Pediatric Outcomes Data Collection Instrument Scores Within Gross Motor Function Classification Scale Levels and Functional Mobility Scale Ratings in Individuals With Cerebral Palsy

Eva Ciccodicola; Adriana Liang; Robert M Kay; Tishya A L Wren

doi:10.1097/BPO.0000000000002684

Pediatric Outcomes Data Collection Instrument Scores Within Gross Motor Function Classification Scale Levels and Functional Mobility Scale Ratings in Individuals With Cerebral Palsy

J Pediatr Orthop. 2024 Apr 9. doi: 10.1097/BPO.0000000000002684. Online ahead of print.

Authors

Eva Ciccodicola¹, Adriana Liang¹, Robert M Kay^{1

2}, Tishya A L Wren^{1

2}

Affiliations

¹ Jackie and Gene Autry Orthopedic Center, Children's Hospital Los Angeles.
² Keck School of Medicine, University of Southern California, Los Angeles, CA.

PMID: 38595088
DOI: 10.1097/BPO.0000000000002684

Abstract

Background and objective: The Pediatric Outcomes Data Collection Instrument (PODCI) is a patient/parent-reported outcome measure used in children with cerebral palsy (CP). PODCI score variability has not been widely examined in patients of Gross Motor Function Classification System (GMFCS) level IV or using the Functional Mobility Scale (FMS). The purpose of this study is to examine the distribution of PODCI scores within patients with CP GMFCS levels I-IV and FMS levels 1-6.

Methods: Retrospectively identified patients with CP whose parent/caregiver had completed the PODCI at their visit were grouped based on GMFCS and FMS level. One-way ANOVA with pairwise Bonferroni-adjusted post hoc tests was performed to compare the effect of GMFCS and FMS levels (1, 2-4, 5, or 6) on PODCI scores.

Results: Three hundred sixty-seven patients were included (128 female, 11.7 years, SD 3.6). Global, Sports, Transfer, and Upper Extremity scores differed among all GMFCS levels (P≤0.056) and were significantly lower for GMFCS IV compared with all other levels. Happiness, Expectations, and Pain scores did not differ significantly among GMFCS levels including level IV (P>0.06). Similar trends were seen at all FMS distances (5, 50, and 500âm). At 50âm, Global, Sports, Transfer, and Upper Extremity scores differed significantly among all FMS levels (P<0.001) except that Upper Extremity Scores were similar between levels 2-4 and level 5 (P=1.00). Happiness and Pain scores were not different between FMS levels (P>0.27). Expectations scores differed only between FMS 1 and FMS 6 with FMS 6 being higher at the 50-m distance only (P=0.03).

Conclusions: Parent-reported outcome measures are important for providing patient-centered care. Providers can examine these measures alongside functional classification systems to create a more complete clinical picture of the patient. Providers should be aware of the score trends seen in our results when evaluating the PODCI for individuals with CP to improve shared decision-making and better monitor their need for future care.

Level of evidence: Level III-retrospective study.