RehabMeasures Instrument
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  2. Orthotics Prosthetics Users Survey

Orthotics Prosthetics Users Survey

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OPUS Clinician Survey
OPUS HQOL Status
OPUS LE Functional Status
OPUS Upper Extremity Functional Status
OPUS Satisfaction
OPUS Upper Extremity Scoring Guide
Satisfaction With Device Score
Arabic OPUS-LEFS
Scoring Guide for the Orthotics and Prosthetics Users Survey

Purpose

The Orthotics and Prosthetics User’s Survey (OPUS) is a self-report questionnaire consisting of five modules. It can be used for prosthetic and orthotic programs for quality assessment, to maintain awareness of improvement in activities, to evaluate changes in patient’s functional status and quality of life, and to assess satisfaction with devices and services.

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instrument details

Acronym OPUS

Cost

Free

Populations

Orthopedic Surgery
Mixed Populations
Limb Loss and Amputation

Key Descriptions

  • OPUS has an original and a modified version. Both the versions have of total five surveys:
    1) The Upper Extremity Functional Status Survey(UEFS)
    2) The Lower Extremity Functional Status Survey (LEFS)
    3) OPUS-Health Related Quality of Life Index (HR-QOL)
    4) OPUS-Satisfaction with Devices (CSD)
    5) OPUS-Satisfaction with Services (CSS)
  • Total items in the original OPUS are 87, and total items in the modified OPUS are 88.
  • Different authors have used scoring for OPUS in a different way, so there is no minimal or maximal score reported. For example, the UEFS has a 5-point Likert scale where Score Points are 0 = not able, 1 = difficult, 2 = easy, 3 = very easy scores are given. The fifth column “not applicable is not scored” by some authors, or scored as “0” and added in the calculation. A total of these score points are considered at the final calculation.
  • The LEFS and HRQOL are also based on a five-point Likert scale and a nominal YES-NO scale. The CSD and CSS use a four-point Likert scale.
  • Easy to understand self-report questionnaire/survey.
  • It can be administered through at clinic (preferred method). However, many studies have administered it via mail, as well as completion at home. These versions are not different from the original forms, and have not been specifically validated for use via mail or at home.

Number of Items

Original: 87
Modified: 88

Equipment Required

  • OPUS questionnaire and a writing utensil

Time to Administer

10-15 minutes

Lindner et. al. has said 10-15 minutes are required to answer the questions in all the modules.
If only one component is used then time required for completion is less than 10 minutes.

Required Training

Reading an Article/Manual

Instrument Reviewers

Initially reviewed by Tanmayi Patgaonkar, MHS, RPT/L in 4/2015

ICF Domain

Activity
Participation
Environment

Considerations

  • OPUS can be used both in clinical as well as research settings. 
  • OPUS has been more widely used as individual components rather than all components together. The modified version of the scale has subtracted and then added few new items to the questionnaire; like the original CSD deleted questions pertaining to cost of device and payment options and few others and added new questions, thus converting original 10 item CSD to 8 items in the modified version. 
  • The test being fairly new, many studies are still going on to determine the other psychometric properties of the scales. 
  • OPUS can be used in all ages, unilateral or bilateral orthotic or prosthetic users, congenital or acquired population with prosthesis, and all levels of orthosis and prosthesis. (Lindner, et. al., 2010)
  • An Arabic language version of the OPUS-LEFS is available (see under "Download" at the top of the summary).

Do you see an error or have a suggestion for this instrument summary? Please e-mail us!

Limb Loss and Amputation

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Minimal Detectable Change (MDC)

Unilateral Lower Limb Amputation: (Resnik, 2011; n=44, 6 months post lower limb prosthesis users) 

  • MDC for LEFS scale=10.3 

  • MDC for HRQOL=9.2 

  • MDC for Device or Service Satisfaction=15.7

Test/Retest Reliability

Unilateral Lower Limb Amputation: (Resnik, 2011) 

  • LEFS: Adequate test-retest reliability (ICC=0.67) 

  • HRQOL: Excellent test-retest reliability (ICC=0.85) 

  • CSD/CSS: Adequate test-retest reliability (ICC=0.50)

Internal Consistency

Unilateral Upper Limb Amputation: (Burger, 2008; n=61, mean age=57+/- 17.1) 

UEFS 

  • Person separation Index- Excellent internal consistency (Cronbach’s alpha = 0.89 (23 items) and 0.88 (19 items)) 

  • Item separation Index- Excellent internal consistency (Cronbach’s alpha= 0.97 (23 items) and 0.96 (19 items))

Floor/Ceiling Effects

Unilateral Lower Limb Amputation: (Resnik, 2011) 

  • Strong statistical strength is noted. Safe to consider. Excellent Floor and ceiling effects.

