Development and performance of PROWalk: a functional mobility person-reported outcome measure based on the PROMIS^®...

Functional mobility, or the capacity to move safely and independently, can be evaluated using performance-based physiological tests, observational assessments, or self-report tools. This study sought to develop the PROWalk™, a PROMIS-based patient-reported outcome measure of perceived gait and balance challenges, and evaluated its performance relative to the Patient-Specific Functional Scale (PSFS) in individuals with sensory peripheral neuropathy.

PROWalk was developed with expert clinician input using selected items from the PROMIS item bank. It was administered via telehealth to participants with lower-extremity peripheral neuropathy (N = 51; age 76 ± 4 years; 4 female) who were prescribed a wearable sensory prosthesis, alongside the PSFS, at baseline and again after 6 weeks.

Both measures displayed significant increases (i.e., improvements) over time with large effect sizes (PROWalk: rrb = -0.878; PSFS: rrb = -0.993), strong temporal correlations (PROWalk: rho = 0.684; PSFS: rho = 0.458), and upward linear trends for each instrument between baseline and 6 weeks. When normalized, the measures showed no bias, large limits of agreement, and moderate convergent validity (rho = 0.582, p < 0.001).

Compared with broader PROMIS Physical Function short forms, PROWalk targets mobility-specific activities relevant to gait and balance. It demonstrated significant improvements in perceived functional mobility over time and strong temporal stability, supporting its use for standardized group-level comparisons. PROWalk appears to be a valid, telehealth-compatible measure for capturing self-reported functional mobility in individuals with sensory neuropathy and may address limitations of more individualized assessment tools.