Continuous Scale Physical Functional Performance; Short Form: Continuous Scale Physical Functional Performance 10; Wheel Chair Users: Wheel Chair Physical Functional Performance

Post-stroke:

(Manns et al, 2009; n = 10 stroke survivors with hemiparesis; mean age = 54(10) time since stroke = 7.5(8.3) years; n = 10 age and sex matched controls; mean age = 54(11))

• Convergent validity of CS-PFP10 total score with:
  • VO₂ peak: Excellent (r = 0.755)
  • Impairment (CMSA aggregate scores): Excellent (r = 0.667)

Stroke survivors:

(Manns et al, 2009)

• Short form CS-PFP10 No floor effects

Manual Wheelchair Users:

(Cress et al, 2002; n = 18, mean age = 49.4(10.6); manual w/c users)

WC-PFP Descriptive Statistics: Mean Score (SD)

• Upper Body Strength = 39.40(26.9)
• Upper Body Flexibility = 43.34(19.2)
• Balance &Coordination = 38.32(23.3)
• Endurance = 41.36(30.1)
• Total = 41.39(23.8)

Manual Wheelchair users

(Cress et al, 2002)

WC-PFP: Test-Retest Reliability for Domain & Total Scores (n = 13;mean age = 52.8(7.0)): Excellent

• Upper Body Strength: (ICC = 0.95)
• Upper Body Flexibility: (ICC = 0.87)
• Balance &Coordination: (ICC = 0.88)
• Endurance: (ICC = 0.96)
• Total: (ICC = 0.96)

Manual Wheelchair users:

(Cress et al, 2002)

WC-PFP: Internal Consistency for Domain & Total Scores (n = 18)

• Upper Body Strength: Excellent (Chronbach’s a = 0.85)
• Upper Body Flexibility: Poor (Chronbach’s a = 0.58)
• Balance &Coordination: Excellent (Chronbach’s a = 0.83)
• Endurance: Excellent (Chronbach’s a = 0.90)
• Total: Excellent (Chronbach’s a = 0.93)

Manual Wheelchair Users:

(Cress et al, 2002)

• No significant correlations between WC-PFP domain and total scores and Sickness Impact Profile (SIP) domain and total scores
• This may be due to the amount of questions on the SIP related to ambulation

Manual Wheelchair Users: WC-PFP

(Cress et al, 2002)

• No floor or ceiling effects

Older adults

(Hearty et al 2007; CS-PFP Total score and domain scores of Non-disabled (ND) adults and adults with Parkinson’s disease (PD))

Older adults:

(Cress et al, 1996; n = 148 total; n = 39 long term are facility residents with some dependence, mean age = 84.65(6.17); n = 31 long term care facility residence living Independently, mean age = 80.51(6.09); n = 48 community dwelling older adults, mean age = 72.29(5.17))

• CS-PFP Test-retest reliability
  • Upper body strength (UBS) = 0.95
  • Upper body flexibility (UBF) = 0.85
  • Lower body strength (LBS) = 0.94
  • Balance and coordination (BALC) = 0.96
  • Endurance (END) = 0.93
  • CS-PFP Total = 0.97
  • The strength of the test-retest reliability data suggests this measure is adequate for individual decision making in all but upper body flexibility domain

(Cress et al 2005, n = 31, mean age = 73.5(6.7); 100% community dwelling older adults)

• CS-PFP10 Community based test-retest reliability: Excellent (r = 0.93 - 0.98) for domain and total scores

Older adults:

(Cress et al, 1996)

• Excellent Inter-rater reliability
  • Upper body strength = 0.92
  • Upper body flexibility = 0.97
  • Lower body strength = 0.98
  • Balance and coordination = 0.99
  • Endurance = 0.95
  • CS-PFP Total = 0.98

(Hearty et al, 2007)

• n = 37 adults with PD
  • Age group 45-54 years old, n = 17, mean age (males) = 49.8(1.5), mean age (females) = 51.0(1.8); years with diagnosis = 4.3(3.5); H&Y score = 2.1(0.5)
  • Age group: 55-64 years old; n = 19; mean age(males) = 60.8(2.1), mean age (females) = 60.2(1.9); years with diagnosis = 4.5(3.5); H&Y score = 2.1(0.2)
• n = 70 non-disabled adults
  • Age group 35-44 years old, n = 26, mean age (males) = 39.2(2.4), mean age (females) = 38.6(3.2);
  • Age group 45-54 years old, n = 23, mean age (males) = 47.3(3.9), mean age (females) = 47.7(2.8)
  • Age group 55-64 years old, n = 21, mean age (males) = 58.8(2.5), mean age (females) = 58.3(2.8)
• n = 72 non-disabled older adults
  • Age group 55-64 years old, n = 33, mean age (males) = 72.5(1.2), mean age (females) = 69.6(2.6)
  • Age group 55-64 years old, n = 39, mean age (males) = 78.7(3.1), mean age (females) = 78.3(2.8)
• Excellent Inter-rater reliability: ICC = 0.97 - 0.99

