Reliability of the functional mobility scale for children with cerebral palsy

Area of Science:

• Pediatrics
• Rehabilitation Medicine
• Neurology

Background:

• Cerebral palsy (CP) significantly impacts childhood mobility.
• Accurate assessment of functional mobility is crucial for intervention planning in children with CP.
• The Functional Mobility Scale (FMS) is a tool used to evaluate mobility in this population.

Purpose of the Study:

• To evaluate the inter-rater reliability of the Functional Mobility Scale (FMS) in children with cerebral palsy (CP).
• To investigate potential rater bias in FMS scoring among different healthcare professionals.
• To determine the feasibility of administering the FMS via telephone.

Main Methods:

• A consecutive sample of 118 children with CP (aged 2-18 years) was assessed.
• Two raters, randomly assigned from orthopedic surgeons and physiotherapists, independently scored each child using the FMS.
• Inter-rater reliability was calculated using quadratic weighted kappa coefficients for mobility ratings across three distances.

Main Results:

• Quadratic weighted kappa coefficients ranged from 0.86 to 0.92, indicating substantial agreement between raters.
• Similar agreement levels were observed for in-person and telephone administration of the FMS.
• A slight tendency for surgeons to rate mobility higher than physiotherapists was noted, though not consistently significant.

Conclusions:

• The Functional Mobility Scale (FMS) is a reliable tool for assessing mobility in children with cerebral palsy.
• The FMS can be administered effectively through both in-person and telephone methods.
• The scale provides consistent mobility ratings across different rater disciplines, supporting its clinical utility.