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, Corinne Ammann-Reiffer, Caroline H G Bastiaenen, Hubertus J A Van Hedel

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.

© The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.

Figures

Figure 1
Figure 1
Frequency distributions of the Functional Mobility Scale (FMS) 5m, 50m, and 500m and the Gillette Functional Assessment Questionnaire walking scale (FAQ). T0, start of active gait rehabilitation; T1, end of active gait rehabilitation.
Figure 2
Figure 2
Comparison of change scores between children who had received surgery or not before undergoing rehabilitation. FMS, Functional Mobility Scale; FAQ, Gillette Functional Assessment Questionnaire walking scale; horizontal line, median; box, interquartile range; whiskers, ±1.5× interquartile range; small circle, mild outlier (more than 1.5× interquartile range); star, extreme outlier (more than 3× interquartile range).

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