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PubMed1999

The American Paediatric Evaluation of Disability Inventory (PEDI). Applicability of PEDI in Sweden for children aged 2.0-6.9 years.

The American Paediatric Evaluation of Disability Inventory (PEDI) is a new instrument for evaluating functional performance in disabled children aged 6 months to 7.5 years. It was developed to determine a child's functional capacity and performance in three domains, self-care, mobility and social function, as reflected in scores on three scales: (i) functional skills (current capability in specific tasks), (ii) caregiver assistance (i.e. provided to facilitate the child's performance), and (iii) modifications (i.e. environmental or technical modifications needed to facilitate the child's function). The present study was designed to compare results obtained using the PEDI in a Swedish sample with the American normative data, and to analyse the content and relevance of PEDI items for use in Sweden. The PEDI was administered as a questionnaire in structured interview form to the parents of 52 non-disabled Swedish children aged 2.0-6.9 years, divided into ten age groups. Correlation analysis (Pearson's r) showed scores for the Swedish sample to manifest strong correlation with the respective American normative data, both for the functional skills (r = 0.90-0.98) and caregiver assistance (r = 0.93-0.99) scales, respectively. Scores for the modification scale were not compared. Thus, the results suggest the American normative data to be appropriate for reference purposes in Sweden.

Activities of Daily Living↗
PubMed1990

Concurrent and construct validity of the Pediatric Evaluation of Disability Inventory.

The purpose of this study was to determine the validity of the Development Edition (pilot version) of the Pediatric Evaluation of Disability Inventory (PEDI) in groups of disabled and nondisabled children. The PEDI is a new functional assessment instrument for the evaluation of disabled children aged 6 months to 7 years. The PEDI has been developed to identify functional status and change along three dimensions: 1) functional skill level, 2) caregiver assistance, and 3) modifications or adaptive equipment used. The PEDIs were administered as a parental-report questionnaire, and the results were compared with data obtained by the Battelle Developmental Inventory Screening Test (BDIST). The BDIST is a standardized assessment with developmental and adaptive content. Subjects were 20 children between the ages of 2 and 8 years with arthritic conditions and spina bifida and 20 nondisabled children matched for age and sex. All subjects' scores on the BDIST cognitive domain were no greater than 1.50 standard deviations below the mean for their age group. Concurrent validity was supported by moderately high Pearson product-moment correlations between BDIST and PEDI summary scores (r = .70-.80). Construct validity was supported by significant differences between the disabled and nondisabled groups' PEDI scores and by discriminant analysis identifying the PEDI scores as better group discriminators than the BDIST scores. Results validate the Developmental Edition of the PEDI and support the further development and standardization of the final version. Use of the PEDI in clinical pediatric physical therapy practice is discussed.

Adolescent↗
PubMed2005

Responsiveness of evaluative measures for children with cerebral palsy: the Gross Motor Function Measure and the Pediatric Evaluation of Disability Inventory.

PURPOSE: The aim of this study is to describe responsiveness of the Gross Motor Function Measure (GMFM) and the Pediatric Evaluation of Disability Inventory (PEDI) in a group of children with cerebral palsy (CP). METHOD: The subjects were 55 children with cerebral palsy aged 2 to 7 years (mean 4.6 years). We described the responsiveness of the GMFM and PEDI for all children (n = 55), for children younger than 4 years of age (n = 22) and those older or equal to 4 years (n = 33). Two frames of references for determining responsiveness were used: change over time and external criterion. Responsiveness was calculated with help of the Effect Size (ES), Standardised Response Mean (SRM) and Spearman rank order correlations of change on both the PEDI and GMFM, with change in motor functioning according to the parents as external criterion. RESULTS: The PEDI has ES and SRM values higher than 0.8. The GMFM has ES and SRM values higher than 0.5. For all dimensions of the PEDI and for almost all dimensions of the GMFM, the ESs and SRMs of the younger group are higher than those of the older group. The ES and the SRM of the GMFM increase with the complexity of the task. When looking at the correlations of the PEDI and GMFM change scores with the opinion of parents, the results are less unequivocal. CONCLUSIONS: Both the GMFM and the PEDI are responsive for change in motor ability over time in children with CP, the most in children younger than 4 years of age.

Age Factors↗
PubMed2005

Assessing mobility in children using a computer adaptive testing version of the pediatric evaluation of disability inventory.

