Lansky Play-Performance Scale for Pediatric Functional Status

Lansky Play-Performance Scale is parent rated qualitative tool which assess the child's performance in response to the given chemotherapy
Patient Description
Fully active, normal 100
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
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
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


Measured Factor
Play activity
Measured Factor Disease
  • Cancer
Measured Factor Detail
Lansky Play-Performance Scale is effective tool in recording play activity as the index of child's performance. By the performance score the response to the treatment can be assessed and proper management of child having cancer can be done.
Body System
Multiple body systems
Measured Factor Low Impact
  • Score of 100 points indicate that the child is fully active and there is no need for special attention to child
Measured Factor High Impact
  • Score of 0 point indicates that the child is unresponsive with severe restriction and needs immediate special attention

Result Interpretation

Ranges Ranges
  • Critical Low: 7000%
Result Low Conditions
  • Moderate to severe restriction can occur
Test Limitations
Lansky’s Play Performance Scale (LPPS) determines only special care based on physical and social functioning of the child.
References: 2, 3


Study Validation 1
The study was conducted on three different groups of children with all types and stages of childhood malignant neoplasms to measure the performance status of the child with cancer. A mean score of 42.3 was observed in in-patients, 98.2 in normals, and 90.7 in outpatients. Analysis of variance (ANOVA) and correlational procedures depicted that the play-performance scale was sensitive to change and was undoubtedly related to the global performance measures of experienced clinicians. The outcomes of the study reported that the play-performance scale provides reproducible, meaningful, and quantifiable data for children.
References: 4
Study Validation 2
The study was conducted on 49 children with all stages of Hodgkin disease between May 1, 2002, and March 31, 2005, to assess the ability to detect the change of health-related quality of life over time. Four different health-related quality of life (HRQL) measures were taken into consideration included: the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core and Cancer Module, the Health Utilities Index Mark 2 and Mark 3, the Lansky Play-Performance Scale, and the EuroQol EQ-5D visual analogue scale (EuroQol) and showed a valid change between Time 1 and Time 4 (<0.05). The results of the study demonstrated that the PedsQL and the EuroQol were most sensitive to change.
References: 5
Study Validation 3
The study was conducted for evaluating the quality of life (QOL) of children with cancer. The Pediatric Oncology Quality of Life Scale (POQOLS) presents a total score and three-factor scores that determine the physical function, emotional distress, reaction to current medical treatment, and role restriction. Internal consistency reliabilities of the three factors and total scale were high and POQOLS scores depicted good discriminant and concurrent relationships with scores on measures of adjustment hypothesized to covary with the dimensions of QOL evaluated.
References: 6
Study Additional 1
The study was conducted on patients with solid tumours aged <18 years between 2000 and 2014 to evaluate prognostic factors of survival in the paediatric phase I trials. By using Cox regression analyses and log-rank test, survival distributions were compared. Complete responses were observed in 2.1%, stable disease in 25.9%, and partial responses in 7.2%. Lansky/Karnofsky ≤80%, no school/work attendance, increased creatinine and the Royal Marsden Hospital (RMH) score ≥1 associated with worse overall survival (OS) in the multivariate analysis. The outcomes of the study demonstrated it to be a useful orientation about potential prognosis and could lead in the future to more paediatric-adapted eligibility criteria in early-phase trials.
References: 7
Study Additional 2
The study was conducted to assess the performance status and mortality of children with primary immunodeficiency disorders (PIDD) in Kuwait. By using the Lansky Play-Performance Scale (LPPS), scoring was done. The observed mean LPPS score for all the patients was found to be 65.5. The study concluded that the patients with PIDD have a high rate of mortality and poor performance status.
References: 8
Study Additional 3
The study was conducted to provide an evidence-based evaluation of the most commonly used measures of HRQOL and functional impairment on their use in the field of pediatric psychology. 16 measures were taken into consideration for the psychometric review and divided into the following three categories: (a) disease-specific quality of life scales, (b) functional impairment rating scales, and (c) generic HRQOL scales. The results of the study reported that psychometric characteristics were strong for the majority of measures reviewed, and met "well-established" evidence-based assessment criteria.
References: 9


  1. Lansky SB, List MA, Lansky LL, Ritter-sterr C, Miller DR. The measurement of performance in childhood cancer patients. Cancer. 1987;60(7):1651-6.
  2. Batra P, Kumar B, Gomber S, Bhatia MS. Assessment of quality of life during treatment of pediatric oncology patients. Indian J Public Health. 2014;58(3):168-73
  3. Jiang F, Torgerson TR, Ayars AG. Health-related quality of life in patients with primary immunodeficiency disease. Allergy Asthma Clin Immunol. 2015;11:27.
  4. Lansky SB, List MA, Lansky LL, Ritter-sterr C, Miller DR. The measurement of performance in childhood cancer patients. Cancer. 1987;60(7):1651-6
  5. Klaassen RJ, Krahn M, Gaboury I, Hughes J, Anderson R, Grundy P, et al. Evaluating the ability to detect change of health-related quality of life in children with Hodgkin disease. Cancer. 2010;116(6):1608-14.
  6. Goodwin, David AJ, Stephen R. Boggs, and John Graham-Pole. "Development and validation of the pediatric oncology quality of life scale." Psychological assessment 6.4 (1994): 321.
  7. Carceller F, Bautista FJ, Jiménez I, Hladun-Álvaro R, Giraud C, Bergamaschi L, et al. Prognostic factors of overall survival in children and adolescents enrolled in dose-finding trials in Europe: An Innovative Therapies for Children with Cancer study. Eur J Cancer. 2016;67:130-140.
  8. Al-Herz W, Zainal ME, Alenezi HM, Husain K, Alshemmari SH. Performance status and deaths among children registered in Kuwait National Primary Immuno-deficiency Disorders Registry. Asian Pacific journal of allergy and immunology. 2010 Jun 1;28(2-3):141.
  9. Palermo TM, Long AC, Lewandowski AS, Drotar D, Quittner AL, Walker LS. Evidence-based assessment of health-related quality of life and functional impairment in pediatric psychology. J Pediatr Psychol. 2008;33(9):983-96.

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