Assessing the Ability of the Hoffer Scale of Functional Ambulation to Indicate Mobility Scores on the Pediatric Evaluation of Disability Inventory Pubblico

Abstract

Background: The interest in research in adult spina bifida and the quality of life for people living with spina bifida across the entire lifespan is growing. As the interest in this field grows, research that focuses on enhancing quality of life for people with spina bifida needs to increase as well. The aim of this study was to assess the ability of the Hoffer Scale of Functional Ambulation to identify participants who score 40 or more points on the PEDI mobility assessment.

Methods: This study was conducted using a population of 103 children between 3 years old and 6 years old that was obtained from spina bifida multidisciplinary clinics located in Arizona and Utah. The Hoffer Scale of Functional Ambulation's ability to act as a proxy for the PEDI was tested using PEDI FS normative scores and CA normative scores. Agreement was tested between the Hoffer categories and PEDI normative scores; Pearson's correlation coefficient used to assess the relationship between PEDI normative scores. Sensitivity analyses were conducted to assess which combination of Hoffer categories was best able to identify normative scores greater than or equal to 40. ROC curves were constructed using normative scores greater than or equal to 40 as the outcome and the area under the curve was used to assess the discriminative ability of the model.

Results: Of the 103 participants, 18 were excluded based on missing information in the PEDI mobility assessment. 12 patients had FS normative scores greater than or equal to 40 and 22 patients were found to have CA normative scores greater than or equal to 40. Kendall's Tau-b correlation between the Hoffer categories and PEDI FA normative scores was found to be 0.57 and 0.51 for CA normative scores. Pearson's correlation coefficient between PEDI normative scores was r = 0.67. The model comparing complete and community ambulators to all others was best able to identify scores greater than or equal to 40. Area under the curve was approximately 0.91 for PEDI FS normative scores and 0.92 for CA normative scores.

Conclusion: The Hoffer Scale of Functional Ambulation can best identify PEDI normative scores greater than or equal to 40 when participant was categorized as a complete or community ambulator. Further research should be conducted with a more representative population and using a variety of assessments.

Table of Contents

1. Background - 1

2. Methods - 9

3. Results - 13

4. Discussion - 16

5. References - 21

6. Tables - 25

7. Figures - 26

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, General
Parola chiave	spina bifida mobility functional ambulation early intervention PEDI
Committee Chair / Thesis Advisor	Janssens, A Cecile, Emory University
Committee Members	Judy, Thibadeau, CDC Ong, Katherine, CDC
Partnering Agencies	Emory University schools, faculty or affiliated programs Hospital or other health care provider CDC

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