Orthopedic Outcomes Measures
for NF
Betty Schorry, M.D.
Cincinnati Children’s Hospital
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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
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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
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Scales of PODCI
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Upper extremity physical function
Transfer and basic mobility scale
Sports and physical functioning scale
Pain/ comfort scale
Happiness core scale
Global functioning scale
– Higher score indicates higher functioning.
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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
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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
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Gait analysis set-up
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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.
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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
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Timed 25 Foot Walk (T25FW)
• Endpoints
– 20% increase/decrease as clinically significant
change
– % of subjects with faster walking speed during
intervention over baseline
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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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