OBJECTIVE: To assess score agreement, validity, precision, and response burden of a prototype computerized adaptive testing (CAT) version of the Mobility Functional Skills Scale (Mob-CAT) of the Pediatric Evaluation of Disability Inventory (PEDI) as compared with the full 59-item version (Mob-59). DESIGN: Computer simulation analysis of cross-sectional and longitudinal retrospective data; and cross-sectional prospective study. SETTING: Pediatric rehabilitation hospital, including inpatient acute rehabilitation, day school program, outpatient clinics, community-based day care, preschool, and children's homes. PARTICIPANTS: Four hundred sixty-nine children with disabilities and 412 children with no disabilities (analytic sample); 41 children without disabilities and 39 with disabilities (cross-validation sample). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Summary scores from a prototype Mob-CAT application and versions using 15-, 10-, and 5-item stopping rules; scores from the Mob-59; and number of items and time (in seconds) to administer assessments. RESULTS: Mob-CAT scores from both computer simulations (intraclass correlation coefficient [ICC] range, .94-.99) and field administrations (ICC=.98) were in high agreement with scores from the Mob-59. Using computer simulations of retrospective data, discriminant validity, and sensitivity to change of the Mob-CAT closely approximated that of the Mob-59, especially when using the 15- and 10-item stopping rule versions of the Mob-CAT. The Mob-CAT used no more than 15% of the items for any single administration, and required 20% of the time needed to administer the Mob-59. CONCLUSIONS: Comparable score estimates for the PEDI mobility scale can be obtained from CAT administrations, with losses in validity and precision for shorter forms, but with a considerable reduction in administration time.

Adolescent↗
PubMed2002

Functional investigation in children with spina bifida -- measured by the Pediatric Evaluation of Disability Inventory (PEDI).

OBJECT: The purpose of this study was to investigate the functional performance in children with spina bifida, using the Pediatric Evaluation of Disability Inventory (PEDI). A comparison was also made between the functional performance of children with myelomeningocele (MMC) and lipomyelomeningocele (LMC). METHODS AND RESULTS: Twenty-six children with MMC and 37 cases with LMC were enrolled in this study. There was no significant difference in gender, age or method of birth delivery between these two study groups. The normative standard scores of PEDI for children with spina bifida were all below the mean standard scores found in non-disabled children, but still within the average range, with exception of mobility score in the MMC group. Patients' neurological level, walking ability, intelligence, independence in activities of daily living, and bowel function showed significant correlation with the PEDI scores ( P<0.05) in the children with MMC. In comparing these two disease groups, the MMC had higher neurological level, poorer walking ability and poorer bladder and bowel function than did the LMC ( P<.05). The former also had significantly lower PEDI scores in the mobility and social function domains. PEDI provided valuable information regarding overall functional performance in daily life for children with spina bifida. CONCLUSION: This information is extremely important for planning a comprehensive and individualized rehabilitation program.

Activities of Daily Living↗
PubMed2006

Measurement precision and efficiency of multidimensional computer adaptive testing of physical functioning using the pediatric evaluation of disability inventory.

OBJECTIVE: To compare the measurement efficiency and precision of a multidimensional computer adaptive testing (M-CAT) application to a unidimensional CAT (U-CAT) comparison using item bank data from 2 of the functional skills scales of the Pediatric Evaluation of Disability Inventory (PEDI). DESIGN: Using existing PEDI mobility and self-care item banks, we compared the stability of item calibrations and model fit between unidimensional and multidimensional Rasch models and compared the efficiency and precision of the U-CAT- and M-CAT-simulated assessments to a random draw of items. SETTING: Pediatric rehabilitation hospital and clinics. PARTICIPANTS: Clinical and normative samples. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Not applicable. RESULTS: The M-CAT had greater levels of precision and efficiency than the separate mobility and self-care U-CAT versions when using a similar number of items for each PEDI subdomain. Equivalent estimation of mobility and self-care scores can be achieved with a 25% to 40% item reduction with the M-CAT compared with the U-CAT. CONCLUSIONS: M-CAT applications appear to have both precision and efficiency advantages compared with separate U-CAT assessments when content subdomains have a high correlation. Practitioners may also realize interpretive advantages of reporting test score information for each subdomain when separate clinical inferences are desired.

Adolescent↗
PubMed1987

CT digital radiography: alternative technique for airway evaluation in physically disabled patients.

Evaluation of the airway for the presence of granulation tissue prior to removal of a tracheostomy is essential to prevent sudden respiratory decompensation secondary to obstruction. Airway examination in a brain and/or spinal cord injured patient is especially difficult under fluoroscopy. The patient's lack of mobility results in poor visualization of the trachea, secondary to the overlying dense osseous components of the shoulders and thoracic cage. A CT localization view (digital view), which allows manipulation and magnification of the digital data in order to see the hidden airway and detect associated obstructing lesions, is proffered as an alternative technique to high KV, magnification technique. Thirteen examinations were performed satisfactorily in eleven patients examined by this technique with little expenditure of time, physical exertion, and irradiation. The sensitivity, specificity and accuracy of digital airway examination were 100%, 67% and 92% respectively with bronchoscopy used as the standard.