Older adults:

(Cress et al, 1996)

• Excellent for all but upper body flexibility
  • Upper body strength = 0.87
  • Upper body flexibility = 0.74
  • Lower body strength = 0.83
  • Balance and coordination = 0.91
  • Endurance = 0.86
  • CS-PFP total = 0.9

(Cress et al, 2005; prospective data: n = 40; mean age = 77.2(6.4); 50% community dwellers)

• Excellent for all but upper body flexibility
  • Upper body strength: a = 0.83
  • Upper body flexibility: a = 0.69
  • Lower body strength: a = 0.87
  • Balance and coordination: a = 0.90
  • Endurance: a = 0.91

Older adults:

(Cress et al, 2005)

Retrospective date : n = 228 subjects total; mean age = 76(7.1): n = 134 independent community dwellers, n = 48 Independent residents in a congregate housing facility, n = 45 Dependent residents in a congregate housing facility

• Concurrent validity of CS-PFP and short form CS-PFP10:
• Excellent
  • Upper body strength = 0.967
  • Upper body flexibility = 1.00
  • Lower body strength = 0.98
  • Balance and coordination = 0.97
  • Endurance = 0.98
  • Total score = 0.99

Prospective data : n = 40; mean age = 77.2(6.4); 50% community dwellers

• Concurrent validity of CS-PFP and short form CS-PFP 10:
• Excellent
• Pearson correlation coefficient domain scores CS-PFP and CS-PFP 10:
  • Upper body strength = 0.95
  • Upper body flexibility = 0.86
  • Lower body strength = 0.94
  • Balance and coordination = 0.95
  • Endurance = 0.93
  • Total score = 0.95

Older adults:

C-PFP10 administered in a lab verses community setting had excellent correlations (Cress et al 2005, n = 20; mean age = 69.3(7.1), community dwellers)

Older Adults:

(Cress et al, 1996)

• Convergent Validity of CS-PFP Total Score with:
  • SF-36 Total: Excellent (r = 0.75)
  • Sickness Impact Profile total: Adequate (r = -0.58)
• Discriminate Validity: SF-36 Mental Health domain and SIP Mood domain have poor correlation (both, r = -0.15) with the CS-PFP; this is expected as the CS-PFP is not intended to address mental health or emotion

(Cress et al, 1997)

• Convergent validity (by domain):
  • Upper body strength & isometric elbow flexion: at 90 degrees/s: Excellent (r = 0.63)
  • Upper body flexibility & shoulder flexion: Poor (r = 0.26)
  • Lower body strength & isokinetic knee extension at 60 degree/second: Excellent (r = 0.69)
  • Balance and coordination & step reaction time: Adequate (r = -0.57)
  • Endurance & maximal O2 consumption: Excellent (r = 0.65)

(Arnett et al, 2008; n=29 older adults; mean age = 76.2(6.2))

• Convergent validity:
  • CS-PFP total and living status: Adequate (r = 0.52)
  • CS-PFP total and Age: Adequate (r = -0.50)

Nonagenarians:

(Frisard et al, 2007; n = 22 nonagenarians; mean age = 93(1)years and n = 32 aged 60–74 years; mean age = 70(1) years)

• Convergent validity of CS-PFP10 with: 
  • Physical activity level: Excellent (r = 0.68) for combined populations
  • Physical activity level: Excellent (r = 0.78) for nonagenarians
  • Physical activity level: Adequate (r = 0.52) for 60-74 year old group 
  • Total Energy Expenditure (adjusted by sex, fat free mass, and fat mass): Adequate (r = 0.35)

Older adults:

(Cress et al, 1996)

• No floor effects; No zeros scores on any domain

(Hearty et al 2007; No ceiling effects in middle-aged subjects)

• CS-PFP designed so that a raw score outside of the range on one task does not result in ceiling or floor effects on domain or total scores
• CS-PFP developed using participants ranging from frail to vigorous and healthy older adults

Older adults:

• The CS-PFP (Cress et al, 1999, Brochu M et al, 2002) and CS-PFP10 (Cress et al, 2005) are more sensitive to change than the SF-36PF

Cress et al, 1997; Exercise Intervention in healthy elders; mean age = 73(5); Trained groups using endurance, strength, or combined: 60 min, 3x/week for 6 months.

