Colorado Limb Donning-Timed Up and Go (COLD-TUG) Test in Lower-Extremity Amputation: Less Donning Time with Osseointegrated Bone-Anchored Prosthetic Limb.

Background: Osseointegration of a bone-anchored limb (BAL) establishes a direct skeletal interface for prosthesis attachment, simplifying the donning/doffing process. The Timed Up and Go (TUG) test reliably assesses mobility in individuals with lower-extremity amputation who use socket prostheses, but it does not account for the time required to don a prosthetic limb. The aim of this study was to develop and examine the reliability and validity of the Colorado Limb Donning-Timed Up and Go (COLD-TUG) test. This test combines the time required for donning a prosthesis with the time to complete the TUG test in lower-extremity amputees using a prosthesis.

Methods: Participants with a unilateral lower-extremity amputation were enrolled in this study; participants were divided into 2 groups: socket prosthesis users (n = 15) and BAL users (n = 22). The COLD-TUG test measured the time (in seconds) required to don the prosthesis, get up from a standard chair, walk 3 m, turn around, walk back to the chair, and sit down again. Group differences as well as the intrarater reliability and concurrent validity of the test were analyzed.

Results: There were no significant differences between the 2 groups in terms of baseline characteristics. The intrarater reliability of the COLD-TUG test was excellent (intraclass correlation coefficient [ICC] = 0.94; p = 0.001). The concurrent validity between the COLD-TUG test and the TUG test in BAL patients was good (r = 0.712; p = 0.006). Participants in the BAL group had a significantly shorter mean COLD-TUG time (16.6 ± 5.6 seconds) compared with participants in the socket-prosthesis group (85.3 ± 61.4 seconds) (p < 0.001).

Conclusions: The COLD-TUG test accurately measures prosthesis-donning burden in the context of functional mobility, thus providing valuable insights into functional abilities and quality of life. Use of a BAL was associated with a shorter donning time compared with use of a socket prosthesis. Methods: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.