Use of the Pediatric Outcomes Data Collection Instrument to Evaluate Functional Outcomes in Arthrogryposis

Author(s): Amor CJ, Spaeth M., Chafey DH, and Gogola GR

Source: J Pediatr Orthop 31(3):293-296, 2011.

Summary:
The pediatric outcomes data collection instrument (PODCI) was developed in collaboration with multiple organizations as a standardized measure of pediatric musculoskeletal conditions.  There are 6 domains: upper extremity function, transfers and mobility, sports participation, pain and comfort, global function, and happiness with physical condition.  Each domain provides a numerical score from 0-100.  The PODCI has been shown to be a reliable valid and sensitive to change.  However, the PODCI has not been applied to children with arthrogryposis.  The question that is to whether or not there is a ceiling or floor affect to PODCI that negates its implantation into children with amyoplasia.
 
This study applied the PODCI to 74 children with amyoplasia or severe arthrogryposis.  Their scores were compared to previously published values for children without musculoskeletal disorders.  The results indicate that the PODCI scores were lower in children with amyoplasia than those with typically developing children in all 6 domains. 
 
The results of this study are not surprising.  The only point is that PODCI can be applied to assess children with amyoplasia.  It does not answer the question as to whether or not the PODCI can detect change in children with amyoplasia that undergo intervention.  The authors do infer that there is a lack of ceiling and floor affect when applied to this particular population.  I do believe the PODCI is valuable tool, but requires substantial time and effort.  In addition, it has been shown to have a ceiling and floor effect on certain patient populations that limit its effectiveness.