Related Experiment Video
Updated: Jul 19, 2026
Measurements of Motor Function and Other Clinical Outcome Parameters in Ambulant Children with Duchenne Muscular Dystrophy
Published on: January 12, 2019
Gross Motor Function Classification System and outcome tools for assessing ambulatory cerebral palsy: a multicenter
D J Oeffinger1, C M Tylkowski, M K Rayens
1Shriners Hospitals for Children, Lexington, KY, USA. doeffinger@shrinenet.org
Insights
The Gross Motor Function Classification System (GMFCS) effectively differentiates ambulatory cerebral palsy severity. Specific measures like the Gross Motor Function Measure (GMFM) accurately predict a child's GMFCS level.
Area of Science:
- Pediatric Rehabilitation
- Neurology
- Biomedical Engineering
Background:
- Ambulatory cerebral palsy (CP) severity varies widely.
- Standardized classification is crucial for research and clinical practice.
- The Gross Motor Function Classification System (GMFCS) is a widely used severity scale.
Purpose of the Study:
- To examine the relationship between GMFCS levels and various pediatric outcome instruments.
- To determine the predictive accuracy of specific outcome measures for GMFCS levels.
- To validate the utility of GMFCS in clinical studies.
Main Methods:
- Data collected from six sites on GMFCS levels I, II, and III.
- Utilized Gross Motor Function Measure (GMFM), Pediatric Orthopaedic Data Collection Instrument (PODCI), gait parameters, and oxygen cost.
- Sample sizes ranged from 226 to 1047 participants for different assessments.
Main Results:
- Significant differences were found among GMFCS levels I, II, and III across multiple outcome tools.
- Strong correlations observed between GMFCS levels and GMFM sections D & E, PODCI measures, gait velocity, and oxygen cost.
- GMFM section E score accurately predicted GMFCS level (76.6% accuracy).
Conclusions:
- Assessed outcome tools effectively distinguish between children with different GMFCS levels.
- GMFM section E score is a significant predictor of GMFCS level.
- The GMFCS is justified as a classification system for clinical studies involving ambulatory CP.
Abstract:
The relationships between different levels of severity of ambulatory cerebral palsy, defined by the Gross Motor Function Classification System (GMFCS), and several pediatric outcome instruments were examined. Data from the Gross Motor Function Measure (GMFM), Pediatric Orthopaedic Data Collection Instrument (PODCI), temporal-spatial gait parameters, and oxygen cost were collected from six sites. The sample size for each assessment tool ranged from 226 to 1047 participants. There were significant differences among GMFCS levels I, II, and III for many of the outcome tools assessed in this study. Strong correlations were seen between GMFCS level and each of the GMFM sections D and E scores, the PODCI measures of Transfer and Mobility, and Sports and Physical Function, Gait Velocity, and Oxygen Cost. Correlations among tools demonstrated that the GMFM sections D and E scores correlated with the largest number of other tools. Logistic regression showed GMFM section E score to be a significant predictor of GMFCS level. GMFM section E score can be used to predict GMFCS level relatively accurately (76.6%). Study data indicate that the assessed outcome tools can distinguish between children with different GMFCS levels. This study establishes justification for using the GMFCS as a classification system in clinical studies.
