DISABILITY MOBILITY GRADES
The SIGMA grades are used by the Consultant in Rehabilitation Medicine and the Multidisciplinary Rehabilitation Team at the limb fitting centre (rehab centre) for measuring your mobility and activity levels. These codes are generally used to aid the rehab team in making an assesment of your needs and in deciding which prosthetic components will best suit your abaility and needs.
SIGMA GRADE
The SIGAM scale is a simple yet fully validated scale of ‘Disability Mobility Grades’
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Grade
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Disability
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Definition
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A
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Non-limb user
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Those who have abandoned the use of an artificial limb or use only non-functioning prostheses
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B
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Therapeutic
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Wear prostheses ONLY in the following circumstances; for transfer, to assist nursing, walking with the physical aid of another OR during therapy.
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C
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Limited/restricted
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Walks up to 50m on even ground with or without walking aids; a=frame, b=2crutches/sticks, c=1crutch/stick, d=no walking aids.
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D
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Impaired
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Walks 50m or more on level ground in good weather with walking aids; a= 2 sticks/crutches, b= 1stick/crutch.
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E
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Independent
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Walks 50m or more without walking aids expect to improve confidence in adverse terrain or weather.
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F
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Normal
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Normal or near normal walking
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The score should be used as a guideline only and should be used in conjunction with the algorithm (questionnaire) developed by Dr N Ryall.
(A)ctivity codes
Another system which was developed to assist the NHS prosthetic limb services within England, in determining each established prosthetic limb user's level of activity, an activity based coding classification system has been produced.
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· Lower limb prosthesis
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A0L
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User does not wear a prosthetic limb
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A1L
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User has the ability to use the prosthesis for transfers or walking on level surfaces for short periods of time. Typical of the prosthetic demands of a limited household/cosmetic user.
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A2L
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User has the ability to use the prosthesis for walking on uneven surfaces or to overcome low-level environmental barriers at fixed cadence. Typical of the prosthetic demands of a limited community or household user.
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A3L
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User has the ability to walk/move with variable cadence. This is typical of a user who had the ability to overcome many environmental barriers and may engage in vocational or leisure activities that demand prosthetic utilization beyond simple locomotion. Typical of the prosthetic demands of an active adult.
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A4L
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User has the ability or potential for prosthetic walking needs that exceed basic walking skills, exhibiting high impact stress or energy levels.
Typical of the prosthetic demands of a very active adult or athlete.
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Extra Contractual Activity
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Specialist sports limbs, high definition silicone cosmesis and silicone restoration including digits and C-legs.From national framework agreement prices with a stipulation that this does not exceed 5% of the total caseload.
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· Upper limb prosthesis
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A0U
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User does not wear a prosthetic limb.
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A1L
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User utilises the prosthesis for cosmetic purposes and does not use it for assistance in manual tasks.
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A2L
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User utilises the prosthesis for manual tasks
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A3L
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User utilises myo-electric prosthesis
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A4L Pay as you go
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From national framework agreement prices with a stipulation that this does not exceed 5% of the total caseload.
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