ArticlePM & R : the journal of injury, function, and rehabilitation2026
Creating adjusted scores targeting mobility empowerment (CASTLE 2): Using response probabilities to expand interpretation of prosthetic limb users survey of mobility (PLUS-M) scores for individuals with lower limb amputation.
Article in PM & R : the journal of injury, function, and rehabilitation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundProsthetists and other rehabilitation specialists often need to identify which aspects of mobility should be prioritized in order to make meaningful changes in a patient's health outcomes. By comparing a patient's responses on the Prosthetic Limb Users Survey of Mobility (PLUS-M) to predicted responses, clinicians can identify areas for improvement and provide more targeted rehabilitation.
objectiveTo generate PLUS-M T-score maps based on patient presentation (ie, etiology and amputation level) to provide guidance on the next steps in a patient's rehabilitation care.
designA frequency response method was used to generate PLUS-M T-score maps. The maps predicted the most probable response to each item on the PLUS-M based on the T-score. The maps were then tested using a separate test dataset. Accuracy was evaluated by comparing differences and Spearman correlation coefficients between predicted and actual scores.
settingClinical orthotics and prosthetics care.
participantsMaps were generated based on a training dataset from a large sample (N = 28,719) of patients with lower limb amputation. A separate test dataset (N = 26,535) was used to test the model. Individuals were included in the training and test datasets if they were adults with unilateral above-knee or below-knee amputation.
interventionsNot applicable. MAIN OUTCOME MEASURE(S): PLUS-M 12-item short form (v1.2).
resultsPLUS-M T-score maps were generated for two amputation levels (above and below knee) and two etiologies (dysvascular and nondysvascular), in addition to one for all patients. PLUS-M T-score maps predicted patient scores with high accuracy (difference scores >91.5% and Spearman correlation coefficients >0.801).
conclusionsClinicians can use the developed PLUS-M T-score maps to better understand patients' mobility. This insight can help clinicians improve care by identifying key rehabilitation goals for their patients.
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