Mixed Populations

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Internal Consistency

Mixed (orthotic and prosthetic users, adults and children both) population for Original OPUS: (Heinemann, 2003; n=164) 

 

Person separation Index 

Item Separation Index 

LEFS 

Excellent Internal consistency (Cronbach’s alpha = 0.94) 

ExcellentInternal consistency (Cronbach’s alpha = 0.98) 

HRQOL 

Excellent Internal consistency (Cronbach’s alpha = 0.88) 

ExcellentInternal consistency (Cronbach’s alpha = 0.96) 

CSD 

Adequate Internal consistency (Cronbach’s alpha = 0.74) 

ExcellentInternal consistency (Cronbach’s alpha = 0.86) 

CSS 

Adequate Internal consistency (Cronbach’s alpha =0.78) 

ExcellentInternal consistency (Cronbach’s alpha = 0.82) 

 

 

Mixed (Adults with orthotic and prosthetics) Population for Modified OPUS: (Jarl, 2012; n=282) 

 

Person Separation Index 

Item Separation Index 

LEFS 

Excellent Internal consistency (Cronbach’s alpha = 0.96) 

Excellent Internal consistency (Cronbach’s alpha = 0.99) 

UEFS 

Excellent Internal consistency (Cronbach’s alpha =0.92) 

Excellent Internal consistency (Cronbach’s alpha = 0.97) 

CSD 

Adequate Internal consistency (Cronbach’s alpha = 0.75 

Excellent Internal consistency (Cronbach’s alpha = 0.96) 

CSS 

Adequate Internal consistency (Cronbach’s alpha = 0.74) 

Excellent Internal consistency (Cronbach’s alpha = 0.94) 

HRQOL-restrictions 

Excellent Internal consistency (Cronbach’s alpha = 0.89) 

Excellent Internal consistency (Cronbach’s alpha = 0.97) 

HRQOL-emotions 

Excellent Internal consistency (Cronbach’s alpha = 0.89) 

Excellent Internal consistency (Cronbach’s alpha = 0.99)

Floor/Ceiling Effects

Mixed Population for Modified OPUS: (Jarl, 2012) 

  • Ceiling effects for UEFS and LEFS: Adequate=2.5 to 19.6%

Orthopedic Surgery

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Minimal Detectable Change (MDC)

UE, LE prosthesis, LE orthosis, insoles, orthopedic shoes: (Jarl et. al., 2014, N=69, Swedish) 

SDD (Smallest detectable difference) 

  • LEFS: 12.1 

  • UEFS: 14.8 

  • CSD: 15 

  • CSS: 16.6 

  • HRQOL: 7.4

Test/Retest Reliability

UE, LE prosthesis, LE orthosis, insoles, orthopedic shoes: (Jarl, 2014) 

  • LEFS: Excellent test-retest reliability (ICC= 0.96) 

  • UEFS: Excellent test-retest reliability (ICC=0.89) 

  • CSD: Excellent test-retest reliability (ICC=0.82) 

  • CSS: Excellent test-retest reliability (ICC=0.77) 

  • HRQOL: Excellent test-retest reliability (ICC=0.91)

Internal Consistency

Orthopedic, neurological, and rheumatic orthosis using population: Bravini, 2014) 

Person separation Index for CSD-IT: Adequate internal consistencyCronbach’s alpha = 0.70 (8 items))

Bibliography

Bettoni, E., et. al. (2014) “A systematic review of questionnaires to assess patient satisfaction with limb orthoses” P & O Intl: 1-12. Find it on PubMed

Bravini, E., et al. (2014) “Validation of the Italian version of the Client Satisfaction with Device module of the Orthotics and Prosthetics Users’ Survey.” Disabil & Health Jour, 7: 442-447. Find it on PubMed

Burger, H. et al. (2008). "Validation of the orthotics and prosthetics user survey upper extremity functional status module in people with unilateral upper limb amputation." J of Rehab Med, 40.5: 393-399. Find it on PubMed

Heinemann, A. W., R. K. Bode, and C. O'Reilly. (2003). "Development and measurement properties of the Orthotics and Prosthetics Users' Survey (OPUS): a comprehensive set of clinical outcome instruments." P & O Intl, 27.3: 191-206. Find it on PubMed

Jarl, GM., Allen W. Heinemann, and Liselotte M. Norling Hermansson. (2012) "Validity evidence for a modified version of the Orthotics and Prosthetics Users' Survey." Disability and Rehab: Assistive Tech, 7.6: 469-478. Find it on PubMed

Jarl, G.M., and Hermansson, L.M.N. (2009) “Translation and linguistic validation of the Swedish version of Orthotics and Prosthetics Users’ Survey.” P &O Intl, 33(4): 329–338. Find it on PubMed

Jarl, G., Holmefur, M., Hermansson, L. (2014) “Test–retest reliability of the Swedish version of the Orthotics and Prosthetics Users’ Survey.” P & O Intl, 38(1): 21–26. Find it on PubMed

Lindner, HN. Natterlund, BS., & Hermansson, LMN. (2010) “Upper limb prosthetic outcome measures: Review and content comparison based on International Classification of Functioning, Disability and Health.” P & O Intl, 34(2): 109–128. Find it on PubMed

Resnik, L., Borgia, M. (2011). “Reliability of outcome measures for people with lower-limb amputations: distinguishing true change from statistical error.” Phys Ther, 91: 555–565. Find it on PubMed

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