Reliability and Responsiveness of the Gross Motor Function Measure-88 in Children With Cerebral Palsy

J. Ko, M. Kim
2012 Physical Therapy  
OBJECTIVES Cerebral Palsy (CP) is the most common disorder resulting in physical disability in children. Physical therapy is the most important modality because children's disabilities primarily entail motor dysfunction. In clinical and research purposes, it is important to determine the effects of therapeutic interventions on motor function with reliable and valid tests. Several evaluation measures are available to assess gross motor development in children with CP , the Gross Motor Function
more » ... asure (GMFM) is the best known and most used around the world. The purpose of this study was to provide valuable information for clinical uses and research purposes by fully estimating the relative and absolute reliabilities and responsiveness of the GMFM-88 for children with CP. METHODS Ten raters scored GMFM-88 of 84 children (mean age: 3.7±1.9 years, range, 10 months to 9 years, 9 months) ( Table 1) from video records across all GMFCS levels to establish interrater reliability. Two raters participated to assess intra-rater reliability. Responsiveness was determined from three additional assessments after the baseline assessment. The inter-and intra-rater intraclass correlation coefficient (ICC) with 95% confidence intervals, standard error of measurement (SEM), smallest real difference (SRD), effect size (ES), and standardized response mean (SRM) were calculated RESULTS The relative reliabilities of the GMFM were excellent (ICCs = 0.986-1.000). The SEM and SRD for total score of the GMFM were acceptable (1.60 and 3.14, respectively) ( Table 2) . Additionally, the ES and SRM of the dimension goal scores increased gradually in the three follow-up assessments (GMFCS level I-II: ES = 0.5, 0.6, and 0.8, SRM = 1.3, 1.8, and 2.0; GMFCS III-V: ES = 0.4, 0.7, and 0.9, SRM = 1.5, 1.7, and 2.0) ( Table 3) .
doi:10.2522/ptj.20110374 pmid:23139425 fatcat:rci6xdhrw5aylgoxfuw5uovh7m