Adolescent↗
PubMed2000

Comparison of the Gross Motor Function Measure and Paediatric Evaluation of Disability Inventory in assessing motor function in children undergoing selective dorsal rhizotomy.

This study was designed to compare assessment with the functional outcome measures Gross Motor Function Measure (GMFM) and Pediatric Evaluation of Disability Inventory (PEDI) over time, in children with cerebral palsy (CP) undergoing selective dorsal rhizotomy combined with individualised physiotherapeutic interventions. Using the Gross Motor Function Classification System (GMFCS), 18 children with spastic diplegia were divided into two groups according to age-related severity of motor function impairment. Data were collected preoperatively, and at 6 and 12 months postoperatively. Both instruments were sensitive to changes in function over time in the series as a whole and in the group with milder impairment, although the PEDI detected significant changes earlier. In the group with more severe impairment, changes in function were detected only with the PEDI, not with the GMFM. Thus, the instruments are to be considered complementary tests, because they measure different aspects of function.

Activities of Daily Living↗
PubMed2005

Applicability of the pediatric evaluation of disability inventory in Slovenia.

In the process of developmental (re)habilitation, determination of the functional abilities of an individual is an important step. For that we need appropriate measurement instruments. Because we do not have such measurement instruments in Slovenia, we chose the Pediatric Evaluation of Disability Inventory (PEDI), translated it, and applied it in daily practice to assess its usefulness and applicability. The purpose of the study was to find out whether the functional abilities of the population of Slovene children evaluated with the Pediatric Evaluation of Disability Inventory is comparable to the American normative data. We also wanted to assess the possible influence of gender, parent education, community size, and the presence of siblings on children's functional abilities. The Pediatric Evaluation of Disability Inventory was administered in the form of a structured interview to the parents of 147 healthy children in three age groups (0.5-1 year, 3-3.5 years, and 5-5.5 years) in different health care centers in Slovenia. Data analysis showed significant differences in functional skills and caregiver assistance scale scores when comparing the Slovene sample with the American normative data, particularly in the youngest age group. Slovene children were found consistently to be different (scoring either higher or lower) from American children at comparable ages in several functional skills and caregiver assistance scales. The analysis also confirmed the importance of gender and the presence of siblings for gaining higher scores on some of the functional skills and caregiver assistance scales. The level of parent education did not prove to have a significant impact on the results. Our results suggest that the American normative data are not completely appropriate for reference purposes in Slovenia. The results are in agreement with the findings of other studies, demonstrating the importance of ascertaining intercultural differences. We believe that adaptation and norming of the Slovene version of the Pediatric Evaluation of Disability Inventory are necessary before using the instrument in clinical practice in our country.

Birth Order↗
PubMed1996

Appreciation of community-based rehabilitation by caregivers of children with a disability.

Evaluations of community-based rehabilitation (CBR) programmes generally focus on quantitative data. To gain insight into the determinants of the outcomes, process-oriented data are needed. From the literature six variables have been identified that possibly correlate with the evaluation of CBR by caregivers of children with a disability. These variables are: (1) traditional beliefs, (2) impact of a child with a disability on the caregiver, (3) community involvement, (4) perceived ability to teach the child, (5) attitude towards various health services, and (6) expectations for the future of a disabled child. The study was done in the CBR projects in Zimbabwe. Seventy-five caregivers were interviewed. Background, perceived abilities to teach and expectations of the caregivers were very different. This study revealed a significant correlation between the appreciation of CBR and the attitude towards various health services, and between the perceived ability to teach and the expectations for the future of the child.

Attitude↗
PubMed2006

Pediatric Evaluation of Disability Inventory: its application to children with obstetric brachial plexus palsy.

PURPOSE: A standardized method of measurement of self-care ability in children with obstetric brachial plexus palsy (OBPP) has not been universally adopted. A study was conducted to determine if the Pediatric Evaluation of Disability Inventory (PEDI) was able to discriminate between the self-care ability of children with OBPP and their peers and distinguish between those with differing severities of OBPP. METHODS: The PEDI self-care domain results for 45 children with OBPP (30 without hand impairment, 15 with hand impairment) were reviewed retrospectively. RESULTS: The group performance of children without hand impairment was within 1 SD above the mean. The group performance of children with hand impairment was more than 2 SDs below the mean. The difference between the 2 groups was statistically significant. CONCLUSIONS: In this study children without hand impairment did not have a self-care activity limitation as measured by the PEDI. A deficit in self-care ability was found in those with hand impairment. The PEDI was able to differentiate between the performances of reported self-care activities of children with differing severities of OBPP; however, it was unable to discriminate between those without hand impairment and their peers. TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic, Level II.

Activities of Daily Living↗
PubMed2005

Correlation of Short Form-36 and disability status with outcomes of arthroscopic acetabular labral debridement.

