Table 7.

Cognitive interviews—sample clinician quotes

MPOMA-G
Right/left swing foot and right/left clear foot	Again, I’m just thinking about children learning to walk where things are more difficult for them. The impact it has on their life at an early stage might not be as great as it does when they’re adults when they may be expected to move around more or walk more, as opposed to kids just learning. People do provide a lot of support, and the expectations are different for a child just learning to walk versus an adult who’s maybe in the position of having to walk longer distances or do more things independently
Step symmetry	I think given the difficulty that it was to administer, I would probably score it—gosh, I’d probably say a 3…. I think because I’m not sure I was consistent when I was observing the gait, I was scoring this in a reliable way, so this was one of those test items that as I’m scoring it, I’m always thinking—you know, I’m trying to relate it to the other tests that I had administered for other patients to think am I being consistent here?
Zeno Walkway™
Relevancy	I actually think it does a couple of things. It actually gives us some of the measures that we’re looking for, that you’re looking at in the MPOMA-G and for the modified POMA-g, and I think it is a way of quantifying in the clinic that doesn’t require gait laps and the gait characteristics of patients with Angelmans, including gait speed, including base of support, including angle of toe out, which isn’t really captured in other areas, so I think those types of measures are helpful to kind of determine progress or regression with gait Gosh, you know, I have no idea if it’s better or worse than an observer scoring the MPOMA. I would think you’re going to get much more—oh, shall we say objective data from the Walkway than you would from the MPOMA, just because there are human beings involved in the MPOMA and the Walkway sort of takes that out of the mix, but it certainly is going to be able to allow you to assess stride length and wide base of gait. I don’t know that it can help you with symmetry and step continuity, so I think it’s got some relevance, but I’m not sure it fits the entire bill of what’s needed, ….We just don’t know. Well, maybe I should say 3, because I don’t think it can capture everything, but what it does capture, it captures much more objectively

MPOMA-G Modified Performance-Oriented Mobility Assessment