CAPPFUL administration to a transhumeral patient

The Capacity Assessment of Prosthetic Performance for Upper Limb (CAPPFUL™)

The CAPPFUL™ is the first representative assessment tool designed exclusively to measure upper limb prosthetic performance. It was created by Arm Dynamics in collaboration with the Food and Drug Administration and the Defense Advanced Research Projects Agency. It has been peer-reviewed and psychometrically validated.

The Challenge

There is a shortage of outcome measures that are designed specifically for upper limb prosthesis users.

Most of the existing assessments that are used with this patient population have been adopted from other medical specialties such as neurological and musculoskeletal disorders. 

In the absence of patient-specific outcome measures, it’s difficult for clinicians to objectively assess their patients’ functional challenges and modify their care plan accordingly.

The Solution

The CAPPFUL is a performance-based outcome measure, designed to assess factors that impact the functional use of an upper limb prosthesis. It consists of a series of functional tasks that are evaluated in several key dimensions including: 

  • Control skills
  • Component utilization
  • Compensatory movements
  • Task completion

After identifying the factors that impact prosthetic use, clinicians modify the care plan to ensure that the patient reaches their maximum rehabilitation potential.

Key Features of This Assessment

The CAPPFUL is based on a series of functional tasks that the patient performs with their prosthesis. Scoring on the assessment compares the performance of a prosthesis to that of a sound upper limb and hand. An occupational or physical therapist works individually with the patient to administer, time and score each task.

Performing CAPPFUL tasks reveals several factors that can inhibit a person’s functional use of a prosthesis. These include issues with the prosthesis such as length, grip strength, wrist flexion/extension, and socket fit, and issues with the user’s performance such as poor body mechanics and lack of prosthetic training.

The assessment is repeated several times, at milestones in the patient’s prosthetic rehabilitation, or when there is a change in prosthetic components or the rehabilitation plan.

When scoring indicates there are issues with the prosthesis performance, the patient’s treatment plan shifts to include one or more of these interventions:

      • Additional prosthetic training with a therapist
      • Adjustment of the existing components
        • A prescriptive recommendation for new prosthetic component(s)
          • Modification to the fit of the prosthesis

The Capacity Assessment of Prosthetic Performance for Upper Limb (CAPPFUL) is the most effective tool available to measure upper limb prosthetic performance. CAPPFUL scores make it possible for clinicians to identify functional deficits and objectively inform revisions to the treatment plan. As a result, these uniquely challenged patients have the opportunity to reach their maximum rehabilitation potential.

CAPPFUL administration

Above, patient Jason Koger performs a CAPPFUL task, bilateral carry of a 6 lb crate. Below, he performs another CAPPFUL task, bilateral tying of a shoe.

Tying Shoes as an ADL in the CAPPFUL

The CAPPFUL is most effective when used in conjunction with a patient-report outcome measure such as the Comprehensive Arm Prosthesis and Rehabilitation Outcomes Questionnaire (CAPROQ™ or CAPROQ-S™). By combining a performance-based measure with a patient-report measure, clinicians are able to capture a spectrum of useful data, making it possible to clearly identify and correct gaps between a patient’s actual prosthetic function and their perceptions.

To thoroughly assess upper limb prosthetic performance, the CAPPFUL™ focuses on these key factors:

Areas of prosthetic performance
Specific functional tasks
Individual grasp patterns
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“We're using the CAPPFUL to assess patients who are wearing Point Digit and Point Partial finger components, and we love the fact that it's designed specifically to measure upper limb prosthesis performance. Our industry finally has a validated outcome measure that delivers comprehensive data based on a range of very appropriate and inclusive tasks."
Levin Sliker

Levin Sliker
Co-founder & CEO, Point Designs

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