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Measures of Motor and Functional Skills for Children With Cerebral Palsy: A Systematic Review
Marina Ferre-Fernández1, María Antonia Murcia-González, María Dolores Barnuevo Espinosa
1Departamento de Ciencias de la Salud (Ms Ferre-Fernández and Dr Murcia-González) and Cátedra de Fisiología del Ejercicio (Dr Barnuevo Espinosa), Facultad de Ciencias de la Salud, Universidad Católica de Murcia, Murcia, Spain; Fundación San Juan de Dios, Centro Universitario de Ciencias de la Salud San Rafael (Dr Ríos-Díaz), Universidad Antonio de Nebrija, Madrid, Spain.
Insights
The Gross Motor Function Measure is a reliable tool for assessing motor skills in children with cerebral palsy. Further research is needed to improve its reliability for stability assessment.
Area of Science:
- Pediatric rehabilitation
- Clinical assessment tools
- Child development
Background:
- Cerebral palsy (CP) affects motor skills in children.
- Standardized outcome measures are crucial for tracking progress.
- The Gross Motor Function Classification System (GMFCS) categorizes functional abilities.
Purpose of the Study:
- To systematically review the evidence for psychometric properties of motor and functional outcome measures.
- To evaluate measures for children with cerebral palsy across GMFCS levels I-V.
Main Methods:
- Systematic literature search across multiple databases (PubMed/MEDLINE, Web of Science, CINAHL, etc.).
- Quality assessment using the COSMIN Risk of Bias checklist and updated measurement criteria.
Main Results:
- Four key outcome measures identified: Gross Motor Function Measure (GMFM), Gross Motor Performance Measure (GMPM), Pediatric Evaluation of Disability Inventory (PEDI), and Functional Independence Measure for Children (WEEFIM).
- Evidence for validity, reliability, and responsiveness varied across these measures.
- The GMFM demonstrated the strongest evidence for validity and responsiveness.
Conclusions:
- The GMFM is the most investigated measure with the strongest psychometric evidence for children with cerebral palsy.
- While GMFM shows good validity and responsiveness, further research is recommended to enhance reliability evidence, particularly for stability.
- The findings guide the selection of appropriate outcome measures in pediatric CP research and clinical practice.
Purpose:
To review the level of evidence of the psychometric properties of outcome measures for motor or functional skills for children with cerebral palsy classified across I to V levels of the Gross Motor Function Classification System.
Methods:
A systematic search was completed in PubMed/MEDLINE, ISI Web of Science, CINAHL, and 4 complementary databases. The COSMIN Risk of Bias checklist and the updated criteria for good measurement properties were applied to assess the quality.
Results:
Four outcome measures were identified from 12 articles: Gross Motor Function Measure, Gross Motor Performance Measure, Pediatric Evaluation of Disability Inventory, and Functional Independence Measure for Children. Evidence levels for validity, reliability, and responsiveness varied among measures.
Conclusions:
Gross Motor Function Measure in all versions was the most investigated measure providing the best results, with the strongest evidence for validity and responsiveness properties. Reliability evidence should be improved to determine stability.
