Objective: To develop a clinical tool to quantify stair descent performance in children with moderate to severe intellectual disability.
Design: Item identification, measurement construction, and basic testing of reliability.
Setting: School for children with intellectual disability.
Participants: A sample of convenience; 18 children (age range, 5-9 yr) with moderate to severe intellectual disability, but who were ambulatory.
Intervention: The Montreal Rehabilitation Performance Profile (MRPP) measurement tool, which has 4 perceptual-motor elements: movement form, time requirement, proprioceptive cues, and external cues.
Main outcome measure: Identification of perceptual-motor elements that underlie skilled stair descent and that are directly quantified from standard video recording.
Results: Interrater reliability measured by percentage agreement (kappa statistic) was high for 3 elements (80%-100%; kappa =.63) and good for the fourth (67%; kappa =.52). The 4 MRPP elements are plotted on cartesian axes to yield (1) the magnitude of the contribution of each independent element to total performance outcome, and (2) a global measurement of level of functional skill, the Performance Composite Score (PCS).
Conclusions: The MRPP, and associated PCS, provide a valid measure of functional stair descent skill that does not rely on cognitive understanding of the process. This tool could be adapted to measure functional capacity in other clinical populations, including geriatric clients.