Article

The L Test is a reliable/valid clinical evaluation of mobility that
measures walking speed in seconds. It can be used with individuals with lower
limb amputation. Responsiveness of the L Test is not yet determined.
The purpose of this pilot study was to determine how well the L Test identified
individuals with a lower limb amputation who have/have not undergone a minimal
clinically important difference. STUDY DESIGN: Prospective follow-up study.
METHODS: In total, 33 individuals with lower limb amputation, deemed to require a
major intervention, were recruited consecutively from a follow-up clinic.
Participants completed the L Test at baseline and follow-up.
A Global Rating
Change scale was also completed at follow-up. RESULTS: The participants had a
mean age +/- standard deviation of 60 +/- 13.0 years, and 81.8% had a transtibial
amputation. The mean +/- standard deviation for the L Test change scores was 6.0
+/- 13.9. The area under the curve was 0.67, and the minimal clinically important
difference was 4.5 s. CONCLUSIONS: The L Test identified individuals as having an
important clinical change. Results must be interpreted with caution, as the
accuracy, based on the Global Rating Change scale, is low. Further inquiry into
the L Test is encouraged. CLINICAL RELEVANCE: The L Test can guide the clinical
management of individuals with lower limb amputation. Results from this pilot
study indicate that individuals with a lower limb amputation who improve by at
least 4.5 s on the L Test after an intervention have likely undergone an
important change. This result must be interpreted with caution given that the
ability of the L Test to correctly identify individuals, who have and have not
undergone an important change, using the Global Rating Change scale as the gold
standard, is limited because this is a pilot study. It is plausible that the precision of the cut-point threshold could increase or decrease given a larger
sample or when using a different method of identifying important clinical change.
CI - (c) The International Society for Prosthetics and Orthotics 2014.

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