The Montreal Rehabilitation Performance Profile: A task-analysis approach to quantify stair descent performance in children with intellectual disability

Objective: To develop a clinical tool to quantify stair descent performance in children with moderate to severe intellectual disability. Design: Item identification, measurement construction, and basic testing of reliability. Setting: School for children with intellectual disability. Participants: A sample of convenience; 18 children (age range, 5-9 yr) with moderate to severe intellectual disability, but who were ambulatory. Intervention: The Montreal Rehabilitation Performance Profile (MRPP) measur ement tool, which has 4 perceptual-motor elements: movement form, time requ irement, proprioceptive cues, and external cues. Main Outcome Measure: Identification of perceptual-motor elements that unde rlie skilled stair descent and that are directly quantified from standard v ideo recording. Results: Interrater reliability measured by percentage agreement (kappa sta tistic) was high for 3 elements (80%-100%; kappa = .63) and good for the fo urth (67%; kappa =.52). The 4 MRPP elements are plotted on cartesian axes t o yield (1) the magnitude of the contribution of each independent element t o total performance outcome, and (2) a global measurement of level of funct ional skill, the Performance Composite Score (PCS). Conclusions: The MRPP, and associated PCS, provide a valid measure of funct ional stair descent skill that does not rely on cognitive understanding of the process. This tool could be adapted to measure functional capacity in o ther clinical populations, including geriatric clients.