Summary

What it measures:

PROMIS Mobility Measure is a subset of PROMIS Physical Health Function self-report outcomes measurement systems. The test is used in adult and pediatric populations with chronic conditions. The mobility subset measures an individual’s self-perceived mobility capabilities, such as getting up from a chair or running. PROMIS Mobility includes adult, pediatric (aged 8-17 years), and parent proxy (aged 5-17 years) report versions. Additional variations include the short form (SF) and computer adaptive test (CAT).

The pediatric version was developed separate from the adult version due to the variation in daily physical activities between the 2 age groups. The parent proxy version was developed for children with comprehension and communication limitations, allowing a parent to provide additional insight. All PROMIS Mobility versions are currently version 2.0.

Taskforce Recommendations:

• Not reported

Clinical Insights

Pediatric SF Version 1.0(9):

• This tool is currently not appropriate for children with CP.
• PROMIS Mobility was not found to detect change at 6 and 12-months postmusculoskeletal surgery compared with other pediatric outcome measures, including Pediatric Quality of Life Inventory Cerebral Palsy Module Version 3.0 (PedsQL CP), Pediatric Outcomes Data Collection Instrument (PODCI), Timed Up and Go (TUG) and Gross Motor Functional Measure (GMFM), which were all found to be responsive to change.
• Seven items of the PROMIS SF were considered by these authors to not be relevant for children with CP.(9)
• Ceiling effects were recorded at baseline and after 6 months.
• Researchers have suggested that this measure should be adapted to the population of those with CP by adding start/stop rules or items that are relevant to children with mobility impairments. It has been suggested that the first item in CAT should discriminate among children with different abilities, followed by items tailored to their abilities.

Pediatric and Parent Proxy Bank:

• Parent proxy and self-report versions of PROMIS Mobility have been shown to be strongly correlated to PROMIS UE (upper extremity) portion of the PROMIS Physical Functioning in a study involving children with upper extremity fractures, aged 5-10 years old.(6)
• A ceiling effect in some patient scores may occur due to the emphasis on the lower extremities in the Mobility test.(6)
• PROMIS Mobility is commonly used in the adult orthopedic population; this study demonstrated it is also effective in the pediatric orthopedic population.(6)
• Parent Proxy may be an alternative when assessing children who have difficulty responding to a self-report due to cognitive or health-related issues. However, the child's self-report and the parent's observation may differ.
• There is a potential for scoring errors using the Likert scale because of the wording. For example, in the Pediatric SF, "With a little trouble" and "With some trouble," could seem to mean the same to the patient when hearing or reading it.