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Research Reports |
DJ Russell, MSc, is Assistant Professor, School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, and Research Coordinator, CanChild, Centre for Childhood Disability Research, Room 408, Institute for Applied Health Sciences, McMaster University, 1400 Main St W, Hamilton, Ontario, Canada L8S 1C7 (russelld{at}fhs.mcmaster.ca). Address all correspondence to Ms Russell
LM Avery, BEng, is Research Assistant, CanChild, Centre for Childhood Disability Research, McMaster University
PL Rosenbaum, MD (FRCP), is Professor, Department of Pediatrics, McMaster University, Co-Director, CanChild, Centre for Childhood Disability Research, McMaster University, and Chief of Medical Staff, Bloorview MacMillan Centre, Toronto, Ontario, Canada
PS Raina, PhD, is Assistant Professor, Department of Health Care and Epidemiology, Centre for Community Health and Health Evaluation Research, BC Research Institute for Children's and Women's Health, University of British Columbia, Vancouver, British Columbia, Canada
SD Walter, PhD, is Professor, Clinical Epidemiology and Biostatistics, McMaster University, and Investigator, CanChild, Centre for Childhood Disability Research, McMaster University
RJ Palisano, PT, ScD, is Professor, Department of Rehabilitation Sciences, MCP Hahnemann University, Philadelphia, Pa, and Co-investigator, CanChild, Centre for Childhood Disability Research, McMaster University
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 (<5 years of age) and have "mild" CP will demonstrate greater change in GMFM-66 scores than children who are older (
5 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 x severity x age interaction supported our hypotheses. Test-retest reliability was high (intraclass correlation coefficient=.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.
Key Words: Cerebral palsy • Gross Motor Function Measure • Motor function • Rasch analysis • Validation
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