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Using artificial intelligence-based technologies to detect clinically relevant changes of gross motor function in
Leonie Schafmeyer1,2, Heike Losch2, Christiane Bossier1,3
1University of Cologne, Medical Faculty and University Hospital, Center of Prevention and Rehabilitation, UniReha, Cologne, Germany.
Insights
The reduced Gross Motor Function Measure (rGMFM-66) accurately detects changes in gross motor function for children with cerebral palsy (CP). This shorter version is a time-saving alternative to the full GMFM-66, suitable for clinical practice.
Area of Science:
- Pediatric Rehabilitation
- Movement Science
- Clinical Assessment Tools
Background:
- Cerebral palsy (CP) significantly impacts gross motor function in children.
- Accurate and efficient measurement of motor function is crucial for rehabilitation progress monitoring.
- The 66-item Gross Motor Function Measure (GMFM-66) is a standard tool, but its length can be a limitation.
Purpose of the Study:
- To compare the efficacy of the 66-item Gross Motor Function Measure (GMFM-66) with its reduced version (rGMFM-66).
- To assess the ability of both measures to detect clinically relevant changes in gross motor function in children with CP.
Main Methods:
- Retrospective analysis of 1352 GMFM-66 and rGMFM-66 measurements from children with CP undergoing rehabilitation.
- Measurements were taken at 5- to 7-month intervals.
- Individual effect size (iES) was calculated to quantify clinically relevant changes.
Main Results:
- A strong correlation (r=0.84) was found between iES calculated using GMFM-66 and rGMFM-66.
- The rGMFM-66 demonstrated excellent agreement in detecting clinically relevant gross motor improvement (AUC=0.90) and deterioration (AUC=0.95).
Conclusions:
- The reduced GMFM-66 (rGMFM-66) is a valid and reliable tool for assessing gross motor function changes in children with CP.
- The rGMFM-66 offers a time-efficient alternative to the full GMFM-66, making it practical for routine clinical use.
Aim:
To compare the 66-item Gross Motor Function Measure (GMFM-66) with the reduced version of the GMFM-66 (rGMFM-66) with respect to the detection of clinically relevant changes in gross motor function in children with cerebral palsy (CP).
Method:
The study was a retrospective single centre analysis of children with CP who participated in a rehabilitation programme. Overall, 1352 pairs of GMFM-66 and rGMFM66 measurements with a time interval of 5 to 7 months were available. To measure clinically relevant changes in gross motor function, the individual effect size (iES) was calculated.
Results:
The study population consisted of 1352 children (539 females), mean age 6 years 4 months (SD 2 years 4 months). The iES based on the GMFM-66 and the rGMFM-66 showed a significant correlation (r = 0.84, p < 0.001). The analysis of the area under the receiver operating characteristic curve showed an excellent agreement for clinically relevant gross motor improvement (Cohen's d ≥ 0.5; area under the curve = 0.90 [95% confidence interval 0.88-0.92]) or deterioration (Cohen's d ≤ -0.5; area under the curve = 0.95 [95% confidence interval 0.92-0.97]).
Interpretation:
Performing the rGMFM-66 saves time compared to the full GMFM-66. The rGMFM-66 showed good agreement with the GMFM-66 with respect to the detection of clinically relevant changes in gross motor function in children with CP, so its use in everyday clinical practice seems justifiable.
What This Paper Adds:
The reduced version of the 66-item Gross Motor Function Measure (rGMFM-66) detects clinically relevant changes in gross motor function in children with cerebral palsy. The rGMFM-66 correlates highly with the full GMFM-66. The rGMFM-66 can be used in clinical practice when the time schedule is limited.
