Using the PODCI to Measure Motor Function and Parent Expectations in Children With Cerebral Palsy

Abstract

Objective: Involving parents in the evaluation of their child with cerebral palsy (CP) is associated with enhanced neurodevelopmental outcomes. The pediatric outcomes data collection instrument (PODCI) is a patient-reported outcome measure primarily used to assess motor function following orthopedic surgical intervention or for older children with more independent motor function. The PODCI expectations scale has infrequently been reported in previous studies. This study aims to determine the relationship between parent-reported motor performance using the PODCI and motor capacity assessed by pediatric therapists for young children with CP across all ability levels and to explore the use of the PODCI expectations scale for quantifying therapy-related parent expectations.

Methods: This prospective cohort study included 108 participants with CP, 2 to 8 years of age, gross motor function classification systems (GMFCS) levels I to V. Measures included the PODCI, gross motor function measure (GMFM), and GMFCS.

Results: There were moderate (r = 0.513) to large (r = 0.885) relationships between PODCI and GMFM scores. PODCI scores were significantly different across GMFCS levels. Weak, significant relationships (r = -0.28) were found between function expectations scores and measures of function.

Conclusion: The PODCI, GMFM, and GMFCS provide different, but strongly related, information about the abilities of young children. The GMFM measures motor capacity. Parents report daily function and health-related quality of life for their child using the PODCI. Parent expectations for intervention outcomes may relate to a child's motor function.

Impact: These study results are consistent with those for older children with greater independent mobility, indicating an opportunity for expanded use of the PODCI for measuring motor performance for younger children with CP across all ability levels. A strategy is provided for using the PODCI expectations scale to quantify parent therapy-related expectations in future research and clinical settings. Therapy-related expectations may relate to child outcomes.

Trial registration: ClinicalTrials.gov NCT02897024.

Keywords: Cerebral Palsy; Child; Gross Motor Function Measure; Parent; Patient-Reported Outcomes Measures; Pediatric Outcome Data Collection Index.

© The Author(s) 2021. Published by Oxford University Press on behalf of the American Physical Therapy Association. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Figures

Figure 1

Individual and mean value plot of PODCI transfer and basic mobility scores for young children across GMFCS levels I–V. Analysis of variance tests for PODCI transfer and sports scores as a function of GMFCS levels. Overall P < .0001. All pairwise comparisons significant (adjusted P < .05) except IV vs V. GMFCS = gross motor function classification system; PODCI = pediatric outcomes data collection instrument.

Figure 2

Individual and mean value plot of PODCI sports and physical function scores for young children across GMFCS levels I–V. Analysis of variance tests for PODCI sports and physical function scores as a function of GMFCS levels (overall P < .0001). Pairwise comparisons revealed 3 significantly different groups for sports and physical function scores: level I, levels II/III, and levels IV/V. GMFCS = gross motor function classification system; PODCI = pediatric outcomes data collection instrument.