Evaluating motor function in children with Down syndrome: validity of the GMFM

Abstract

The Gross Motor Function Measure (GMFM) was developed and validated originally by Russell and colleagues as an evaluative assessment of gross motor function in children with cerebral palsy (CP). The present study reports the results of reliability and validity testing of the GMFM for use with children with Down syndrome (DS). One hundred and twenty-three children with DS were assessed twice over a 6-month period, using the GMFM and the motor scale of the Bayley Scales of Infant Development -second edition (BSID-II). In addition to the usual method of scoring the GMFM using only observed motor behaviours (standard score), parent reports of children's activities not seen by the assessor on the day of testing were also obtained and a second score (reported score) was calculated for each GMFM assessment.Test-retest and interrater reliabilities were excellent (all > 0.90). Observed correlations between change on GMFM and judgements of change made independently by parents, intervenors, and masked video raters were lower than hypothesized. However, the pattern of change scores in predefined age and severity subgroups supported the contention that the GBWM was able to detect differential amounts of change as predicted. The GMFM was shown to be relatively more responsive to change in gross motor function than the motor scale of the BSID-XI. The 'reported' scores on the GMFM demonstrated better evidence of reliability, validity, and responsiveness than the standard scoring method and this approach is recommended for use when assessing children with DS.

The Reliability and Concurrent Validity of the GMFCS for Children with Cerebral Palsy

“…Rater B had 8 months of experience in the evaluation and treatment of children with CP (the newly trained PT), while rater K had 12 years of experience in pediatric physical therapy (the Expert PT). A number of studies [14][15][16] have used videotapes of patients to permit multiple raters to observe the same performance. According to Gross and Conrad 17) , videotaping permits less biased estimates of reliability.…”

Terapia neuromotora intensiva nas habilidades motoras de criança com Síndrome de Down

“…A escala de avaliação GMFM (medida da função motora grossa) é uma escala de função quantitativa (Anexo A), com 88 itens que avaliam detalhadamente as dimensões da funcionalidade do movimento, a partir do princípio de desenvolvimento motor normal de crianças. Essa medida de função foi elaborada para pacientes com paralisia cerebral, porém há estudos que indiquem e validem seu uso para indivíduos com SD 13,15,16 . O Pediasuit ® é uma técnica individualizada e intensiva, que visa ao ganho de força muscular, em indivíduos com algum distúrbio, sequela ou atraso no desenvolvimento neurológico e/ou motor, além de prevenir deformidades de algumas patologias e diminuir o desuso e contraturas musculares, adaptando a criança aos estímulos externos, utilizando roupas especiais (trajes -órtese dinâmica), sendo colete preso a um calção de tamanho próximo ou idêntico ao da criança, joelheira e sapatos equipados com ganchos, cujos são acoplados a roupa, elásticos com tensão específica para auxiliar no alinhamento postural do corpo e devidamente ajustados conforme deformidades ou necessidades do paciente.…”

Comparative Reliability of the PEDI, GMFM and TUG Tests for Children with Cerebral Palsy

“…The reliability of these tests for children with disabilities has been examined in a number of studies. Russel et al 17) found excellent reliability for the GMFM, using123 children with Down Syndrome over a 6-month period (ICC > 0. 90).…”