Evaluation

Evaluation

Step 1

Create video as this one &
Sent on info@adkanellopoulos.eu or WhatsApp

Step 2

Complete the following questionnaires

SPML EVALUATION CHECKLIST
Information Packet for SPML Procedure

Thank you for your inquiry. Enclosed please find the patient questionnaire and other information. You can return the completed forms to the clinic by email.
The email address is info@adkanellopoulos.eu

Once the completed forms, videos and the X-Rays have been received, the clinic will call you to arrange for a telephone conference or Zoom conference.
This process can take approximately 2  weeks.

If you have any questions, please call:

She will be happy to answer any of your questions.
Thank you again and we look forward to hearing from you info@adkanellopoulos.eu

Patient Questionnaire
Functional Mobility Scale (FMS)

Please read the following questions and fill the boxes with the rating (see below) that best represents your child’s mobility method:

(5 metres, 50 metres, 500 metres)

Rating:
N= Does not apply: e.g., child does not complete the distance.
C= Crawling: child crawls for mobility at home (5 m).
1= Uses wheelchair: may stand for transfers, may do some stepping supported by another person or
using a walker/frame.
2= Uses a walker or frame: without help from another person.
3= Uses crutches: without help from another person.
4= Uses one crouch or one or two single point sticks: without help from another person.
5= Independent on level surfaces: Does not use walking aids or need help from another person.*
Requires a rail for stairs. *If uses furniture, walls, fences, shop fronts for support, please use 4 as
the appropriate description.
6= Independent on all surfaces: Does not use any walking aids or need any help from another person when walking over all surfaces including uneven ground, curbs etc. and in a crowded environment.

Copyright © 2024 SPML Greece. All rights reserved.
Developed by Findigital