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Functional Mobility Scale
Availability
Please visit this website for more information about the instrument: Functional Mobility Scale.
Classification
Supplemental: Cerebral Palsy (CP)
Short Description of Instrument
The Functional Mobility Scale (FMS) has been constructed to classify functional mobility in children, taking into account the range of assistive devices a child might use. The scale can be used to classify children’s functional mobility, document change over time in the same child and to document change seen following interventions.
 
The FMS rates walking ability at three specific distances, 5, 50 and 500 metres, (or 5, 50, 500 yards). This represents the child’s mobility in the home, at school and in the community setting. It therefore accounts for different assistive devices used by the same child in different environments.
Assessment is by the clinician on the basis of questions asked of the child/parent (not direct observation). The walking ability of the child is rated at each of the three distances according to the need for assistive devices such as crutches, walkers or wheelchair. Orthotics which are regularly used should be included for the rating.
 
The FMS is a performance measure. It is important to rate what the child actually does at this point in time, not what they can do or used to be able to do.
Comments/Special Instructions
Administration time: 3 minutes
Equipment: none
Examiner training: none
Scoring
A score of 1–6 is determined for walking ability at each of the three specific distances (5, 50 and 500 metres) representing mobility in the home, at school, and in the community. 1=Uses wheelchair, 2=Uses a walker of frame, 3=Uses crutches, 4=Uses sticks (one or two), 5=Independent on level surfaces, 6=Independent on all surfaces.
 
To obtain answers that reflect performance, the manner in which the questions are asked of the child/parent is important. The recommended questions are:
  1. How does your child move around for short distances in the house? (5m)
  2. How does your child move around in and between classes at school? (50m)
  3. How does your child move around for long distances such as at the shopping centre? (500m)
The distances are a guide. It is the environment that is most relevant.
Rationale/Justification
Strengths/Weaknesses: Can be performed quickly in a clinical setting without special equipment. Requires conversation with parent or other person who is able to speak about the child’s mobility in all environments. Designed for children with CP at all levels of the GMFCS.
 
Reliability: Quadratic weighted kappa coefficients for mobility ratings varied from 0.86 to 0.92 for the three distances, indicating substantial chance corrected agreement among various clinician raters. Levels of agreement were similar when administering the scale in person and by telephone, suggesting that the FMS can be administered by either method. (Harvey et al, 2010.)
References
Graham HK, Harvey A, Rodda J, Nattrass GR, Pirpiris M. The Functional Mobility Scale (FMS). J Pediatr Orthop. 2004;24(5):514–520.
 
Additonal references:
 
Harvey AR, Morris ME, Graham HK, Wolfe R, Baker R. Reliability of the functional mobility scale for children with cerebral palsy. Phys Occup Ther Pediatr. 2010;30(2):139–149.
 
Himuro N, Abe H, Nishibu H, Seino T, Mori M. Easy-to-use clinical measures of  walking ability in children and adolescents with cerebral palsy: a systematic review. Disabil Rehabil. 2016; 23:1–12.
 
Palisano RJ, Tieman BL, Walter SD, Bartlett DJ, Rosenbaum PL, Russell D, Hanna SE. Effect of environmental setting on mobility methods of children with cerebral palsy. Dev Med Child Neurol. 2003;45(2):113–120.
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