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

Published online by Cambridge University Press:  21 April 2004

D J Oeffinger
Affiliation:
Shriners Hospitals for Children, Lexington, KY, USA.
C M Tylkowski
Affiliation:
Shriners Hospitals for Children, Lexington, KY, USA.
M K Rayens
Affiliation:
Biostatistics Consulting Unit, University of Kentucky Medical Center, Lexington, KY, USA.
R F Davis
Affiliation:
Shriners Hospitals for Children, Lexington, KY, USA.
G E Gorton, III
Affiliation:
Shriners Hospitals for Children, Springfield, MA, USA.
J D'Astous
Affiliation:
Shriners Hospitals for Children, Intermountain, Salt Lake City, UT, USA.
D E Nicholson
Affiliation:
Shriners Hospitals for Children, Intermountain, Salt Lake City, UT, USA.
D L Damiano
Affiliation:
Washington University, St. Louis, MO, USA.
M F Abel
Affiliation:
University of Virginia, Department of Orthopedics, Charlottesville, VA, USA.
A M Bagley
Affiliation:
Shriners Hospitals for Children, Northern California, Sacramento, CA, USA.
J Luan
Affiliation:
Biostatistics Consulting Unit, University of Kentucky Medical Center, Lexington, KY, USA.
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Abstract

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.

Type
Original Articles
Copyright
© 2004 Mac Keith Press

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