• CS-PFP sensitivity to change: Large effect sizes for change following exercise intervention

Cress et al, 1999; n = 49 Community dwelling older adults; mean age 76(4); Control n = 26; Exercise group = 23

• Exercise group showed significant improvement with large effect sizes for CS-PFP total and Upper body strength, lower body strength and endurance domains
  • CS-PFP Total score effect size = 0.80
  • Upper body strength ES = 0.94
  • Lower body strength ES = 0.74
  • Endurance ES = 0.64

Parkinson’s Disease:

(Schenkman et al, 2002; n = 42; mean age = 63.7(11.5); mean H&Y Stage = 2.07(0.79); community dwelling people with Parkinson’s disease)

• Normative Data
  • Upper body strength = 55.7(19.9)
  • Upper body flexibility = 54.7(16.8)
  • Lower body strength = 39.3(19.7)
  • Balance/coordination = 38.5(16.8)
  • Endurance = 44.1(18.4)
  • CS-PFP Total = 44.3(17.6)
• Mean CS-PFP total score by PD H&Y stage
  • Stage 1, n = 13: 55.75(12.06)
  • Stage 2, n = 10: 50.90(13.18)
  • Stage 2.5, n = 8: 41.75(13.28)
  • Stage 3, n = 11: 25.36(12.68)

Parkinson’s disease: CS-PFP

(Schenkman et al, 2002: Excellent (Kappa = -0.95))

Parkinson’s disease:

(Schenkman et al, 2002)

• Convergent validity of CS-PFP Total score with:
  • UPDRS: Excellent (r = -0.62)
  • Northwestern University Disability Scale: Adequate (r = 0.43)
  • Functional reach: Excellent (r = 0.70)
  • TUG: Excellent (r = -0.69)
  • 360 turn (steps): Adequate (r = -0.54)
  • 360 (time): Adequate (r = -0.53)

Parkinson’s Disease:

(Schenkman et al, 2012 indicates that the CS-PFP is responsive to an exercise program consisting of functional and flexibility training)

• At 4 months post-intervention, the flexibility and functional training intervention group improved more than the control group on the CS-PFP (mean difference 4.3, [1.2-7.3 95%CI]) and the Aerobic exercise group (mean difference 3.1, [0-6.2 95% CI]). The aerobic conditioning group did not improve more than the control group (mean difference 1.2, [-2.0-4.3 95%CI]).

(Schenkman et al, 2011)

• CS-PFP was able to detect differences from age appropriate norms in participants in the earliest stage of PD, unlike other measures

Fibromyalgia:CS-PFP

(Panton et al, 2006; n = 29 women with FM, mean age = 46(7), FM duration 8(6) years)

• Excellent (r = 0.90)

Chronic Heart failure:

(Savage et al, 2011; n = 10 subjects with chronic heart failure, mean age = 73.4(2.4); n = 11 control group; mean age = 72.1(2.1))

• Convergent validity of CS-PFP10 with:
  • Peak VO2: Excellent (r = 0.78)
  • Composite 1RM (7 exercises): Excellent (r = 0.64)
  • Mental component score (MPS SF-36): Adequate (r = 0.44)
  • Ejection fraction: Adequate (r = 0.38)

(Brochu et al, 2002; n = 30 women with CHD > 6 month divided into 2 groups: n = 13 Resistance exercise group (3x / week for 6 months), mean age = 70.5(4.0); n = 12 control group (3x/week for 30-40 min for 6 months: yoga, breathing, stretching, calisthenics); mean age = 70.7(5.3))

• Convergent validity of the CS-PFP with:
  • Hand-grip strength: Excellent (r = 0.67)
  •  Peak VO2: Adequate (r = 0.59)
• Discriminate validity of the CS-PFP with:
  • SF-36: Poor (r = 0.24) indicating the two assess different concepts

Excellent

• CS-PFP is a measure of functional performance with activities of daily living and each of its individual components actually tests these activities of daily living.
• The 5 domain scores (upper body strength, upper body flexibility, lower body strength, balance and coordination, and endurance) are all collections of tasks that appear to, at face value, represent those domains

Chronic Heart Disease:

(Brochu et al, 2002)

• Significant change in total CS-PFP score between exercise and control group (24% vs. 3%)
• Changes in total CS-PFP physical performance score were correlated with changes in maximal strength for the bench press (r = 0.71, P = 0.001) and for leg extension (r = 0.53, P = 0.01)

Community Dwellers (Independent) & Congregate Care Facility Residents (Dependent & Independent)

(Cress et al, 2003; 3 groups: Community dwellers, Independent: n = 98, Mean age CD/I = 74(3); Congregate care facility residents, Independent: n = 49 Mean age CCF/I = 79(6); Congregate care facility residents, Dependent: n = 45 Mean age CCF/D = 84(7); Well-educated Caucasians of middle and higher socioeconomic status)

• CS-PFP Score³ 57 units = independent, (All were living independently; 79% community dwellers, 21% congregate care facility residents)
• CS-PFP score < 57 = not independent (57% living independently; 30% community dwellers, and the remaining 27% congregate care facility residents not reporting functional limitations)

(The maximum score is a 100 with higher scores indicating better function)