Lansky Play-Performance Scale for Pediatric Functional Status

Lansky Play-Performance Scale

Performance Status

Score:–

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Uses parent description of child’s activity to assess ability and response to treatment.

Why Use

Performance status in adults is highly correlated with survival time and need for services in the home. It may also help predict tolerance to treatments. This may apply to children as well.

When to Use

Pediatric cancer patients — or possibly other children with serious chronic or life-threatening diseases.

Formula

Criteria Score Description Fully active, normal. 100 Able to carry on normal activity; no special care is needed. Minor restrictions in strenuous physical activity. 90 Active, but gets tired more quickly. 80 Greater restriction of play and less time spent in play activity. 70 Mild to moderate restriction. Up and around, but active play minimal; keeps busy by being involved in quieter activities. 60 Lying around much of the day, but gets dressed; no active playing participates in all quiet play and activities. 50 Mainly in bed; participates in quiet activities. 40 Moderate to severe restriction. Bedbound; needing assistance even for quiet play. 30 Sleeping often; play entirely limited to very passive activities. 20 Doesn't play; does not get out of bed. 10 Unresponsive. 0

Pearls / Pitfalls

The Lansky Play-Performance Scale offers an approachable method for describing functional status in children. It was derived and internally validated in children with cancer to assess response to therapies and overall status.

Management

We are unaware of validated management algorithms using the Lansky Scale.

Critical Actions

The Lansky Scale and other performance scales should be used in the holistic assessment of cancer patients, although their use for prognosis or treatment choice is not well understood.

Advice

Quantifying functional status is useful in all facets of patient care and may improve understanding of patient needs and abilities, as well as prognosis.