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Agreement between parents and clinicians for the motor functional classification systems of children with cerebral
Akmer Mutlu1, Ozgun Kaya Kara, Mintaze Kerem Gunel
1Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Hacettepe University, Ankara, Turkey. akmer@hacettepe.edu.tr
Insights
Parents and clinicians demonstrated excellent agreement when classifying children with cerebral palsy (CP) using the Gross Motor Function Classification System (GMFCS E&R) and Manual Ability Classification System (MACS). This suggests a shared understanding in assessing motor function in children with CP.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) classification systems are crucial for understanding motor function.
- The Gross Motor Function Classification System (GMFCS E&R) and Manual Ability Classification System (MACS) are widely used for children with CP.
- Interrater reliability, especially between parents and clinicians, is essential for consistent application.
Purpose of the Study:
- To assess the agreement between parental and clinician ratings for GMFCS E&R and MACS in children with CP.
- To evaluate the intertester reliability of these classification systems between parents and clinicians.
Main Methods:
- Data collected from 100 children with CP and their parents.
- Parents utilized the GMFCS E&R and MACS for their children.
- Intraclass correlation coefficient (ICC) analyzed parent-physiotherapist agreement for GMFCS and MACS scores.
Main Results:
- Excellent agreement observed between parents and physiotherapists for both GMFCS E&R and MACS.
- Intraclass correlation coefficient (ICC) values were 0.96 for GMFCS and 0.96 for MACS.
- Confidence intervals indicated high precision for the agreement estimates.
Conclusions:
- Parents and clinicians exhibit a shared understanding when using GMFCS E&R and MACS for children with CP.
- Careful administration of these classification systems can foster consistent communication between parents and healthcare providers.
- This agreement supports the use of parental input in classifying motor function for children with cerebral palsy.
Purpose:
This study aimed to evaluate whether parental ratings of expanded and revised Gross Motor Function Classification System (GMFCS E&R) and Manual Ability Classification System (MACS) had agreement with clinicians' ratings when classifying children with CP to these two well-known classifications of motor functioning and hereby to evaluate intertester reliability of the classification systems between clinicians and parents.
Method:
The process of study was designed to collect data from parents using the GMFCS E&R and MACS. The total participants consisted of 100 children with CP and their parents. The overall agreement between the parents and physiotherapist GMFCS and MACS scores was analysed using intraclass correlation coefficient (ICC).
Results:
The ICC value between parents and physiotherapist was 0.96 (95% confidence interval [CI] 0.95-0.97) for GMFCS and 0.96 (95% CI 0.94-0.97) for MACS and indicated excellent agreement.
Conclusions:
The excellent agreement between parents and clinicians indicated that parents and clinicians can talk in the same language for the motor functional classification systems of children with CP if careful administrations are provided.
