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Appendix V: Amputee Mobility Predictor (AMP) scoring …

Standard of Care: Lower Extremity Amputation Copyright 2011 The Brigham and Women s Hospital, Inc., Department of Rehabilitation Services. All Rights Reserved. 36 Appendix V: Amputee Mobility Predictor (AMP) scoring form19 Amputee Mobility Predictor QuestionnaireInitial instructions: Testee is seated in a hard chair with arms. The following maneuvers are tested with or without the use ofthe prosthesis. Advise the person of each task or group of tasks prior to performance. Please avoid unnecessary chatter throughout the test. Safety first, no task should be performed if either the tester or testee is uncertain of a safe outcome. The Right Limb is: - PF - TT - KD - TF - HD - intact. The Left Limb is: - PF - TT - KD - TF - HD Sitting balance: sitforward inachair with arms folded across chest for Sitting reach: reach forward and grasp the ruler. (Tester holds ruler 12in beyond extended arms midline to the sternum.)

16. Step continuity. Stopping or discontinuity between steps (stop & go = 0 gait) Steps appear continuous = 1 17. Turning: 1800 turn when returning to chair. Unable to turn, requires intervention to prevent falling = 0 Greater than 3 steps but completes task without intervention No more than 3 continuous steps with or without assistive aid = 1

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