Use of the AM-PAC 6 Clicks Basic Mobility Short Forms as a Measure of Functional Change in the Pediatric Heart Failure Population.

Objectives: To evaluate the responsiveness of the 6 Clicks Basic Mobility Short Form (BMSF) and Basic Mobility Short Form - Low Function (BMSF-LF) in children with heart failure (HF) and to assess the correlations of the BMSF with the 6-Minute Walk Test (6MWT) and the 60-Second Sit-to-Stand (60sSTS) test. Design: Retrospective cohort study. Setting: Inpatient acute cardiac center in a large, urban children's hospital. Participants: Sixty-six participants (N=66) between 1 and 21 years of age with a diagnosis of pediatric HF and at least 2 documented BMSF and/or BMSF-LF in the electronic medical record. Chart reviews were completed for each participant to determine if change was a result of functional improvement or a change in medical status resulting in functional decline. Data for the 60sSTS and 6MWT were included if completed within 48 hours of a documented BMSF. Thirty participants completed a 60sSTS and 21 participants completed a 6MWT. Interventions: Not applicable. Main Outcome Measures: BMSF, BMSF-LF, 6MWT, and 60sSTS. Results: Large effect sizes as measured by standardized response mean (SRM) were found for both the BMSF (SRM=0.96) and BMSF-LF (SRM=1.07) for functional improvement as well as for functional decline with the BMSF (SRM=-1.35) and BMSF-LF (SRM=-1.34). There was a significant, moderate positive correlation between the BMSF and the 6MWT distance (ρ=0.47, Conclusions: The 6 Clicks BMSF and BMSF-LF demonstrate excellent responsiveness to both functional improvement and functional decline in pediatric patients with HF. The moderate correlation between the BMSF and the 6MWT suggests a positive association between performance-based endurance testing and functional status.