Loading…

Protocol - Physical Mobility - Adult

Add to My Toolkit
Description

Patient-Reported Outcomes Measurement Information System® (PROMIS®) Item Bank v2.1 Mobility is a 44-item self-administered questionnaire, with items prompting on a scale from 1-5 how well an individual can perform a specified task. This protocol was validated in individuals aged 18 years and older.

Specific Instructions
The PhenX Working Group recommends this PROMIS® protocol. For additional information regarding PROMIS® instruments (including scoring, validity, and interpretation) please visit: www.healthmeasures.net. For specific information about this instrument, please visit: www.healthmeasures.net/index.php?option=com_instruments&view=measure&id=3392&Itemid=992
Protocol

Patient-Reported Outcomes Measurement Information System® (PROMIS) Item Bank v2.1 - Mobility

Please respond to each item by marking one box per row.

Without any difficulty

With a little difficulty

With some difficulty

With much difficulty

Unable to do

Are you able to stand for one hour?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to stand up from an armless straight chair?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to run or jog for two miles (3 km)?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to go up and down stairs at a normal pace?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to go for a walk of at least 15 minutes?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to step up and down curbs?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to stand with your knees straight?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to stand for short periods of time?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to run at a fast pace for two miles (3 km)?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to squat and get up?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to climb up five steps?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to run a short distance, such as to catch a bus?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to stand unsupported for 10 minutes?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to stand up on tiptoes?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to stand unsupported for 30 minutes?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to jump up and down?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to run 100 yards (100 m)?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to walk up and down two steps?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to climb up 5 flights of stairs?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to walk at a normal speed?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to stand without losing your balance for several minutes?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to kneel on the floor?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to walk a block (about 100 m) on flat ground?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to run five miles (8 km)?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to climb the stairs of a 10-story building without stopping?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to walk briskly for 20 minutes without stopping to rest?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to come to a complete stop while running?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to make sharp turns while running fast?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to jump over an object that is 1 foot (30 cm) tall?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to jump 2 feet (60 cm) high?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to walk across a balance beam?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to walk in a straight line putting one foot in front of the other (heel to toe) for 5 yards (5 m)?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to dance energetically for an hour?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to run on uneven ground?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to run on even ground?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to run ten miles (16 km)?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Are you able to stand on one foot with your eyes closed for 30 seconds?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Does your health now limit you in bending, kneeling, or stooping?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Does your health now limit you in going for a short walk (less than 15 minutes)?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Does your health now limit you in hiking a couple of miles (3 km) on uneven surfaces, including hills?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Does your health now limit you in climbing several flights of stairs?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Does your health now limit you in walking more than a mile (1.6 km)?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Does your health now limit you in climbing one flight of stairs?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Does your health now limit you in walking about the house?

[ ]
5

[ ]
4

[ ]
3

[ ]
2

[ ]
1

Availability

Available

Personnel and Training Required

None

Equipment Needs

None

Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Self-administered questionnaire

Lifestage

Adult, Senior

Participants

Adults aged 18 years and older

Selection Rationale

The Patient-Reported Outcomes Measurement Information System® (PROMIS®) protocols have been tested and have been found to be reliable and comparable to established measures of these same content areas. Additionally, they are quick and easy to administer, either via paper and pencil or as a computer-based instrument.

Language

English, Spanish

Standards
StandardNameIDSource
caDSR Common Data Elements (CDE) Pain Physical Mobility-Adult Assessment Score   7997228 CDE Browser
Derived Variables

None

Process and Review

Not Applicable

Protocol Name from Source

Patient-Reported Outcomes Measurement Information System® (PROMIS) Item Bank v2.1 - Mobility

Source

Hays, R. D., Spritzer, K. L., Amtmann, D., Lai, J-S., Dewitt, E. M., Rothrock, N., Dewalt, D. A., Riley, W. T., Fries, J. F., & Krishnan, E. (2013). Upper-extremity and mobility subdomains from the Patient-Reported Outcomes Measurement Information System (PROMIS) adult physical functioning item bank. Archives of Physical Medicine and Rehabilitation, 94(11), 2291-2296.

General References

McDermott, M. M., Spring, B., Berger, J. S., Treat-Jacobson, D., Conte, M. S., Creager, M. A., Criqui, M. H., Ferrucci, L., Gornik, H. L., Guralnik, J. M., Hahn, E. A., Henke, P., Kibbe, M. R., Kohlman-Trighoff, D., Li, L., Lloyd-Jones, D., McCarthy, W., Polonsky, T. S., Skelly, C., Tian, L., … Rejeski, W. J. (2018). Effect of a home-based exercise intervention of wearable technology and telephone coaching on walking performance in peripheral artery disease: The HONOR Randomized Clinical Trial. JAMA, 319(16), 1665-1676.

Protocol ID

860901

Variables
Export Variables
Variable Name Variable IDVariable DescriptiondbGaP Mapping
Pain
Measure Name

Physical Mobility

Release Date

May 18, 2022

Definition

Measure that rates an individual's overall physical mobility.

Purpose

Ratings from this measure can be used to determine if an individual's physical ability or mobility is limited.

Keywords

Physical function, mobility, adult, PROMIS, Patient-Reported Outcomes Measurement Information System, sickle cell disease, pain, functional assessment

Measure Protocols
Protocol ID Protocol Name
860901 Physical Mobility - Adult
860902 Physical Mobility - Child
860903 Physical Mobility - Hospitalized Individuals
Publications

There are no publications listed for this protocol.