitt lag der Score des LCI-5-D bei 40,13 ± 16,64 Punkten. Hohe Deckeneffekte lagen nur für die Subskala „Basic-items“ vor (57,7% Maximalwert). Die interne Konsistenz zeigte hervorragende Ergebnisse (Cronbachs α = 0,97). Eine starke Korrelation zum RMI (r = 0,863; p < 0,001) und zum TUG (r = − 0,714; p < 0,001) belegen die Konstruktvalidität. Die Test-Rest-Reliabilität wurde nach einer gemittelten Zeitspanne von 5,3 ± 2,47 Tagen gemessen und ergab eine sehr hohe Reliabilität (ICC [2, 1] = 0,97; p < 0,001). Der MDC betrug 7,57 Punkte für den Gesamtscore.

Schlussfolgerung Der LCI-5-D ist ein valides und reliables PROM zur Messung der Mobilität mit Prothesen bei deutschsprachigen Patienten mit Majoramputation der unteren Extremität. Der Score ist am besten für Personen mit geringen bis mittleren Mobilitätsfähigkeiten geeignet. Der LCI-5-D kann in einer deutschsprachigen Population eingesetzt werden und wird reliable, valide und objektive Aussagen über die Mobilität mit Prothese treffen können.

Key words

lower limb amputation - Locomotor Capabilities Index - LCI-5 - mobility

Schlüsselwörter

Amputation - Locomotor Capabilities Index - LCI-5 - Mobilität mit Prothese

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