Gross Motor Function Measure
Introduction
The Gross Motor Function Measure (GMFM) is an observational clinical tool designed to evaluate change in gross motor function in children with cerebral palsy. There are two versions of the GMFM - the original 88-item measure (GMFM-88) and the more recent 66-item GMFM (GMFM-66) [1] .
Objective
The objective of Gross Motor Function Measure is to evaluate the gross motor functions in children with Cerebral Palsy (CP). The evaluation of motor function is essential to monitor and adjust therapies to optimize the effect of rehabilitation of children with cerebral palsy (CP).
Intended Population
Children with Cerebral Palsy (CP) aged between 5 months to 16 years whose motor skills is delayed compared to those of the same age. Although the GMFM-88 has been developed for children with CP, it is also validated for other populations, such as children with Down Syndrome and acquired brain damage. Whereas the GMFM-66 is so far only validated in children with CP [2] .
Method of Use
The GMFM-88 item scores can be summed to calculate raw and percent scores for each of the five GMFM dimensions of interest, selected goal areas and a total GMFM-88 score. For the GMFM-66 a free computer program, the Gross Motor Ability Estimator (GMAE), is required to calculate total scores.
GMFM Scores
The scoring system of the GMFM is a four-point scale that consists of 66 items divided into five dimensions of gross motor function:(a) lying and rolling, (b) sitting, (c) crawling and kneeling, (d) standing, and (e) walking, running and jumping [3]. Specific descriptors for scoring items are detailed in the administration and scoring guidelines. A 5-year old child without motor disabilities is able to reach the maximum score [1] .
Time Administer
Administering the GMFM-88 may take approximately 45 to 60 minutes for someone familiar with the measure, depending on the skill of the assessor, the ability of the child and the child’s level of the cooperation and understanding. The GMFM-66 should take less time to administer as there are fewer items [1] .
Required Qualifications
The GMFM was designed for use by pediatric therapists who are familiar with assessing motor skills in children. Users should familiarize themselves with the GMFM guidelines and score sheet prior to assessing children.
Equipment Needed
Physiotherapy gym (e.g mat, bench, toys).Access to stairs (with at least 5 steps) is also necessary .
Evidence
The GMFM show sufficient validity, responsiveness, and reliability for assessment of motor skills of children with Cerebral Palsy undergoing rehabilitation [5]. Therefore, for young children and children with severe motor disabilities the GMFM-88 gives a more detailed description of their abilities and limitations. Additionally, the GMFM-88 can be administrated with shoes, ambulatory aids and/or orthoses, whereas the GMFM-66 must be administrated barefoot without aids [2].
Reliability & Validity
Reliability refers to dependability, consistency, and stability of scores on an assessment tool. Both versions of GMFM were shown to be highly reliable, with the intraclass correlation coefficient (ICC)s of greater than .98 (95% confidence interval=0.965-0.994) and both of them can be used in clinical practice or research.
Validity and Responsiveness: Validity includes responsiveness, which is defined as the ability to differentiate clinically important differences. Both versions of GMFM also demonstrated high levels of validity, with an intraclass correlation coefficient (ICC) of .99 (95% confidence interval=0.972-0.997), reflecting associations with the GMFM-66.
Miscellaneous
Evaluating child abilities and the level of difficulty using the GMFM can be useful in identifying the impairments in motor skills and in evaluating the improvement as a result of intervention thereby providing much more information to assist with realistic goal setting [5].
Links
Cerebral Palsy Outcome Measures
https://www.ncbi.nlm.nih.gov/pubmed/24702540
Reference
- ↑ 1.0 1.1 1.2 Ko J, Kim M. Reliability and responsiveness of the gross motor function measure-88 in children with cerebral palsy. Physical therapy. 2013 Mar 1;93(3):393-400.
- ↑ 2.0 2.1 Beckers LW, Bastiaenen CH. Application of the Gross Motor Function Measure-66 (GMFM-66) in Dutch clinical practice: a survey study. BMC pediatrics. 2015 Dec;15(1):1-10.
- ↑ Vaščáková T, Kudláček M, Barrett U. Halliwick concept of swimming and its influence on motoric competencies of children with severe disabilities. European Journal of Adapted Physical Activity. 2015;8(2).
- ↑ Concepts F. GMFCS for Cerebral Palsy [Internet]. Youtube; 2013 [cited 2023 Apr 16]. Available from: https://www.youtube.com/watch?v=5u2sLAznhnY
- ↑ 5.0 5.1 Russell DJ, Rosenbaum P, Wright M, Avery LM. Gross motor function measure (GMFM-66 & GMFM-88) users manual. Mac keith press; 2002.