Development and performance of PROWalk: a functional mobility person-reported outcome measure based on the PROMIS^® adult physical function item bank

Introduction: Functional mobility, or the capacity to move safely and independently, can be evaluated using performance-based physiological tests, observational assessments, or self-report tools. This study sought to develop the PROWalk™, a PROMIS-based patient-reported outcome measure of perceived gait and balance challenges, and evaluated its performance relative to the Patient-Specific Functional Scale (PSFS) in individuals with sensory peripheral neuropathy. Methods: PROWalk was developed with expert clinician input using selected items from the PROMIS item bank. It was administered via telehealth to participants with lower-extremity peripheral neuropathy (N = 51; age 76 ± 4 years; 4 female) who were prescribed a wearable sensory prosthesis, alongside the PSFS, at baseline and again after 6 weeks. Results: Both measures displayed significant increases (i.e., improvements) over time with large effect sizes (PROWalk: rrb = −0.878; PSFS: rrb = −0.993), strong temporal correlations (PROWalk: rho = 0.684; PSFS: rho = 0.458), and upward linear trends for each instrument between baseline and 6 weeks. When normalized, the measures showed no bias, large limits of agreement, and moderate convergent validity (rho = 0.582, p < 0.001). Discussion: Compared with broader PROMIS Physical Function short forms, PROWalk targets mobility-specific activities relevant to gait and balance. It demonstrated significant improvements in perceived functional mobility over time and strong temporal stability, supporting its use for standardized group-level comparisons. PROWalk appears to be a valid, telehealth-compatible measure for capturing self-reported functional mobility in individuals with sensory neuropathy and may address limitations of more individualized assessment tools.