Measuring change in gait performance of children with motor disorders: assessing the Functional Mobility Scale and the Gillette Functional Assessment Questionnaire walking scale

Abstract

Aim To examine the responsiveness and minimal important change (MIC) of two gait performance measures, the Functional Mobility Scale (FMS) and the Gillette Functional Assessment Questionnaire walking scale (FAQ), in a paediatric inpatient setting. Method Sixty‐four children and adolescents with a motor disorder, including cerebral palsy, traumatic brain injury, or stroke (25 females, 39 males; mean age [SD] 12y 6mo [3y 2mo], range 6–18y 6mo), were recruited. Physiotherapists scored the FMS and FAQ at the start and end of active gait rehabilitation. Change scores were compared with changes in gait capacity tests, the walking item of the Functional Independence Measure for Children, and a global rating scale (GRS) on the physiotherapists’ perceived change of the child's functional mobility. The GRS was also used to define the MIC. Results Change scores of the FMS and FAQ correlated between 0.35 and 0.49 with those of the capacity tests, 0.54 to 0.76 with the Functional Independence Measure for Children walking item change scores, and 0.57 to 0.76 with the GRS. The MIC values for the FMS and FAQ were 0.5 and 1.5 respectively. Interpretation FMS and FAQ can illustrate change in inpatient gait performance of children and adolescents with motor disorders. An improvement of one level in the FMS and two levels in the FAQ is considered as a clinically meaningful change. What this paper adds The Functional Mobility Scale (FMS) can detect change in children's inpatient gait performance. The Gillette Functional Assessment Questionnaire walking scale (FAQ) can also detect change in children's inpatient gait performance. A one‐level improvement in the FMS is clinically relevant. A two‐level improvement in the FAQ is clinically relevant.

Age-related gait standards for healthy children and young people: the GOS-ICH paediatric gait centiles

“…Gait assessment may contribute to diagnosis, describe the natural history or categorise the severity of pathology 2 3. It is also used as an outcome to demonstrate the efficacy of surgery, therapy or medications 4 5…”

Knee flexion contracture impacts functional mobility in children with cerebral palsy with various degree of involvement: a cross-sectional register study of 2,838 individuals

“…Furthermore Ammann-Reiffer et al. ( 2019 ) reported that a change of 1 FMS level is a clinically meaningful change in the rehabilitation of gait performance in children with motor disorders, though not exclusively CP. The Gillette Functional Assessment Questionnaire has proven sensitive and detected improved function after surgery (Novacheck et al.…”

Evaluating the Gillette Functional Assessment Questionnaire and the Functional Mobility Scale in a pediatric inpatient setting

“…Ammann‐Reiffer et al . examine the responsiveness and minimal important change (MIC) of the Functional Mobility Scale (FMS) and the walking scale portion of the Gillette Functional Assessment Questionnaire (FAQ‐w) in a pediatric inpatient setting . The prospective longitudinal psychometric study used ‘a construct and criterion approach to evaluate responsiveness and an anchor‐based approach to assess the minimal important change’ for each measure.…”

“…Ammann-Reiffer et al 1 examine the responsiveness and minimal important change (MIC) of the Functional Mobility Scale (FMS) 2 and the walking scale portion of the Gillette Functional Assessment Questionnaire 3 (FAQ-w) in a pediatric inpatient setting. 1 The prospective longitudinal psychometric study used 'a construct and criterion approach to evaluate responsiveness and an anchor-based approach to assess the minimal important change' for each measure. This study represents an important addition to the body of work on these commonly used instruments as responsiveness in an inpatient setting has not previously been reported.The pediatric inpatient rehabilitation setting presents unique challenges to research.…”

“…Before effectiveness of care can be truly assessed, it is important to assure that the instruments used to evaluate that care are valid, reliable, and responsive in the setting where the care was performed. Ammann-Reiffer et al 1 examine the responsiveness and minimal important change (MIC) of the Functional Mobility Scale (FMS) 2 and the walking scale portion of the Gillette Functional Assessment Questionnaire 3 (FAQ-w) in a pediatric inpatient setting. 1 The prospective longitudinal psychometric study used 'a construct and criterion approach to evaluate responsiveness and an anchor-based approach to assess the minimal important change' for each measure.…”