Measuring change in gait performance of children with motor disorders: assessing the Functional Mobility Scale and the Gillette Functional Assessment Questionnaire walking scale.
Corinne Ammann-Reiffer, Caroline H G Bastiaenen, Hubertus J A Van Hedel
PMID 30341775WHAT IT FOUND
In children with motor disorders in inpatient rehabilitation, the Functional Mobility Scale and Gillette walking scale could detect meaningful gait change.
A meaningful change was at least one Functional Mobility Scale level or two Gillette walking scale levels.
Key findings
01Change scores on the Functional Mobility Scale and Gillette walking scale correlated moderate to strong with physiotherapists' global ratings of functional mobility change.
02Both scales could separate children whose walking performance improved from those whose performance remained unchanged, with area under ROC curve values of 0.79, 0.75, 0.76 and 0.80.
03A clinically meaningful change was at least one level on the Functional Mobility Scale and two levels on the Gillette walking scale.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The global rating scale used as the anchor had unknown reliability. The treating physiotherapist rated change, which may have slightly overestimated improvement. The Functional Mobility Scale distances were adapted from home, school and community to the patient room, within the centre and outside the centre. Samples for capacity tests and surgical subgroups were smaller than the full study sample, so those results are less stable. The minimum important change may differ at the lower and higher ends of the ordinal scales. No child was rated worse on the global rating scale, although six children partly deteriorated in Functional Mobility Scale or Gillette walking scale scores, so worsening was not captured by the anchor.
Declared interests
The supplied text does not report conflicts of interest. The publication type is listed as Research Support, Non-U.S. Gov't.
The easy way to misread this
Do not read the one-level Functional Mobility Scale or two-level Gillette walking scale change as proof that rehabilitation caused improvement. The study tested measurement properties and minimum important change, not the effect of the rehabilitation programme.