Video summary

Amputee Mobility Predictor - Setup and Instruction

Main summary

Key takeaways

Educational

Main ideas / purpose

  • The Amputee Mobility Predictor (AMP) is an outcome measure used in lower-extremity amputation care.
  • It helps clinicians:
    • Prescribe prosthetic componentry by assigning a K-Level (mobility category).
    • Assess functional mobility in lower-extremity amputees.
    • Support collaboration between physical therapists and prosthetists.
  • The video introduces two versions of the measure:
    • AMPPRO = AMP performed with a prosthetic limb
    • AMPnoPRO = AMP performed without a prosthesis

Setup / materials checklist (before testing)

Environment setup

  • Place two hard chairs with arm rests at 90 degrees to each other.
  • Measure a 12-foot (≈4 m) walkway from one chair.
  • Mark the endpoint of the runway using tape or cones.
  • Ensure access to at least 2 stairs with a rail on both sides.

Materials to gather

  • Stopwatch
  • Pencil
  • 12-inch ruler
  • Movable box: 4 inches high (e.g., a shoebox)
  • A copy of the AMP clinical instrument (AMP or AMPnoPRO as appropriate)

Clinical instrument preparation (form items)

  • At the top of the form, checkboxes indicate the physical status of each lower extremity:
    • Partial foot
    • Trans-tibial
    • Knee disarticulation
    • Trans-femoral
    • Hip disarticulation
    • Intact (no amputation)
  • Mark the appropriate boxes for each limb.
  • Scoring note: each item is scored based on the initial attempt (unless otherwise noted).

Testing instructions (AMP items 1–21)

Items 1–13 (chair-based / balance / reach)

  1. Sitting Balance

    • Patient sits with arms folded across chest for 60 seconds.
    • Score as indicated.

  2. Sitting Reach

    • Patient extends arms forward.
    • Hold a 12-inch ruler about 12 inches beyond the fingertips.
    • Patient reaches forward and grasps the ruler.
    • Score as indicated.

  3. Chair to Chair Transfer

    • With chairs at 90 degrees, patient transfers chair to chair, using arms as needed.

  4. Arises From a Chair

    • Patient folds arms across chest and stands.
    • Use arms or assistive device as needed.

  5. Attempts to Arise From a Chair

    • If patient rises in one attempt: score full points.
    • If multiple attempts are required or assist is needed: score according to chart.

  6. Immediate Standing Balance

    • After standing, assess balance during the first 5 seconds.

  7. Standing Balance (assess with device rules)

    • For items 7 & 8, first attempt is without an assistive device.
    • If support is required, allow it after the initial attempt.
    • Have patient stand for 30 seconds (assistive device allowed only after initial attempt).
    • Score as indicated.

  8. Single Limb Standing Balance

    • If performing AMPnoPRO: skip this item and assign no score.
    • If performing AMPPRO:
      • Have patient stand on one limb at a time (test both sides).
      • Use assistance as necessary.
      • Time with stopwatch for up to 30 seconds.
      • Only one trial per side.
    • Score as indicated.

  9. Standing Reach

    • Patient stands, extends arms forward.
    • Hold ruler 12 inches beyond extended arms.
    • Patient reaches and grasps ruler.
    • Score as indicated.

  10. Nudge Test

    • Feet as close together as possible.
    • Push on patient’s sternum 3 times with palm of hand.
    • Stop at the point where toes rise.
    • Score as indicated.

  11. Eyes Closed

    • Patient stands with eyes closed for 30 seconds.
    • Use assistive device as necessary.
    • Score as indicated.

  12. Picking Up Object Off the Floor

    • Place a pencil on ground at patient’s midline, 12 inches in front of the foot.
    • Patient picks up pencil and returns to standing.

  13. Stand to Sit

    • Patient folds arms across chest and sits.
    • Use arms or assistive device as necessary.

Items 14–20 (12-foot / 4-meter walkway tasks)

  • Patient starts seated at the chair at the beginning of the walkway.
  • Version differences:
    • For AMPnoPRO, patient performs items 14–20 by hopping with an appropriate assistance device.

  1. Initiation of Gait

    • Patient walks (AMPPRO) or hops (AMPnoPRO) the length of the walkway.
    • Observe for any hesitation.
    • Score as indicated.

  2. Movement mechanics (version-specific)

    • AMPnoPRO (hopping):
      • Assess hop length (target: at least 12 inches).
      • Assess foot clearance (clearing of foot).
      • Score both hop length and foot clearance.
    • AMPPRO (walking):
      • Assess step length (swing limb should advance 12 inches).
      • Assess foot clearance.
      • Score both step length and height/clearance for each limb.

  3. Step / Hop Continuity

    • Patient continues walking (AMPPRO) or hopping (AMPnoPRO) the walkway.
    • Observe continuity once moving.
    • If hesitancy occurs between steps/hops, score as indicated.

  4. Turning

    • At end of walkway, patient turns 180 degrees.
    • Assess number of steps/hops and assistance required to complete transition.
    • Score as indicated.
    • Practical note from video: with practice, clinician can often perform tasks 14–17 while patient does only one walk down the walkway.

  5. Variable Cadence

    • Patient walks/hops the 12-foot walkway 4 separate times.
    • Vary speed according to instructions: slow or fast.
    • Recommended pattern: slow, fast, fast, slow (each pass).
    • Observe changes in cadence and any asymmetries.

  6. Stepping Over an Obstacle

    • Place the movable box (4 inches / 10 cm high) in the walkway.
    • Patient steps over or hops over it.
    • Observe:
      • clearance over the box
      • consistent stride
    • For above-knee amputees: lead with the prosthetic limb.

  7. Stairs

    • Ascend and descend at least 2 stairs.
    • No hand assist if able.
    • Do not hesitate to allow hand use if patient perceives risk.
    • Score based on pattern:
      • step-over-step vs step-to
    • Above-knee amputees should only perform step-to pattern unless trained in step-over-step.

  8. Assistive Device Selection (scoring)

    • For the final item, score the assistive device used by the patient for at least two of the test items.

Scoring and clinical interpretation

  • After completing all test items:
    • Add all scores up through the relevant version (AMPPRO or AMPnoPRO) to get the patient’s total.
  • Documentation requirement:
    • Ensure you note which version (AMPPRO vs AMPnoPRO) was performed.
  • Clinical use:
    • Compared with normative data, the total score supports prosthetic prescription via the patient’s K-Level.
    • Can be used as an outcome measurement during rehabilitation care.

Sources / speakers featured

  • Mission Gait (organization; video promotes resources and toolkit at missiongait.org)
  • No individual person or narrator is explicitly identified in the provided subtitles.

Original video