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Reliability of retrospective assignment of gross motor function classification system scores
T A Mayson1, V Ward, K R Davies
1Shriners Gait Lab, Sunny Hill Health Centre for Children, Vancouver, British Columbia, Canada. tmayson@cw.bc.ca
Insights
Retrospective Gross Motor Function Classification System (GMFCS) scores demonstrate reliable alternate forms and inter-rater reliability. This suggests retrospective GMFCS scoring is a valid method for assessing children with cerebral palsy.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- The Gross Motor Function Classification System (GMFCS) is a widely used tool for classifying motor function in children with cerebral palsy.
- Reliability of GMFCS scoring is crucial for accurate assessment and treatment planning.
Purpose of the Study:
- To evaluate the alternate forms reliability and inter-rater reliability of GMFCS scores.
- To determine if retrospective GMFCS score assignment is a reliable method.
Main Methods:
- Fifty children with cerebral palsy were assessed.
- Two physiotherapists independently assigned GMFCS scores to children based on database information.
- Scores were compared to assess inter-rater reliability and alternate forms reliability.
Main Results:
- High inter-rater reliability was observed, with kappa values of 0.84 and 0.95.
- Alternate forms reliability between direct and retrospective assessment was 0.79.
- These findings indicate strong agreement between different methods of GMFCS scoring.
Conclusions:
- Retrospective assignment of GMFCS scores is a reliable method.
- This supports the use of retrospective data for GMFCS classification in children with cerebral palsy.
Objectives:
To assess "alternate forms" reliability and inter-rater reliability of Gross Motor Function Classification System (GMFCS) scores.
Methods:
Fifty randomly selected children with cerebral palsy were divided into two groups: (1) GMFCS score assigned during gait assessment ("GMFCS previously assigned") and (2) no GMFCS score assigned. Using database information, two physiotherapists independently determined GMFCS scores for 25 children from the "previously assigned" group, and 25 from the "no score assigned" group. Therapists compared their recently assigned scores for the "previously assigned" group, discussing discrepancies until attaining agreement. This group's consensus scores were compared to GMFCS scores assigned at time of actual assessment to calculate "alternate forms" reliability.
Results:
Between-therapist agreements were kappa = 0.84 for "GMFCS previously assigned" group and 0.95 for "no GMFCS assigned" group. Kappa agreement between direct assessment and retrospectively assigned scores for the "GMFCS previously assigned" group was 0.79.
Conclusions:
Retrospective GMFCS scores can be reliably assigned.
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