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Interrater Reliability of Mechanical Tests for Prosthesis Classification

This study assesses the interrater reliability of American Orthotic & Prosthetic Association L-code classifications test outcomes between two administrators using the same testing facility. The results support the integration of these mechanical tests for prosthesis classification, enhancing objectivity and optimizing the prosthesis-patient matching process.

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Interrater Reliability of Mechanical Tests for Prosthesis Classification

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  1. Interrater reliability of mechanical tests for functional classification of transtibial prosthesis components distal to the socket Matthew J. Major, PhD; William Brett Johnson, PhD; Steven A. Gard, PhD

  2. Aim • To assess the interrater reliability of American Orthotic & Prosthetic Association L-code classifications test outcomes between two administrators using the same testing facility. • Relevance • Evidence suggests that the design and associated mechanical function of lower-limb prostheses affects user health and mobility, supporting common standards of clinical practice for appropriate matching of prosthesis design and user needs.

  3. Method • Mechanical tests require use of test-specific fixtures to be installed in a materials testing machine by a test administrator. • 10 prosthetic components (8 feet and 2 pylons) that spanned the range of commercial designs were subjected to all appropriate tests. • Two research engineers independently administered each mechanical test and responsible for the entire setup of fixtures and component installation, as well as tuning the materials test machine control parameters for each component.

  4. Results • Tests with scalar outcomes demonstrated high interrater reliability (interclass correlation coefficient (2,1) ≥ 0.935). • No discrepancy in observation-based outcomes between administrators occurred.

  5. Conclusion • These results support the integration of these mechanical tests for prosthesis classification, which will help enhance objectivity and optimization of the prosthesis-patient matching process for maximizing rehabilitation outcomes.

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