By Kaasvi Bhatia and Helen McLaughlin
LIMB-Q Kids, a novel patient-reported outcome measure (PROM), designed by researchers from the University of British Columbia and McMaster University specifically for children and adolescents with lower limb differences, has completed international field testing and is now officially launched.
LIMB-Q Kids has been made possible thanks to the generous support of four key grants: a CIHR Project Grant, two Canadian Orthopaedic Foundation grants, and an Orthopaedic Research and Education Foundation (OREF) grant from the UBC Department of Orthopaedics. This funding has been instrumental in advancing the development and impact of the project.
What is LIMB-Q Kids?
LIMB-Q Kids is a rigorously developed patient-reported outcome measure designed to assess outcomes in children and adolescents with lower limb differences. These differences can result from a wide range of conditions, both congenital and acquired.
Thoughtfully crafted, LIMB-Q Kids empowers children to share how their lives are impacted by having a lower limb difference and captures what matters most to them beyond just physical function. Conditions such as leg length discrepancies, congenital limb deficiencies, and acquired deficiencies can significantly impact a child’s ability to move, play, and engage in daily life.
Until now, no validated tool existed to truly capture how these children feel about their condition and treatment.
Voice of Young Patients
More than a questionnaire, LIMB-Q Kids is a voice for young patients, a tool that brings their experiences to the forefront and helps shape more compassionate, patient-centered care worldwide.
Developed using a concept-driven approach, LIMB-Q Kids was built from the ground up by listening to what matters most to patients. Researchers conducted interviews with 79 children and their parents from five hospitals in Canada, Ethiopia, India and the USA to understand their experiences. The tool was then refined with input from 40 patients, parents and clinical experts from Australia, Canada, Ethiopia, India, the UK and the USA.
Field testing and validation were done with 800 participants from 16 sites across 7 countries, including Australia, Canada, Denmark, Germany, India, the UK and the USA.
“My hope is that the use of LIMB-Q Kids will aid and shape the future of limb reconstruction surgery, allowing patient voices to be heard and improving the overall patient experience”
— Michaela Ironside, Former Patient, Limb Reconstruction Clinic, BC Children’s Hospital
Michaela Ironside, a former patient of the Limb Reconstruction Clinic at BC Children’s Hospital in 2014, reflects on her experience with LIMB-Q Kids: “Being involved in this process has not only given me the opportunity to help improve future patient experience but has also made me feel like my own journey is seen and valued.”
Watch Michaela’s Video Short to hear why being part of this journey still matters to her today—more than a decade later.
Modular, multilingual, and made for global care
LIMB-Q Kids is focused on three key areas:
Appearance
How children feel about the look of their leg(s)
Health-related quality of life
Including physical, psychological, and social function, as well as leg-related distress
Symptoms
Covering pain and discomfort in the ankle and foot, knee, hip and leg
Its modular design allows clinicians and researchers to select only the scales relevant to their needs, making it adaptable for both clinical care and research studies and minimizing patient burden in completing questionnaires.
The tool has already been translated and culturally adapted into multiple languages, including Arabic, Danish, Dutch, English, Finnish, German, Hindi, Hebrew, and Portuguese, with more in progress.
LIMB-Q Kids applications
With applications spanning research, industry, and clinical care, LIMB-Q Kids is now available to make a meaningful impact across several key areas.
Research
Supporting clinical trials and comparative studies of treatments
Industry
Meeting regulatory standards for product development and evaluation
Benchmarking
Helping institutions measure and improve care quality
Patient Care
Guiding personalized, patient-centered treatment decisions
Global partnerships: the power behind LIMB-Q Kids
With contributions from 16 international partners, LIMB-Q Kids reflects a shared commitment to improving care for children with lower limb differences—no matter where they live. Researchers, clinicians, patients, and families came together across continents to ensure that the voices of young patients are heard and valued in healthcare.
Our International Partners
A decade of scientific rigor: from systematic review to validation study
In July 2025, the LIMB-Q Kids field test manuscript was published in the Journal of Patient-Reported Outcomes (JPRO)—a major milestone for the project. This follows the successful completion of the field test in February 2024, with contributions from 16 international collaborators.
