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Evaluating the responsiveness of 2 versions of the gross motor function measure for children with cerebral palsy
1School of Physical Therapy, Kaohsiung Medical University, Kaohsiung, Taiwan. hywang@cc.kmu.edu.tw
Insights
The Gross Motor Function Measure-66 (GMFM-66) shows better responsiveness to motor changes in children with cerebral palsy (CP) compared to the original GMFM-88. This updated version aligns more consistently with clinical judgments of improvement.
Area of Science:
- Pediatric Rehabilitation
- Motor Development in Cerebral Palsy
- Clinical Outcome Measurement
Background:
- The Gross Motor Function Measure (GMFM) is widely used to assess motor function in children with cerebral palsy (CP).
- Evaluating the responsiveness of different versions of the GMFM is crucial for accurate clinical assessment and research.
- Previous versions may have limitations in detecting subtle motor improvements.
Purpose of the Study:
- To compare the responsiveness of the original Gross Motor Function Measure (GMFM-88) and its revised version (GMFM-66) in detecting motor changes in children with CP.
- To determine which GMFM version better reflects meaningful motor improvement as judged by therapists.
Main Methods:
- A cross-sectional study involving 65 children with CP aged 0.5–9.4 years.
- Motor ability was assessed twice over a mean interval of 3.5 months using all items of the GMFM-88.
- Therapist judgments of meaningful motor improvement served as an external standard for comparison.
Main Results:
- The GMFM-66 demonstrated superior overall responsiveness compared to the GMFM-88 when correlated with therapist judgments.
- Both GMFM versions exhibited similar sensitivity in detecting motor changes.
- The GMFM-66 showed higher specificity in reflecting clinically meaningful improvements.
Conclusions:
- The GMFM-66 is a more responsive tool than the GMFM-88 for evaluating motor changes in children with CP over short intervals.
- The GMFM-66 provides a more consistent measure of motor improvement aligned with clinical expertise.
- This suggests the GMFM-66 is a preferred instrument for tracking functional gains in pediatric CP populations.
Objective:
To compare the responsiveness to motor change of the original version of Gross Motor Function Measure (GMFM-88) and its second version (GMFM-66) in children with cerebral palsy (CP).
Design:
Cross-sectional study.
Setting:
Seven rehabilitation pediatric clinics.
Participants:
Sixty-five children with CP (age range, 0.5-9.4y; mean, 3.7+/-1.9y) were recruited.
Intervention:
The children's motor ability was assessed twice with a mean interval of 3.5 months using all of the GMFM-88 items. A 3-category range of therapist judgments on the children's meaningful motor improvement was used as an external standard.
Main Outcome Measures:
GMFM-88 scores, GMFM-66 scores, and therapists' judgments.
Results:
Regarding the association with the therapist judgments, the overall responsiveness of GMFM-66 is superior to that of GMFM-88. Both measures' sensitivities of the responsiveness are similar, but GMFM-66 has better specificity.
Conclusions:
To evaluate the motor change in a sample of children with CP over a mean interval of 3.5 months by using the 2 versions of GMFM, the GMFM-66 was more responsive than the GMFM-88 with respect to consistency with therapist clinically meaningful judgments.
