How does the intensity of physical therapy affect the Gross Motor Function Measure (GMFM-66) total score in children with cerebral palsy? A systematic review protocol (original) (raw)
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Test-Retest Reliability of the Gross Motor Function Measure in Children with Cerebral Palsy
Pediatric Physical Therapy, 2000
The purpose of this study was to describe the test-retest reliability of the Gross Motor Function Measure (GMFM) in children with cerebral palsy. The GMFM was administered twice, within a oneweek time period, to twenty-one children with cerebral palsy. The time of day, therapists, and evaluation setting were held constant. Intra-class correlations ranged from .76 to 1.00. The data suggest that the GMFM is consistent in the measurement of gross motor skills and that children with cerebral palsy exhibit stable gross motor skills during repeat measurement. This information will be helpful in future analysis of treatment efficacy using the GMFM as an outcome measure. (Article copies available for a fee Jkoin The Haworth Docwnent Delivery Phys Occup Ther Pediatr Downloaded from informahealthcare.com by University of Washington on 08/18/14
Physical Therapy, 2000
Background and Purpose. This study examined the reliability, validity, and responsiveness to change of measurements obtained with a 66-item version of the Gross Motor Function Measure (GMFM-66) developed using Rasch analysis. Subjects and Methods. The validity of measurements obtained with the GMFM-66 was assessed by examining the hierarchy of items and the GMFM-66 scores for different groups of children from a stratified random community-based sample of 537 children with cerebral palsy (CP). A subset of 228 children who had been reassessed at 12 months was used to test the hypothesis that children who are young (Ͻ5 years of age) and have "mild" CP will demonstrate greater change in GMFM-66 scores than children who are older (Ն5 years of age) and whose CP is more severe. Data from an additional 19 children with CP who were assessed twice, one week apart, were used to examine test-retest reliability. Results. The overall changes in GMFM-66 scores over 12 months and a time ϫ severity ϫ age interaction supported our hypotheses. Test-retest reliability was high (intraclass correlation coefficientϭ.99). Conclusion and Discussion. This study demonstrated that the GMFM-66 has good psychometric properties. By providing a hierarchical structure and interval scaling, the GMFM-66 can provide a better understanding of motor development for children with CP than the 88 item GMFM and can improve the scoring and interpretation of data obtained with the GMFM. [Russell DJ, Avery LM, Rosenbaum PL, et al. Improved scaling of the Gross Motor Function Measure for children with cerebral palsy: evidence of reliability and validity. Phys Ther. 2000;80:873-885.]
Improved scaling of the Gross Motor Function Measure for children with cerebral palsy
Physical Therapy
Background and Purpose. This study examined the reliability, validity, and responsiveness to change of measurements obtained with a 66-item version of the Gross Motor Function Measure (GMFM-66) developed using Rasch analysis. Subjects and Methods. The validity of measurements obtained with the GMFM-66 was assessed by examining the hierarchy of items and the GMFM-66 scores for different groups of children from a stratified random community-based sample of 537 children with cerebral palsy (CP). A subset of 228 children who had been reassessed at 12 months was used to test the hypothesis that children who are young (Ͻ5 years of age) and have "mild" CP will demonstrate greater change in GMFM-66 scores than children who are older (Ն5 years of age) and whose CP is more severe. Data from an additional 19 children with CP who were assessed twice, one week apart, were used to examine test-retest reliability. Results. The overall changes in GMFM-66 scores over 12 months and a time ϫ severity ϫ age interaction supported our hypotheses. Test-retest reliability was high (intraclass correlation coefficientϭ.99). Conclusion and Discussion. This study demonstrated that the GMFM-66 has good psychometric properties. By providing a hierarchical structure and interval scaling, the GMFM-66 can provide a better understanding of motor development for children with CP than the 88 item GMFM and can improve the scoring and interpretation of data obtained with the GMFM. [Russell DJ, Avery LM, Rosenbaum PL, et al. Improved scaling of the Gross Motor Function Measure for children with cerebral palsy: evidence of reliability and validity. Phys Ther. 2000;80:873-885.]
