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OVERVIEW

The Functional Mobility Assessment (FMA) is a simple and validated consumer-centered questionnaire developed by clinical investigators at the University of Pittsburgh (Pitt).  It measures a person’s satisfaction in performing common Mobility Related Activities of Daily Living (MRADLs).  It has been well accepted by providers in the field as it has 10 items and typically takes less than 5 minutes to administer.  The tool is ideal to serve as an outcome measure given scores can be compared pre and post provision of a properly fitted mobility device or intervention (i.e. walking aids, prosthetics, and wheelchairs).  The tool can also be used to follow people over time. It is a derivative of the Functioning Everyday with a Wheelchair (FEW) questionnaire as well as FEW-Capacity and FEW-Performance observational tools.

The FMA is appropriate for people who can accurately self-report however a family-centered version (FMA-FC) has also been designed and validated for parents and/or caregivers of children or adults with disabilities who cannot accurately self-report.  There are also validated Spanish translations of the FMA and FMA-FC.

 

GOAL OF THE PROJECT

U.S. Rehab, a division of The VGM Group and Pitt have collaborated to collect large-scale FMA data from their network of accredited Equipment Suppliers into an FMA Registry.  Combined with a de-identified minimum/uniform dataset (M/UDS), large datasets can be systematically analyzed to demonstrate more scientifically which types of mobility devices and service delivery models work best for given populations based on diagnosis, functional status, and environmental factors.  Ultimately, it is expected that large data analyses will confirm that provision of properly fitted mobility equipment does improve function and comfort, reduces hospitalizations and secondary medical complications (i.e. falls and pressure sores), and promotes participation. Publication of these findings in the scientific literature will increase the body of knowledge, foster evidence-based practice, and ultimately influence more equitable coverage policies by third party payers.

 

METHODOLOGY

As part of routine business practices U.S. Rehab suppliers will collaborate with clinicians to administer the FMA to people at the time of initial evaluation for a new mobility intervention.  The supplier will also gather the M/UDS data.  No less than 21 days following delivery of a new mobility device, a trained U.S. Rehab representative will contact the person by telephone to re-administer the FMA and M/UDS.  The person will receive follow-ups at 21 days post-delivery of new equipment, 90 days, 180 days, 365 days and annually thereafter.  Data will be entered and stored in the existing secured Homelink database housed at VGM Headquarters.  Through a vetted data sharing agreement, VGM will send batches of de-identified data to Pitt investigators for analyses.  At no point will Pitt be able to trace data back to identify a specific individual by name or other Protected Health Information (PHI).  This project is modeled in a similar manner to the Functional Independence Measure (FIM) UDS used throughout the field of rehabilitation.  

 

BENEFIT

The benefit to all stakeholders is an improved body of evidence to the benefits of properly prescribed mobility interventions.  The benefit to clinicians is a more quantifiable means of measuring patient-centered function and outcomes.  The project also supports a means of routine follow-up to identify any issues and take preventative measures.  The benefit to organizations is a systematic means of measuring program effectiveness as well as to satisfy Quality Assurance requirements of accreditation bodies such as CARF or the Joint Commission.  The benefit to researchers is a multi-site collaborative Registry that can be mined to answer research questions as well as an opportunity to seek extracurricular funding to do so.  The benefit to payers is better assurance of properly provided and cost-effective interventions. 

 

CONTACT

Please contact VGM / US Rehab at https://fma.usrehab.com/ for more information on how to participate in the FMA Outcomes project.  

 

 

PUBLICATIONS

Paulisso, D.C., Cruz, D.M.C., Allegretti, A.L.C., Schein, R.M., Costa, J.D., Campos, L.C.B., & Schmeler, M.R. (2020). Cross-cultural adaption and face validity of the Functional Mobility Assessment into Brazilian Portuguese. Occupational Therapy International, Volume 2020, Article ID 8150718. doi.org/10.1155/2020/8150718

Paulisso, D.C., Schmeler, M.R., Schein, R.M., Allegretti, A.L.C., Campos, L.C.B., Costa, J.D. Fachin-Martins, E., & Cruz, D.M.C.D. (2019). Functional Mobility Assessment is Reliable and Correlated with Satisfaction, Independence and Skills. Assistive Technology. Published online 2019 Jun 17. DOI: 10.1080/10400435.2019.1629125 

Faieta, J., Schmeler, M.R., Schiappa, V.J., Hand, B.N., Schein, R.M., Saptono, A., Berner, T., & DiGiovine, C. (2019). Evaluation of Service Delivery Effectiveness through Patient Reported Outcome Measures. American Journal of Physical Medicine and Rehabilitation. June 13, 2019 - Volume Ahead of Print - Issue - p ; DOI: 10.1097/PHM.0000000000001245 

Schmeler, M.R., Schein, R.M., Saptono, A., & Schiappa, V.J. (2019). Development and Implementation of a Wheelchair Outcomes Registry. Archives of Physical Medicine and Rehabilitation, 100(9), 1779-1781. DOI: 10.1016/j.apmr.2019.03.007  

U.S. Rehab Discusses Outcomes in VGM Podcast. Episode 28: Why Outcomes Matter in CRT (2019, May 6). Host Brian Thompson is joined by President of U.S. Rehab, Greg Packer, and Dr. Mark Schmeler, Associate Professor, Department of Rehabilitation Science and Technology at the University of Pittsburgh. The three of them discuss U.S. Rehab's Functional Mobility Assessment (FMA) and the importance of outcomes in the CRT industry. Click here to listen to Episode 28:Why Outcomes Matter in CRT

