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Orthopedic Outcomes Measures for NF

Orthopedic Outcomes Measures for NF. Betty Schorry , M.D. Cincinnati Children’s Hospital. PODCI. Pediatric Outcomes Data Collection Instrument Developed by POSNA (Pediatric orthopaedic society of North America) in 1994

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Orthopedic Outcomes Measures for NF

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  1. Orthopedic Outcomes Measures for NF Betty Schorry, M.D. Cincinnati Children’s Hospital

  2. PODCI • Pediatric Outcomes Data Collection Instrument • Developed by POSNA (Pediatric orthopaedic society of North America) in 1994 • Measure of functional health in children and adolescents with musculoskeletal conditions • Validated on group of 530 pediatric patients and parents • All scales with good – exc. internal reliability (>0.80) • Good-exc. test-retest reliability • Published extensively

  3. PODCI – cont. • Pediatric questionnaire (ages 2-10 years) • Adolescent (self-reported) questionnaire (ages 11-18) • Parent-reported Adolescent questionnaire • Total of 83 – 86 questions • 4 or 5 point Likert scale • Takes 15-20 min. to complete

  4. Scales of PODCI • 1. Upper extremity physical function • 2. Transfer and basic mobility scale • 3. Sports and physical functioning scale • 4. Pain/ comfort scale • 5. Happiness core scale • 6. Global functioning scale • Higher score indicates higher functioning.

  5. Advantages of PODCI • Extensive questionnaire • Valuable for studies where primary assessment involves musculoskeletal system • Tibial dysplasia; scoliosis; paraspinal tumors; motor coordination • DISADVANTAGES of PODCI • Length of questionnaire • Not available for adults

  6. Functional Orthopaedic Measures for NF Studies • Clinical Gait Analysis • Used in some rehabilitation programs; athletes • Uses computerized system with multiple cameras • Marks are placed on different joints • Can calculate kinematic data • Beginning to be used in research

  7. Gait analysis set-up

  8. Data available • Kinematics – 3-dimensional movement of joints • Kinetics - study of forces involved in walking • Can add dynamic EMG data • One study of gait analysis in 12 children with repaired tibial pseudarthrosis (1998) • Could have potential future use in clinical trials of musculoskeletal complications of NF.

  9. Timed 25 Foot Walk (T25FW) • Time taken to walk 25 feet • Represented as time (sec) or velocity (feet/sec) • No learning effect • Used in studies of multiple sclerosis, spinal cord injury, Friedrich’s ataxia

  10. Timed 25 Foot Walk (T25FW) • Endpoints • 20% increase/decrease as clinically significant change • % of subjects with faster walking speed during intervention over baseline

  11. Walking (from approval of ampyra) • Inclusion criteria included the ability to walk 25 feet in 8–45 seconds • The primary measure of efficacy in both trials was walking speed (in feet per second) as measured by the Timed 25-foot Walk (T25W), using a responder analysis. • A responder was defined as a patient who showed faster walking speed for a least three visits out of a possible four during the double-blind period than the maximum value achieved in the five non-double-blind no treatment visits (four before the double-blind period and one after).

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