International Journal of Human Movement and Sports Sciences, 2022
This study aimed to evaluate the effect of physical exercise intervention on gross motor function in children with cerebral palsy (CP). Computer searches of Web of Science, PubMed, Embase (Ovid), Cochrane Library, and Medline databases were conducted on October 6, 2021. Randomized controlled trials (RCTs) or quasi-experimental studies were included. Ten methodological quality trials were identified, and the literature's quality was assessed using the PEDro scale. Data from the Gross Motor Function Assessment Scale GMFM-66, GMFM-88 and A (lying and turning), B (sitting), C (climbing and kneeling), D (standing), and E (walking, running, and jumping) dimension scores were extracted, and Meta-analysis was performed using Revman 5.4. Data were pooled and expressed as mean difference (MD) or standardized difference (SMD) with 95% CI. The results showed that GMFM-66 [SMD=1.
The Gross Motor Performance Measure: validity and responsiveness of a measure of quality of movement
Physical therapy, 1995
This article presents the results of a study to validate a measure of gross motor performance for its capacity to detect changes in the quality of movement in children with cerebral palsy aged 0 to 12 years. On two occasions, 4 to 6 months apart, physical therapists from three children's treatment centers assessed 106 children with cerebral palsy, 18 children who had sustained an acute head injury, and 29 nondisabled children. Validity was demonstrated by comparing changes on the measure across diagnoses, severity, and age groups. Several a priori hypotheses were supported; however, relationships with parent and therapist ratings were not clearly demonstrated. The measure was found to be differentially responsive to changes in "stable" and "responsive" groups.
Pediatric Physical Therapy, 2006
Purpose/Hypothesis: The purpose of this pilot study was to examine the effects of an intensive therapy protocol that uses the TheraSuit TM on the gross motor performance of children with cerebral palsy (CP). Number of Subjects: Participants were 20 children with CP. The mean age was 7 years with a range of 3-17. Children were classified into Gross Motor Function Classification System (GMFCS) levels. Materials/Methods: A pre and posttest design with one group was used. The children received therapy 4 hours a day, 5 days a week for 3 weeks using primary equipment of a TheraSuit TM and a universal exercise unit. The GMFM was videotaped for each child. The outcome measures were the Gross Motor Function Measure (GMFM), clinical judgment of change, and observation of postural alignment, latency of response, and duration of movement [quality of movement]. Rater reliability on the measures was determined before data collection. An investigator who was unfamiliar with the children and blinded to test order assessed the videotapes by scoring the GMFM and a clinical observation checklist that assessed quality of movement. Spearman rho correlation coefficients examined relationships among GMFM scores and participant characteristics. Paired sample t tests assessed changes in GMFM88, GMFM66, and quality of movement. A repeated measure MANOVA examined changes in pre and post GMFM88 and GMFM66 mean scores based on GMFCS levels. Results: The GMFM88 and GMFM Goal Total mean scores increased following the intervention (t ϭ-3.566, P ϭ 0.002 and t ϭ-3.094, P ϭ 0.006, respectively), but the GMFM66 mean scores and quality of movement mean totals did not. The correlation coefficients between Pediatric Physical Therapy Abstracts for the 2006 Combined Sections Meeting 73 strength training on quality of life. The purpose of this case study is to report the effect of strength training in a 17 year old female with cerebral palsy. Case Description: The subject is a 17 year old female with spastic quadriplegic CP who received Botox and Phenol injections to her bilateral lower extremities. She attended a day hospital rehabilitation program where she received 1.5 hours of physical therapy and 1 hour of occupational therapy 5 days per week. The subject participated in a 6 week therapy regimen which focused on quadriceps and gluteal strengthening 3 days per week and general balance and gait training on alternate days. Initial load for weight training was calculated as 65% of her maximal isometric knee extension and hip extension peak torque as measured on the Biodex System 3. Repetitions and/or exercise load was increased as the subject demonstrated improvement in ability to perform prescribed exercises. Isometric peak torque, TUG, the 9 minute walk run, EEI, GMFM, and the PedsQL were performed pre and post physical therapy intervention. Outcomes: Isometric peak torque for knee extension increased 92% and hip extension 57%, 9 minute walk run improved 1105 feet, EEI decreased from 4.7 to 0.99 beats/m, GMFM total increased 12% and standing domain increased 41%, TUG decreased 3.72 seconds, PedsQL decreased 9 points Discussion: Dramatic improvements were noted in gluteal and quadriceps strength following the 6 week strength training program. Although items from the GMFM were not specifically practiced, the subject showed improvement in all areas, most significantly in the domain of standing. Additionally, while endurance training was not a focus of physical therapy, significant change was made on the 9 minute walk run as well as the EEI. Most notably, the subjects EEI improved to within normal limits for healthy age-matched peers. Items of improvement on the PedsQL included attitude toward walking, participation in household chores, feeling afraid and keeping up with and fitting in with peers. Though the PedsQL has been shown as a reliable and valid measure of quality of life in pediatric populations, there have been few comments in the literature associating a physical therapist prescribed strengthening program with quality of life in children with chronic health conditions such as cerebral palsy. The dramatic improvements in strength, function, endurance, and energy expenditure seen in this subject corresponded to an improvement in quality of life as measured by the PedsQL. Further research is warranted to examine this relationship. This case supports the use of intensive strength training as a primary physical therapy intervention to achieve patient and family goals related to function and quality of life.