Turzy, R. (2018, September 7). New Functional Mobility Assessment (FMA) Data Shows Increase in Positive Outcomes [Blog Post]. Retrieved from http://blog.usrehab.com/new-functional-mobility-assessment-fma-data-shows-increase-in-positive-outcomes/

Baker, D. (2018, August). FMA: Confirming Validity Outcomes Measures for CRT. Directions, 40-44. http://mydigitalpublication.com/publication/?i=513464#{%22issue_id%22:513464,%22page%22:0}

CRT Trends: BIG Data, Quality Assurance & The FMA: Secondary Health Conditions & Environments. August 1, 2018. Mobility Management. https://mobilitymgmt.com/Articles/2018/08/01/Secondary-Health-Conditions.aspx?Page=1

CRT Trends: BIG Data, Quality Assurance & The FMA: What Clients Say About CRT. July 1, 2018. Mobility Management. https://mobilitymgmt.com/articles/2018/07/01/quality-assurance.aspx

CRT Trends: BIG Data, Quality Assurance and the Functional Mobility Assessment. June 1, 2018. Mobility Management. https://mobilitymgmt.com/Articles/2018/06/01/Quality-Assurance.aspx?Page=1

U.S. Rehab and University of Pittsburgh Partner on Outcome Measures Study. March 1, 2018. Mobility Management. https://mobilitymgmt.com/Articles/2018/03/01/Outcome-Measures.aspx

Arredondo, J. M. (2018). Cross-Cultural Adaptation of the Functional Mobility Assessment (FMA) and Functional Mobility Assessment – Family Centered (FMA-FC) to Latin American Spanish. Master’s Thesis, University of Pittsburgh. URI: http://d-scholarship.pitt.edu/34242/ 

Beavers, D.B., Holm, M.B., Rogers, J.C., Plummer, T., & Schmeler, M.R. (2018). Adaptation of the adult Functional Mobility Assessment (FMA) into a FMA‐Family Centered (FMA‐FC) paediatric version. Child Care Health Dev, 1‐6. PMID: 29761533    DOI: 10.1111/cch.12571

Carver, J., Ganus, A., Ivey, J.M., Plummer, T. & Eubank, E. (2016) The impact of mobility assistive technology devices on participation for individuals with disabilities. Disability and Rehabilitation: Assistive Technology, 11(6), 468-477. PMID: 25815679    DOI: 10.3109/17483107.2015.1027295

Beavers, D.B. (2016). Development of the Functional Mobility Assessment-Family Centered Version. Doctoral Dissertation, University of Pittsburgh. URI: http://d-scholarship.pitt.edu/id/eprint/27680

Kumar, A., Schmeler, M.R., Karmarkar, A.M., Collins, D.M., Cooper, R., Cooper, R.A., & Holm, M.B. (2013). Test-retest reliability of the functional mobility assessment (FMA): a pilot study. Disability and Rehabilitation Assistive Technology. 8(3), 213-219. PMID: 22612721    DOI: 10.3109/17483107.2012.688240

Schein, R.M., Schmeler, M.R., Holm, M.B., Pramuka, M., Saptono, A., & Brienza, D.M. (2011). Telerehabilitation assessment using the Functioning Everyday with a Wheelchair-Capacity instrument. Journal of Rehabilitation Research and Development, 48(2), 115-124. PMID: 21480086. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21480086. Accessed May 22, 2018.

Schein, R.M., Schmeler, M.R., Holm, M.B., Saptono, A., Brienza, D.M. (2010) Telerehabilitation wheeled mobility and seating assessments compared with in person. Archives of Physical Medicine and Rehabilitation, 2010(91), 874-878. PMID: 20510977    DOI: 10.1016/j.apmr.2010.01.017

Mortenson, W.M. & Auger, C. (2008). Issues for the selection of wheelchair-specific activity and participation outcome measures: A review. Archives of Physical Medicine and Rehabilitation, 89, 1177-1186.  PMID: 18503817    PMCID: PMC4085084    DOI: 10.1016/j.apmr.2008.01.010

Mills, T., Holm, M. B., & Schmeler, M. (2007). Test-Retest Reliability and Cross Validation of the Functioning Everyday with a Wheelchair Instrument. Assistive Technology. 19(2), 61-77. PMID: 17727074    DOI: 10.1080/10400435.2007.10131866

Schmeler, M. R., Holm, M., & Mills, T. L. (2006). Wheelchairs functional outcome measures and functioning everyday with wheelchair. Canadian Seating and Mobility Conference. Retrieved from http://www.csmc.ca/docs/archives/2006_archive/ws/w13.pdf. Accessed Feb 13, 2017.

Schmeler, M.R. (2005). Development and testing of a clinical outcome measurement tool to assess wheeled mobility and seating interventions. Doctoral Dissertation, University of Pittsburgh. URI: http://d-scholarship.pitt.edu/id/eprint/9562

Mills, T., Holm, M. B., Schmeler, M., Trefler, E., Fitzgerald, S., Boninger, M., & Shapcott, N. (2002). The Functional Evaluation in a Wheelchair (FEW) instrument: Test-retest reliability and cross-validation with consumer goals. In RESNA 2002 Annual Conference Proceedings (327-329). Minneapolis, MN: RESNA Press.

Mills, T., Holm, M. B., Trefler, E., Schmeler, M., Fitzgerald, S., & Boninger, M. (2002). Development and consumer validation of the Functional Evaluation in a Wheelchair Instrument (FEW). Disability and Rehabilitation Assistive Technology. 24, 38-46. PMID: 11827153. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/11827153. Accessed May 22, 2018.