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Reliability and responsiveness of the gross motor function measure-88 in children with cerebral palsy
1Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, Republic of Korea.
Insights
The Gross Motor Function Measure (GMFM-88) is reliable and responsive for assessing gross motor function in children with cerebral palsy (CP). This study confirms its effectiveness across various GMFCS levels.
Area of Science:
- Pediatric Rehabilitation
- Clinical Measurement
- Neurology
Background:
- The Gross Motor Function Measure (GMFM-88) is a standard tool for evaluating gross motor function in children with cerebral palsy (CP).
- While relative reliability is established, absolute reliability and responsiveness data for the GMFM-88 in CP populations are limited.
Purpose of the Study:
- To assess the absolute and relative reliability of the GMFM-88.
- To determine the responsiveness of the GMFM-88 in children with CP.
Main Methods:
- A clinical measurement design was employed.
- Interrater and intrarater reliability were evaluated using 10 and 2 raters, respectively, scoring 84 children with CP across all GMFCS levels from video records.
- Responsiveness was assessed through 3 follow-up evaluations post-baseline, calculating ICCs, SEM, SRD, ES, and SRM.
Main Results:
- The GMFM-88 demonstrated excellent relative reliability (ICCs=.952-1.000).
- Acceptable absolute reliability was indicated by SEM (1.60) and SRD (3.14) for the total score.
- Effect size and standardized response mean values showed gradual increases across follow-up assessments, indicating responsiveness.
Conclusions:
- The GMFM-88 exhibits reasonable reliability and responsiveness for evaluating gross motor function in children with CP.
- Results should be interpreted with caution for children over 10 years old due to their exclusion from the study.
Background:
The Gross Motor Function Measure (GMFM-88) is commonly used in the evaluation of gross motor function in children with cerebral palsy (CP). The relative reliability of GMFM-88 has been assessed in children with CP. However, little information is available regarding the absolute reliability or responsiveness of GMFM-88.
Objective:
The purpose of this study was to determine the absolute and relative reliability and the responsiveness of the GMFM-88 in evaluating gross motor function in children with CP.
Design:
A clinical measurement design was used.
Methods:
Ten raters scored the GMFM-88 in 84 children (mean age=3.7 years, SD=1.9, range=10 months to 9 years 9 months) from video records across all Gross Motor Function Classification System (GMFCS) levels to establish interrater reliability. Two raters participated to assess intrarater reliability. Responsiveness was determined from 3 additional assessments after the baseline assessment. The interrater and intrarater intraclass correlation coefficients (ICCs) with 95% confidence intervals, standard error of measurement (SEM), smallest real difference (SRD), effect size (ES), and standardized response mean (SRM) were calculated.
Results:
The relative reliability of the GMFM was excellent (ICCs=.952-1.000). The SEM and SRD for total score of the GMFM were acceptable (1.60 and 3.14, respectively). Additionally, the ES and SRM of the dimension goal scores increased gradually in the 3 follow-up assessments (GMFCS levels I and II: ES=0.5, 0.6, and 0.8 and SRM=1.3, 1.8, and 2.0; GMFCS levels III-V: ES=0.4, 0.7, and 0.9 and SRM=1.5, 1.7, and 2.0).
Limitations:
Children over 10 years of age with CP were not included in this study, so the results should not be generalized to all children with CP.
Conclusions:
Both the reliability and the responsiveness of the GMFM-88 are reasonable for measuring gross motor function in children with CP.
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