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Longitudinal reference centiles for the Gross Motor Function Measure-66 in children and adolescents with cerebral
Ibrahim Duran1,2, Leonie Schafmeyer1, Bruno Lentzen1,2
1University of Cologne, Medical Faculty and University Hospital Center of Prevention and Rehabilitation, UniReha, Cologne, Germany.
Insights
New reference values for the Gross Motor Function Measure-66 (GMFM-66) in children with cerebral palsy aged 3-18 years have been established. These values enable more accurate tracking of motor function changes over time.
Area of Science:
- Pediatric rehabilitation
- Neurology
- Biostatistics
Background:
- Accurate assessment of motor function changes is crucial for children with cerebral palsy (CP).
- Existing reference values for the Gross Motor Function Measure-66 (GMFM-66) have limitations in age range.
- Longitudinal data is needed to establish reliable assessment tools for CP.
Purpose of the Study:
- To establish novel longitudinal reference values for the GMFM-66 in children and adolescents with CP.
- To extend the age range for GMFM-66 reference values to 18 years.
- To enable more precise evaluation of motor function changes in CP.
Main Methods:
- Retrospective analysis of 1190 paired GMFM-66 measurements from patients in a rehabilitation program (2006-2022).
- Application of the lambda-mu-sigma method to establish reference centiles for GMFM-66 change over 6 months.
- Validation of new reference values against existing methods.
Main Results:
- New reference centiles for GMFM-66 changes over 6 months were created for ages 3-18 years.
- The new values demonstrated a high correlation with previously published values (Pearson's r = 0.981).
- The established z-scores for GMFM-66 change showed high correlation with individual effect size calculations.
Conclusions:
- Novel longitudinal GMFM-66 reference values for children with CP aged 3-18 years have been successfully established.
- These new values extend the applicability of GMFM-66 assessments to older children with CP.
- The findings facilitate improved evaluation of medical treatments and rehabilitation progress in pediatric CP.
Aim:
To establish novel longitudinal reference values for the Gross Motor Function Measure-66 (GMFM-66) in children and adolescents with cerebral palsy aged 3 to 18 years, to enable more accurate assessments of changes in motor function.
Method:
This was a single-centre retrospective analysis of patients who participated in a rehabilitation programme between January 2006 and March 2022. The GMFM-66 was used to measure gross motor function. Paired GMFM-66 measurements from the follow-up phase of the rehabilitation programme were used to establish a reference centile for the change in GMFM-66 over a 6-month period using the lambda-mu-sigma method.
Results:
Reference centiles for GMFM-66 changes (over a 6-month period; ±1 month) were created using 1190 longitudinal data pairs of GMFM-66 measurements (mean age 8 years 4 months [standard deviation 7 years 11 months] at start of follow-up), Gross Motor Function Classification System levels I to V. The z-scores for GMFM-66 change of a validation dataset by the new tool and the previously described method to quantify a change in GMFM-66 by individual effect size were highly correlated (Pearson's rank correlation coefficient 0.981 [95% confidence interval 0.979-0.984], p < 0.001) INTERPRETATION: The new reference values showed a high correlation with the previously published reference values, which were limited to an age range of 3 to 12 years. The new reference values can be applied from an age of 3 to 18 years. This facilitates the evaluation of medical treatment after a 6-month period also for children with cerebral palsy who are older than 12 years.
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