Development and validation of a modified performance-oriented mobility assessment tool for assessing mobility in children with hypophosphatasia.
Dawn Phillips, Donna Griffin, Tracy Przybylski and 5 others
PMID 30223404WHAT IT FOUND
The modified POMA-G is a reliable and valid tool for assessing gait impairment in children with hypophosphatasia aged 5 to 15.
It scores step length, symmetry, continuity, trunk sway, and stance from video, showing strong agreement between raters and correlation with functional measures.
Key findings
01The modified POMA-G demonstrated good interrater and intrarater reliability with an ICC of 0.76.
02mPOMA-G scores showed strong concurrent validity with the CHAQ Disability Index, PODCI subscales, and the 6-Minute Walk Test in children with infantile and childhood HPP.
03The tool was validated for use in children aged 5 years and older, as younger children may have difficulty following instructions.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study only included 14 children, which is a small sample size for validation. The tool has not been validated in typically developing children or in children under 5 years of age. The mPOMA-G may still have ceiling effects for some patients, particularly on the PODCI Transfer and Basic Mobility subscale which showed weaker correlations. The validation was based on video scoring, so real-time application in clinical practice may differ slightly.
Declared interests
Funding and support were provided by the study sponsors of the underlying clinical trials (NCT00952484, NCT01203826, NCT02235493), which involved asfotase alfa, an enzyme-replacement therapy for HPP. The authors declared no other conflicts of interest.
The easy way to misread this
Do not use the mPOMA-G for children under 5 years old or for typically developing children, as it has only been validated in children with HPP aged 5 to 15. Additionally, do not interpret a high mPOMA-G score as evidence of no functional limitation, as the tool may not capture all aspects of mobility or participation barriers.