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Use of the Physical Abilities and Mobility Scale (PAMS) in Children Receiving Inpatient Rehabilitation for Spinal
Cynthia Salorio1,2, Kelsey Rogers1, Erin Neuland1
1International Center for Spinal Cord Injury, Kennedy Krieger Institute, Baltimore, MD, USA.
Insights
The Physical Abilities and Mobility Scale (PAMS) effectively measures functional motor skill improvements in children with spinal cord paralysis during inpatient rehabilitation, showing high reliability and validity.
Area of Science:
- Pediatric rehabilitation
- Neurology
- Physical therapy
Background:
- Children with spinal cord disease and injury (SCD/SCI) require specialized inpatient rehabilitation.
- Assessing functional motor skills is crucial for tracking progress in pediatric rehabilitation.
Purpose of the Study:
- To evaluate the performance of the Physical Abilities and Mobility Scale (PAMS) in children with paralysis due to SCD/SCI undergoing inpatient rehabilitation.
Main Methods:
- A retrospective chart review of 146 children (aged 2-21) with SCD/SCI was conducted.
- PAMS and WeeFIM® scores were analyzed for internal consistency, inter-rater reliability, construct validity, criterion validity, and sensitivity to change.
Main Results:
- The PAMS demonstrated high internal consistency (0.94-0.95) and inter-rater reliability.
- PAMS scores strongly correlated with WeeFIM® scores, particularly for mobility.
- Significant increases in PAMS scores were observed from admission to discharge.
Conclusions:
- The PAMS is a reliable and valid tool for assessing functional motor skills in children with spinal cord-related paralysis during inpatient rehabilitation.
- It effectively captures granular changes in motor abilities throughout the rehabilitation process.
Objectives:
To investigate the performance of the Physical Abilities and Mobility Scale (PAMS) in children receiving inpatient rehabilitation for paralysis related to spinal cord disease and injury (SCD/SCI).
Methods:
Participants were 146 children with paralysis related to SCD/SCI, aged 2-21, admitted between January 2010 and 2017 for inpatient rehabilitation at a single free-standing academically affiliated pediatric rehabilitation hospital. Retrospective chart review was performed to obtain admission and discharge scores on the PAMS and the functional independence measure for children (WeeFIM®), collected as part of clinical care. Internal consistency was evaluated using Cronbach's alpha. Inter-rater reliability was evaluated through overall agreement, Pearson correlations, and intraclass correlations. Construct validity was examined through exploratory factor analysis. Criterion validity was explored through correlations of PAMS overall and item scores with WeeFIM® total and subscale scores. Sensitivity to change was tested using paired t-tests examining differences between admission and discharge scores for each item and for the total score on the PAMS.
Results:
Internal consistency and inter-rater reliability were high (0.94 at admission and 0.95 at discharge). Total PAMS scores are highly correlated with total WeeFIM®, mobility, self-care, and cognitive subscores at admission and discharge. Correlations with the WeeFIM® ranged from low (cognitive) to strong (mobility). Total PAMS score and all individual items increased significantly between admission and discharge.
Conclusions:
The PAMS is a useful measure capturing incremental and granular functional motor skills changes occurring during inpatient rehabilitation for children with spinal cord-related paralysis.
