Highlights
- •The SHAP measures function in upper limb amputation but many items are too difficult
- •Validity of the SHAP overall score, the IOF, was supported
- •The validity of individual grip scores of the SHAP was not supported.
- •We examined properties of the SHAP and proposed a modified version, the P-IOF
- •The P-IOF is valid, takes less time to administer and is easy to score
Abstract
Background
The 26-item Southampton Hand Assessment Protocol (SHAP) is a test of prosthetic hand
function that generates an Index of Functionality (IOF), and prehensile pattern (PP)
scores. Prior researchers identified potential issues in SHAP scoring, proposing alternative
scoring methods (LIF and W-LIF).
Study design
Cross-sectional study.
Purpose
Evaluate the psychometric properties of the SHAP IOF, LIF, and W-LIF and PP scores
and develop the Prosthesis Index of Functionality (P-IOF).
Methods
We examined item completion, floor andceiling effects, concurrent, discriminant, construct
and structural validity. The P-IOF used increased boundary limits and information
from item completion and completion time. Calibration used a nonlinear mixed model.
Scores were estimated using maximum a posteriori Bayesian estimation. Mixed integer
linear programing (MILP) informed development of a shorter measure. Validity analyses
were repeated using the P-IOF.
Results
126 persons, mean age 57 (sd 15.8), 69% with transradial amputation were included.
Floors effects were observed in 18.3%-19.1% for the IOF, LIF, and W-LIF. Ten items
were not completed by >15% of participants. Boundary limits were problematic for all
but 1 item. Correlations with dexterity measures were strong (r = 0.54-0.73). Scores differed by amputation level (p > .0001). Factor analysis did not support use of PP scores. The P-IOF used expanded boundary
limits to decrease floor effects. MILP identified 10 items that could be dropped.
The 26-item P-IOF and 16-item P-IOF had reduced floor effects (<7.5%), strong evidence
of concurrent and discriminant validity, and construct validity. P-IOF reduced administrative
burden by 9.5 (sd 5.6) minutes.
Discussion
Floor effects limit a measure's ability to distinguish between persons with low function.
Conclusion
Analyses supported the validity of the SHAP IOF, LIF, and W-LIF, but identified large
floor effects, as well as issues with structural validity of the PP scores. The 16-item
P-IOF minimizes floor effects and reduces administrative burden.
Keywords
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JHT Read for Credit
Quiz: # 885
Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
- # 1.The SHAP generates scores for
- a.comfort and compliance
- b.PP and IOF
- c.ICE and PQ
- d.sensitivity and specificity
- a.
- # 2.The authors sought to develop the
- a.best practices for prosthetic rehabilitation
- b.prosthetic version of the Quick DASH
- c.I-PP
- d.P-IOF
- a.
- # 3.The investigators were especially concerned with
- a.ceiling and floor limits
- b.reproducibility
- c.validity
- d.reliability
- a.
- # 4.In creating their tool the authors
- a.reduced their boundary limits by 50% of the normative values
- b.increased their boundary limits to 12 x the normative values
- c.used the currently established normative values
- d.disregarded established normative values
- a.
- # 5.The P-IOF maximizes the ceiling effect and virtually eliminates any administrative burden
- a.false
- b.true
- a.
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Article info
Publication history
Published online: July 07, 2021
Accepted:
July 4,
2021
Received in revised form:
June 22,
2021
Received:
August 5,
2020
Identification
Copyright
Published by Elsevier Inc.
