Related Experiment Video
Updated: May 16, 2026
Repeated Transcranial Magnetic Stimulation Combined with Action Observation Training in Children with Spastic Cerebral Palsy
Published on: August 9, 2024
Factor analysis of the WeeFIM in children with spastic cerebral palsy
Eun-Young Park1, Won-Ho Kim, Yoo-Im Choi
1Department of Secondary Special Education, College of Education, Jeonju University, Jeonju, Republic of Korea.
Insights
This study found that the Functional Independence Measure for Children (WeeFIM) has three distinct factors—self-care, motor, and cognitive—in children with spastic cerebral palsy (CP). These findings suggest using separate scales for each domain to improve assessment accuracy for spastic CP.
Area of Science:
- Pediatrics
- Rehabilitation Medicine
- Neuroscience
Background:
- The Functional Independence Measure for Children (WeeFIM) is a tool used to assess functional abilities in children.
- Understanding the psychometric properties of the WeeFIM is crucial for accurately evaluating children with spastic cerebral palsy (CP).
- Previous factor analyses of the WeeFIM in this population have yielded varied results.
Purpose of the Study:
- To investigate the factor structure of the WeeFIM in children diagnosed with spastic cerebral palsy (CP).
- To determine the reliability and validity of the WeeFIM for assessing this specific pediatric population.
Main Methods:
- A cross-sectional study involving 207 children with spastic CP (mean age 9.10 years).
- Data collected via questionnaire including the WeeFIM.
- Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were employed to analyze the WeeFIM's factor structure.
- Internal consistency was assessed using Cronbach's alpha.
Main Results:
- The WeeFIM demonstrated high internal consistency (Cronbach's α = 0.98).
- Confirmatory factor analysis indicated that 1- and 2-factor models did not fit the data adequately.
- A 3-factor structure (self-care, motor, and cognitive) was supported by both EFA and CFA, explaining 87.12% of the variance.
Conclusions:
- Factor analysis identified three distinct domains within the WeeFIM for children with spastic CP: self-care, motor, and cognitive.
- The study recommends treating these three domains as separate scales for more precise assessment in children with spastic CP.
- This approach can enhance the comprehensive evaluation of functional independence in this population.
Purpose:
Determining the psychometric properties such as reliability and validity of Functional Independence Measure for Children (WeeFIM) instrument would help health professionals to understand the comprehensive assessment of children with spastic cerebral palsy (CP). The purpose of this study was to investigate the factor structure of the WeeFIM in children with spastic CP.
Methods:
Two hundred seven children (138 boys, 69 girls) with spastic CP were recruited in this cross-sectional study; their mean age (SD) was 9.10 (2.7) years. Data were collected through a questionnaire that included the WeeFIM. Of the 207 children, 57 (27%), 105 (51%), and 45 (22%) were quadriplegic, diplegic, and hemiplegic, respectively. In each of these groups, 49 (24%), 32 (15%), 31 (15%), 19 (9%), and 76 (37%) children were classified as Gross Motor Function Classification System (GMFCS) levels I-V, respectively. The factor structure of the WeeFIM was analyzed by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) by using AMOS 20.0. The reliability of WeeFIM was assessed by calculating the internal consistency of Cronbach's α.
Results:
The internal consistency of Cronbach's α was 0.98. The 1- and 2-factor models did not demonstrate adequate fit indices according to CFA. However, the 3-factor structure (i.e. self-care, motor, and cognitive factors) was supported by EFA and CFA, which explained 87.12% of the variance. The self-care factor included 6 items (eating, grooming, dressing upper, dressing lower, bathing, and toileting), the motor factor included 7 items (bladder and bowel management, bed/chair/wheelchair, toilet, tub/shower, walk/wheelchair, and stairs), and the cognitive factor included the same 5 items as the original cognitive domain.
Conclusion:
In children with spastic CP, 3 factors of the WeeFIM were determined by factor analysis. Therefore, self-care, motor, and cognitive domains should be treated as separate scales in children with spastic CP.
