Self-reported functional ambulation is related to physical mobility status in polio survivors; a cross-sectional observational study

Background: The condensed 3-level version of the self-reported ambulation classification by Perry is a validated, simple-to-use instrument in clinical practice to classify functional ambulation. Objective: To further validate the clinical meaning of the classification for polio survivors, we compared physical mobility status across 3 functional ambulation categories and investigated the relation between physical mobility and functional ambulation category. Methods: We investigated a convenience sample of 140 individuals with polio [mean (SD) age 59.4 (12.1) years; 74 men] who were able to walk at least indoors. For indicators of physical mobility status, we assessed the walked distance (m) and walking energy cost (Jkg ⁻¹m ⁻¹) during a 6-min walk test at a comfortable speed. Furthermore, self-reported physical functioning and fatigue were assessed with the 36-item Short Form Health Survey physical functioning scale (SF36-PF) and Fatigue Severity Scale (FSS), respectively. Self-reported functional ambulation was classified as household walker, limited community walker or full community walker. Results: The mean (SD) walked distance, energy cost, and SF36-PF and FSS scores significantly differed between household walkers (n = 48) and limited community walkers (n = 63) [275 (67) m; 6.35 (1.80) Jkg ⁻¹m ⁻¹; 27.7 (13.5), 5.53 (1.06), respectively, and 323 (73) m; 5.49 (1.50) Jkg ⁻¹m ⁻¹; 40.1 (15.1); 4.81 (1.38) (P < 0.018)] and full community walkers (n = 29) [383 (66) m; 4.68 (0.85) Jkg ⁻¹m ⁻¹; 63.9 (18.5), 3.85 (1.54) (P < 0.001)], with significant differences also present between limited and full community walkers (P < 0.05). Walked distance and SF36-PF score were significantly associated with functional ambulation level, determining 46% of the variance in ambulation level. Conclusion: The simple, self-reported classification of functional ambulation in 3 levels is clinically meaningful for polio survivors because it consistently corresponds to differences in objective and self-reported indicators of physical mobility and, as such, can be used to better manage rehabilitation treatment.