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Reliability of the gross motor function measure for children with osteogenesis imperfecta
J Ruck-Gibis1, H Plotkin, J Hanley
1Shriners Hospital for Children (J.R.-G., H.P.), Department of Epidemiology, Biostatistics and Occupational Health (J.H.) and School of Physical and Occupational Therapy (S.W.-D.) McGill University, Montreal, Quebec, Canada.
Insights
The Gross Motor Function Measure (GMFM) is reliable for children with osteogenesis imperfecta (OI). This study confirmed its intra- and interrater reliability, supporting its use in assessing motor function in children with OI.
Area of Science:
- Pediatric Physical Therapy
- Motor Function Assessment
- Rare Bone Disorders
Background:
- The Gross Motor Function Measure (GMFM) is a standard tool for assessing motor function in children with cerebral palsy (CP).
- Its reliability has not been established for children with osteogenesis imperfecta (OI), a genetic disorder affecting bone fragility.
Purpose of the Study:
- To evaluate the intra- and interrater reliability of the GMFM when used with children diagnosed with osteogenesis imperfecta (OI).
- To determine if the GMFM is a dependable measure for tracking motor function changes in this population.
Main Methods:
- Nineteen children with OI underwent GMFM assessments administered by a physical therapist.
- Assessments were videotaped and independently scored by five physical therapists at least six weeks later.
- Intraclass correlation coefficients (ICCs) and Kappa statistics were used to analyze reliability.
Main Results:
- Excellent intrarater reliability was found, with ICCs of 0.99 for all dimensions and the total score.
- High interrater reliability was observed, with ICCs ranging from 0.98 to 0.99 across dimensions and the total score.
- Kappa statistics indicated good to excellent agreement for most items.
Conclusions:
- The GMFM demonstrates high reliability for assessing gross motor function in children with OI.
- Pediatric physical therapists familiar with the GMFM can confidently use it for this population.
- Videotaped assessments ensured consistency and minimized direct patient interaction bias.
Purpose:
The Gross Motor Function Measure (GMFM) is a criterion-referenced evaluative measure designed to detect change over time for children diagnosed with cerebral palsy (CP). Reliability of this measure has not been tested for children with osteogenesis imperfecta (OI). The purpose of this study was to determine the intra- and interrater reliabilities of the GMFM for use with children diagnosed with OI.
Method:
One physical therapist administered and scored the GMFM for 19 children with OI who were followed at the Shriners Hospital for Children. The assessments were videotaped, then viewed and scored by five physical therapists, including the author, at least six weeks later. Intra- and interrater reliabilities were assessed using intraclass correlation coefficients (ICCs). Kappa statistics were calculated for items demonstrating more disagreement than the majority.
Results:
The ICCs for intrarater reliability of the five dimensions and total score were 0.99. The ICCs for interrater reliability were 0.98 for the lying and rolling dimension and 0.99 for the other dimensions and total score. Kappa statistics for items demonstrating more disagreement than the majority ranged from 0.552 to 1.00.
Conclusions:
This study provides evidence of the reliability of the GMFM for children with OI when scored by pediatric physical therapists familiar with the measure. The videotape provided a consistent situation because each therapist did not directly interact with each child, but rather rated a videotaped session of the child's performance.
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