Publication in a peer-reviewed journal not only validates the scientific rigor and global relevance of LIMB-Q Kids, but also paves the way for its broader adoption in clinical practice, research, and policy-making. It marks a critical step toward ensuring that the voices of children with lower limb differences are systematically captured and used to improve care.
Meet the LIMB-Q Kids development team
LIMB-Q Kids is the result of a remarkable international effort—uniting voices, expertise, and experiences from around the world. Co-developed by Dr. Harpreet Kaur Chhina and Dr. Anthony Cooper at UBC, alongside Dr. Anne Klassen at McMaster University, this initiative exemplifies what’s possible when borders don’t limit collaboration.
Dr. Harpreet Kaur Chhina
Research Associate, Department of Orthopaedics, UBC
Dr. Harpreet Kaur Chhina is a Research Associate in the Department of Orthopaedics at the University of British Columbia and co-leads the Walk Tall Research Program at BC Children’s Hospital alongside Dr. Anthony Cooper. Her research focuses on pediatric limb differences, health-related quality of life, patient-reported outcomes, and international orthopaedic registries. She is also the scientific lead for the International Limb Differences Network (ILDN) and the International Limb Differences Registry.
Dr. Anthony Cooper
Clinical Associate Professor & Head, Division of Pediatric Orthopaedics, UBC
Dr. Anthony Cooper is a Clinical Associate Professor and Head of the Division of Pediatric Orthopaedics at UBC, as well as an Orthopaedic Surgeon and Head of Pediatric Orthopaedics at BC Children’s Hospital. He is the founder of the International Limb Differences Network (ILDN), a global collaboration of healthcare professionals and researchers dedicated to improving the lives of children with limb differences.
Dr. Anne Klassen
Professor of Pediatrics & Associate Member, Departments of Surgery and Health Research Methods, Evidence, and Impact (HEI), McMaster University
Dr. Anne Klassen is a Professor of Pediatrics and Associate Member in the Departments of Surgery and Health Research Methods, Evidence, and Impact (HEI) at McMaster University. Internationally recognized for her leadership in developing the Q-Portfolio of patient-reported outcome instruments, she also leads research on self-management tools for adolescents and currently holds a CIHR Sex & Gender Science Chair and a CIHR Foundation Grant to advance outcome measurement in gender-affirming healthcare
Get Involved
Join the LIMB-Q Kids team in shaping the future of care for children and adolescents with limb differences.
LIMB-Q Kids is more than just a patient-reported outcome measure—it’s a movement to amplify the voices of children and adolescents with limb differences. With your involvement, we can ensure that the care is guided by what matters most to patients and families.
For clinicians
- Implement LIMB-Q Kids in your practice to enhance shared decision-making and track outcomes that matter to your patients.
- Use LIMB-Q Kids to support quality improvement—monitor trends, address gaps, and improve experiences across the care journey.
For researchers
- Collaborate on studies using LIMB-Q Kids to assess treatment outcomes, surgical interventions, and long-term follow-up.
- Translate and culturally adapt LIMB-Q Kids for use in your country/language—we welcome partnerships to broaden its global reach.
For industry and health systems
- Use LIMB-Q Kids as a validated tool to measure patient-centered outcomes in trials of implants, devices, or surgical innovations.
- Support studies that show how your products impact quality of life, function, and recovery—directly from the patient’s perspective.
For patients and families
- Your voice matters. Help shape the future of care for children and youth with limb differences.
- LIMB-Q Kids is a tool created with patients and families—to make sure care focuses on what really matters to you.
- Ask your doctor or clinic if they use LIMB-Q Kids. Filling it out helps your care team understand how you’re really doing—beyond X-rays and check-ups. This will help ensure that you have the support you need specifically while you go through complex treatments.
To use LIMB-Q Kids for research, clinical trials, evaluation, or observation, please complete the Copyright License or Permission Request form on the McMaster University website.
For more information about LIMB-Q Kids, visit the Limb Network Website.
Publication
- Chhina, H., Rae, C., Podeszwa, D. et al. Psychometric findings for LIMB-Q kids based on an international study of 800 children and adolescents with lower limb differences. J Patient Rep Outcomes 9, 82 (2025).
Learn more
- LIMB-Q Kids
- LIMB-Q Kids licensing request
- International Limb Differences Network (ILDN)
- Walk Tall Research Program
