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 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:
After identifying the factors that impact prosthetic use, clinicians modify the care plan to ensure that the patient reaches their maximum rehabilitation potential.
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:
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.
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.
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.
Levin Sliker
Co-founder & CEO, Point Designs
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