Gross Motor Function Classification System Expanded & Revised (GMFCS E & R): reliability between therapists and...

Area of Science:

• Pediatrics
• Rehabilitation Medicine
• Neurology

Background:

• Cerebral palsy (CP) significantly impacts gross motor function in children.
• The Gross Motor Function Classification System (GMFCS) is crucial for assessing CP-related motor impairments.
• Reliability of the GMFCS Expanded & Revised (E&R) in Brazil requires investigation.

Purpose of the Study:

• To assess the intra- and inter-rater reliability of the Portuguese-Brazil GMFCS E&R version.
• To compare therapist classifications with parent-reported data using the GMFCS Family Report Questionnaire.
• To validate the GMFCS E&R for clinical use in Brazil.

Main Methods:

• Study involved 90 children with CP (ages 4-18) in Brazil.
• Therapists utilized the GMFCS E&R for motor function assessment.
• Parents completed the GMFCS Family Report Questionnaire; reliability analyzed using Kappa statistics.

Main Results:

• Therapist inter-rater reliability was almost perfect (Kappa=0.90).
• Therapist intra-rater reliability was perfect (Kappa=1.00).
• Agreement between therapists and parents was substantial (Kappa=0.716), with parents reporting more severe impairment.

Conclusions:

• The Portuguese GMFCS E&R demonstrates high reliability for both therapists and parents.
• Parents may perceive their child's gross motor limitations as more severe due to environmental context.
• The GMFCS E&R is a reliable tool for CP assessment in Brazil.