The Functional mobility scale (FMS)
Department of Orthopaedics, Royal Children's Hospital, Victoria, Australia. Journal of Pediatric Orthopaedics
(Impact Factor: 1.47).
09/2004; 24(5):514-20. DOI: 10.1097/00004694-200409000-00011
We devised a new Functional Mobility Scale (FMS) to describe functional mobility in children with cerebral palsy, as an aid to communication between orthopaedic surgeons and health professionals. The unique feature of the FMS is the freedom to score functional mobility over three distinct distances, chosen to represent mobility in the home, at school and in the wider community. We examined the construct, content, and concurrent validity of the FMS in a cohort of 310 children with cerebral palsy by comparing the FMS to existing scales and to instrumented measures of physical function. We demonstrated the scale to be both valid and reliable in a consecutive population sample of 310 children with cerebral palsy seen in our tertiary referral center. The FMS was useful for discriminating between large groups of children with varying levels of disabilities and functional mobility and sensitive to detect change after operative intervention.
Available from: Vincent Pomero
- "A retrospective search was conducted of the laboratory database from 2006 and 2013. The following inclusion–exclusion criteria were used: (1) the individuals had a clinical diagnosis of CP; (2) the individuals were able to walk without assistive devices; (3) the age of the individual was between 3 and 30 years on the date of the examination; (4) the individuals had completed a clinical examination and a CGA on the same date; and (5) the individuals had no surgery 1 year before the CGA and no pharmacological treatment 6 months before the CGA (Graham et al. 2004). "
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ABSTRACT: The aim of this study was to evaluate whether clinical parameters are sufficient using, a multilinear regression model, to reproduce the sagittal plane joint angles (hip, knee, and ankle) in cerebral palsy gait. A total of 154 patients were included. The two legs were considered (308 observations). Thirty-six clinical parameters were used as regressors (range of motion, muscle strength, and spasticity of the lower). From the clinical gait analysis, the joint angles of the sagittal plane were selected. Results showed that clinical parameter does not provide sufficient information to recover joint angles and/or that the multilinear regression model is not an appropriate solution.
Available from: PubMed Central
- "According to the gross motor function classification system (GMFCS) (Palisano et al. 1997), 2 children were at level I, 23 were at level II, and 9 were at level III preoperatively. Gait function was evaluated with the functional mobility scale (FMS), rating walking ability at 3 specific distances: 5, 50, and 500 m (Graham et al. 2004). A rating of 6 means that the child walks independently on all surfaces, and 5 means walking without support on level surfaces. "
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ABSTRACT: Background and purpose — Instrumented 3-D gait analyses (GA) in children with cerebral palsy (CP) have shown improved gait function 1 year postoperatively. Using GA, we assessed the outcome after 5 years and evaluated parental satisfaction with the surgery and the need for additional surgery.
Patients and methods — 34 ambulatory children with spastic diplegia had preoperative GA. Based on this GA, the children underwent 195 orthopedic procedures on their lower limbs at a mean age of 11.6 (6–19) years. On average, 5.7 (1–11) procedures per child were performed. Outcome measures were evaluation of gait quality using the gait profile score (GPS) and selected kinematic parameters, functional level using the functional mobility scale (FMS), and the degree of parental satisfaction.
Results — The mean GPS improved from 20.7° (95% CI: 19–23) preoperatively to 15.4° (95% CI: 14–17) 5 years postoperatively. There was no significant change in GPS between 1 and 5 years. The individual kinematic parameters at the ankle, knee, and hip improved statistically significantly, as did gait function (FMS). The mean parental satisfaction, on a scale from 0 to 10, was 7.7 (2–10) points. There was a need for additional surgical procedures in 14 children; this was more frequent in those who had the index operation at an early age.
Interpretation — The main finding was that orthopedic surgery based on preoperative GA gave marked improvements in gait function and quality, which were stable over a 5-year period. Nevertheless, additional orthopedic procedures were necessary in almost half of the children and further follow-up with GA for more than 1 year postoperatively is recommended in children with risk factors for such surgery.
Available from: Andrea Superti-Furga
- "The pain score ranged from a minimum of " 0 " to a maximum of " 10 " corresponding to " no pain " and " the worst pain he had ever had in his entire life " , respectively. The patient was also assessed with functional mobility scale (FMS) before and after the end of six months of treatment [Graham et al., 2004]. "
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ABSTRACT: Camurati–Engelmann disease is characterized by hyperostosis of the long bones and the skull, muscle atrophy, severe limb pain, and progressive joint contractures in some patients. It is caused by heterozygous mutations in the transforming growth factor β1 (TGFβ1) believed to result in improper folding of the latency-associated peptide domain of TGFβ1 and thus in increased or deregulated bioactivity. Losartan, an angiotensin II type 1 receptor antagonist, has been found to downregulate the expression of TGFβ type 1 and 2 receptors. Clinical trials with losartan have shown a benefit in Marfan syndrome, while trials are underway for Duchenne muscular dystrophy and other myopathies associated with TGFβ1 signaling. We hypothesized that due to its anti-TGFβ1 activity, losartan might be beneficial in Camurati–Engelmann disease. This report concerns a boy who presented at age 13 years with severe limb pain and difficulty in walking. Clinical and radiographic evaluation results were compatible with Camurati–Engelmann disease and the diagnosis was confirmed by mutation analysis (c.652C > T [p.Arg218Cys]). The boy underwent an experimental treatment with losartan at a dosage of 50 mg/day, orally. During the treatment period of 18 months, the intensity and frequency of limb pain decreased significantly (as shown by a pain diary), and muscle strength improved, allowing the boy to resume walking and climbing stairs. No obvious side effects were observed. We cautiously conclude that TGFβ1 inhibition with losartan deserves further evaluation in the clinical management of Camurati–Engelmann disease. © 2014 Wiley Periodicals, Inc.
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