Stability of the gross motor function classification system in children with cerebral palsy for two years

Area of Science:

• Pediatrics
• Neurology
• Rehabilitation Medicine

Background:

• Gross motor function prognosis is crucial for pediatric cerebral palsy (CP) interventions.
• The Gross Motor Function Classification System (GMFCS) aids professional-family communication and is actively studied.
• Understanding GMFCS stability is vital for effective therapeutic planning in children with CP.

Purpose of the Study:

• To evaluate the stability of the Gross Motor Function Classification System (GMFCS) over a two-year period in children diagnosed with cerebral palsy (CP).
• To investigate the influence of age on GMFCS stability in children with CP.
• To provide evidence-based recommendations for GMFCS assessment frequency.

Main Methods:

• The GMFCS levels of 100 children with CP (aged 2-12 years) were assessed at three time points.
• Participants were undergoing rehabilitation or attending special elementary schools in South Korea.
• Statistical analysis using weighted kappa coefficients was employed to determine inter-rater reliability and stability.

Main Results:

• Statistically significant weighted kappa coefficients (p < .05) indicated overall GMFCS stability.
• Coefficients ranged from 0.690 to 0.789 for children aged 2-12 years, suggesting good reliability.
• A lower coefficient (0.557) was observed in the 2-4 year age group between the first and third measurements, indicating potential for change.

Conclusions:

• GMFCS demonstrated stability for the first year, with potential for changes during the second year, particularly in younger children (2-4 years).
• GMFCS stability is influenced by time, duration of assessment, and the child's age.
• Periodic GMFCS assessments are recommended, with increased necessity for children aged 2-4 years to track functional changes accurately.