ABSTRACT

Objectives: To investigate the performance of the Physical Abilities and Mobility Scale (PAMS) in children receiving inpatient rehabilitation for paralysis related to spinal cord disease and injury (SCD/SCI).

Methods: Participants were 146 children with paralysis related to SCD/SCI, aged 2–21, admitted between January 2010 and 2017 for inpatient rehabilitation at a single free-standing academically affiliated pediatric rehabilitation hospital. Retrospective chart review was performed to obtain admission and discharge scores on the PAMS and the functional independence measure for children (WeeFIM®), collected as part of clinical care. Internal consistency was evaluated using Cronbach's alpha. Inter-rater reliability was evaluated through overall agreement, Pearson correlations, and intraclass correlations. Construct validity was examined through exploratory factor analysis. Criterion validity was explored through correlations of PAMS overall and item scores with WeeFIM® total and subscale scores. Sensitivity to change was tested using paired t-tests examining differences between admission and discharge scores for each item and for the total score on the PAMS.

Results: Internal consistency and inter-rater reliability were high (0.94 at admission and 0.95 at discharge). Total PAMS scores are highly correlated with total WeeFIM®, mobility, self-care, and cognitive subscores at admission and discharge. Correlations with the WeeFIM® ranged from low (cognitive) to strong (mobility). Total PAMS score and all individual items increased significantly between admission and discharge.

Conclusions: The PAMS is a useful measure capturing incremental and granular functional motor skills changes occurring during inpatient rehabilitation for children with spinal cord-related paralysis.

摘要

目的：调查因脊髓疾病和损伤 (SCD/SCI) 相关瘫痪而接受住院康复的儿童的身体能力和活动能力量表 (PAMS) 的表现。

方法：参与者是 146 名患有 SCD/SCI 相关瘫痪的儿童，年龄在 2-21 岁之间，于 2010 年 1 月至 2017 年期间在一家独立的学术附属儿科康复医院接受住院康复治疗。进行了回顾性图表审查，以获得 PAMS 的入院和出院分数以及儿童功能独立性测量 (WeeFIM®)，作为临床护理的一部分收集。使用 Cronbach 的 alpha 评估内部一致性。通过总体一致性、Pearson 相关性和组内相关性评估评分者间的可靠性。通过探索性因素分析检查结构有效性。通过 PAMS 总体和项目分数与 WeeFIM® 总分和子量表分数的相关性来探索标准有效性。

结果：内部一致性和评分者间信度很高（入院时为 0.94，出院时为 0.95）。PAMS 总分与入院和出院时的 WeeFIM® 总分、活动能力、自我护理和认知分项高度相关。与 WeeFIM® 的相关性从低（认知）到强（流动性）不等。PAMS 总分和所有单项在入院和出院之间显着增加。

结论：PAMS 是一种有用的测量方法，可以捕捉脊髓相关麻痹儿童在住院康复过程中发生的增量和细粒度的功能性运动技能变化。