Gross Motor Function Classification System and outcome tools for assessing ambulatory cerebral palsy: a multicenter study

The relationships between different levels of severity of ambulatory cerebral palsy, defined by the Gross Motor Function Classification System (GMFCS), and several pediatric outcome instruments were examined. Data from the Gross Motor Function Measure (GMFM), Pediatric Orthopaedic Data Collection In...

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Bibliographic Details
Published in:Developmental medicine and child neurology 2004-05, Vol.46 (5), p.311-319
Main Authors: Oeffinger, D J, Tylkowski, C M, Rayens, M K, Davis, R F, Gorton, III, G E, D'Astous, J, Nicholson, D E, Damiano, D L, Abel, M F, Bagley, A M, Luan, J
Format: Article
Language:English
Subjects:
Adolescent
Adult
Ambulatory Care
Anatomy
Cerebral Palsy
Cerebral Palsy - epidemiology
Cerebral Palsy - physiopathology
Child
Child, Preschool
Cluster Analysis
Confidence Intervals
Content Validity
Data Collection
Disability Evaluation
Female
Humans
Interpersonal Relations
Interrater Reliability
Logistic Models
Male
Measurement Techniques
Motor Skills Disorders - classification
Motor Skills Disorders - etiology
Original Articles
Outcome Assessment (Health Care) - methods
Oxygen Consumption - physiology
Reproducibility of Results
Severity of Illness Index
Social Environment
Test Reliability
Validity
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Summary:The relationships between different levels of severity of ambulatory cerebral palsy, defined by the Gross Motor Function Classification System (GMFCS), and several pediatric outcome instruments were examined. Data from the Gross Motor Function Measure (GMFM), Pediatric Orthopaedic Data Collection Instrument (PODCI), temporal–spatial gait parameters, and oxygen cost were collected from six sites. The sample size for each assessment tool ranged from 226 to 1047 participants. There were significant differences among GMFCS levels I, II, and III for many of the outcome tools assessed in this study. Strong correlations were seen between GMFCS level and each of the GMFM sections D and E scores, the PODCI measures of Transfer and Mobility, and Sports and Physical Function, Gait Velocity, and Oxygen Cost. Correlations among tools demonstrated that the GMFM sections D and E scores correlated with the largest number of other tools. Logistic regression showed GMFM section E score to be a significant predictor of GMFCS level. GMFM section E score can be used to predict GMFCS level relatively accurately (76.6%). Study data indicate that the assessed outcome tools can distinguish between children with different GMFCS levels. This study establishes justification for using the GMFCS as a classification system in clinical studies.
ISSN:0012-1622
1469-8749
DOI:10.1017/S0012162204000519