Indonesian Journal of Physical Medicine & Rehabilitation, 1970
Objectives: Cerebral palsy (CP) is the most physical disabling disease in children. Gross motor capacity in CP usually measured and evaluated by Gross Motor Function Measure (GMFM), a standardizedobservational instrument to evaluate gross motor function. Studies showed GMFM reliable, valid, and responsive to change of CP gross motor function. This research aims to examine validity and reliabilityof GMFM translated into Indonesian.Methods: Cross sectional study with consecutive sampling of CP children aged 2-15 years came to pediatric rehabilitation clinic at RSCM Medical Rehabilitation Department or YPAC Jakarta. Subjects classified by age, type, anatomical distribution, and severity.Gross motor function evaluated with 88 GMFM items translated into Indonesia. Inter-rater evaluated gross motor function through video records. Criterion validity tested by correlation coefficient, construct validity tested by comparing GMFM item with dimension total scores and GMFM total score with co...
Acta Medica Academica, 2010
Objective. To determine the outcome of rehabilitation treatment after orthopedic-surgical treatment of the lower extremities in relation to motor function and degree of disability in children with cerebral palsy. Subjects and methods. An historical-prospective study included 44 treated children with CP from May 2000 until June 2009 at the Department of Physical Medicine and Rehabilitation University Clinical Centre Tuzla. The main criteria for entering the study were diagnosed CP and performed orthopedic-surgery of the lower extremities during rehabilitation treatment. Assessment of the motor function score was performed according to the Gross Motor Function Measure 88 (GMFM-88), and classification of the degree of disability was developed based on the scale of the Gross Motor Function Classification System (GM-FCS). Results. In our study, motor functions were improved, so that the median value and interquartil range (IQR) of the total GMFM score before surgery was 35.7 (IQR from 22.9 to 57.2), and after postoperative rehabilitation 58.6 (IQR from 31.2 to 85.2) with a high statistical significance (p<0.0001). Median value GMFCS scores before surgery ranged around 5 (IQR from 4 to 5), and after postoperative rehabilitation ranged around 3 (IQR from 2 to 5), which shows a highly statistically significant reduction in the degree of disability (p<0.001). Conclusion. Surgical intervention performed on the lower extremities in children with cerebral palsy may improve motor function in all developmental stages and reduce the degree of disability with intensive rehabilitation.
Targeted selection of physical exercises and right use of methods made on the basis of correct diagnosis represent important factors for ensuring targetoriented physical therapy treatment. The objective of our research was measuring effectiveness of physical therapy treatment in cases of cerebral palsy, and defining the influence of correct and targeted physical therapy treatment on functional independence. Importance of the research outcomes on early regular physical therapy treatment effects [using Gross Motor Function Measure] lies in fact that according to the study, it is essential to start treatment from the very early age for the purpose of effective controlling of anomalous patterns. The study has also shown that the goal and target oriented physical therapy treatment results in decrease of disability levels and increases quality life of persons with disabilities