BACKGROUND: Arthroscopic debridement is the standard of care for the treatment of acetabular labral tears. The Short Form-36 has not been used to measure hip arthroscopy outcomes, and the impact of disability status on hip arthroscopy outcomes has not been reported. HYPOTHESIS: Short Form-36 subscale scores will demonstrate good correlation with the modified Harris hip score, but patients undergoing disability evaluation will have significantly worse outcome scores. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: The records of active-duty soldiers who underwent hip arthroscopy at the authors' institution were retrospectively reviewed. Forty consecutive patients who underwent hip arthroscopy for the primary indication of labral tear formed the basis of the study group. Patients completed the modified Harris hip score, the Short Form-36 general health survey, and a subjective overall satisfaction questionnaire. RESULTS: Thirty-three patients, with a mean age of 34.6 years, were available for follow-up at a mean of 25.7 months postoperatively. Fourteen (43%) patients were undergoing medical evaluation boards (military equivalent of workers' compensation or disability claim). Pearson correlation coefficients for comparing the Short Form-36 Bodily Pain, Physical Function, and Physical Component subscale scores to the modified Harris hip score were 0.73, 0.71, and 0.85, respectively (P < .001). The mean modified Harris hip score was significantly lower in patients on disability status than in those who were not (92.4 vs 61.1; P < .0001). The Short Form-36 subscale scores were significantly lower in disability patients (P < .02). Patient-reported satisfaction rates (70% overall) were 50% for those undergoing disability evaluations and 84% for those who were not (P < .04). There was no significant difference in outcomes based on patient age, surgically proven chondromalacia, or gender for military evaluation board status. CONCLUSION: The Short Form-36 demonstrated good correlation with the modified Harris hip score for measuring outcomes after arthroscopic partial limbectomy. Arthroscopic debridement yielded a high percentage of good results when patients undergoing disability evaluations were excluded. Disability status may be a negative predictor of success after hip arthroscopy.

Acetabulum↗
PubMed2001

Self-care recovery of children with brain injury: descriptive analysis using the Pediatric Evaluation of Disability Inventory (PEDI) functional classification levels.

The purpose of this study was to describe self-care recovery of children and adolescents with acquired brain injury using six newly derived self-care functional classification levels, to examine the responsiveness of the levels, and to compare level changes with scaled score changes. Upon admission and discharge to inpatient rehabilitation, the Pediatric Evaluation of Disability Inventory (PEDI) Functional Skills Self-Care domain was administered by occupational therapy staff to 152 children and adolescents with brain injury (mean age = 9.3 years; SD = +/- 5.2). Scaled scores were converted to self-care classification levels. Using the Wilcoxon matched pairs signed rank test, a difference between admission and discharge level was found for the entire group. Children with traumatic brain injury and stroke demonstrated the most change. When compared with scaled score changes, minimal sensitivity was lost when using classification levels. The PEDI self-care levels provide a responsive analysis of recovery and offer an alternative to the reporting of change scores.

Activities of Daily Living↗
PubMed1998

[Evaluation of disability pensions by a medical polyclinic: 1990-1995].

The question if and in what manner changes of the labour market, in first line increasing unemployment, may influence the composition of the collective demanding a disability pension on one hand and the diagnoses relevant for assessment of requests on the other hand have been investigated as well as possible influences on the criteria for assessments. To this end all expert reports elaborated by the Medical Outpatient Clinic of the University Hospital of Zürich and submitted to the disability insurance between 1990 and 1995 have been evaluated retrospectively. The results show that the fraction of men remained stable around 70% over the whole observation period. The number of persons employed in auxiliary functions remained also constantly high. Over the whole period of observation there was a high, growing percentage of foreign applicants. The most marked change during the observation period was a significant increase of unemployment in the collective. This increase particularly affected applicants with higher ranking jobs or persons over 50. Foreigners became an important part of the unemployed applicants. Rheumatoid disorders and "back pain" in particular were of increasing importance among the relevant diagnoses for assessment of disability. There was a significant decline in the extent of invalidity acknowledged in marked contrast to our initial expectation that the strictness of the applied criteria would weaken when confronted with an increasing number of applications.

Adult↗
PubMed2001

Content and construct validity of a Spanish translation of the Pediatric Evaluation of Disability Inventory for children living in Puerto Rico.

Although Puerto Rican children with disabilities are at high risk for poor developmental outcomes, no standardized measures are validated for use with these children. In this study, we evaluated the content and construct validity of a Spanish translation of the Pediatric Evaluation of Disability Inventory (PEDI) for use with children living in Puerto Rico. Methods included expert content review, surveys of parents, and the evaluation of 44 children with and without disabilities, who were matched for socio-economic status, age, and gender. The results demonstrated that the translated version of the PEDI is valid; yet additional research is warranted to identify socio-cultural influences on the performance and capability of typically developing Puerto Rican children.

Child↗