Efecto del traje terapéutico en la función motora gruesa de niños con parálisis cerebral / Effect of therapeutic suit on the gross motor function in children with cerebral palsy

Introducción: El traje terapéutico o Therasuit es una órtesis blanda que se usa durante el entrenamiento intensivo de patrones de movimiento en personas con afecciones neurológicas como la parálisis cerebral. Objetivo: Describir los cambios en la función motora gruesa en una población pediátrica con distintos tipos de parálisis cerebral, tratada con el traje terapéutico. Métodos: Estudio observacional longitudinal y retrospectivo donde se tomaron mediciones de la función motora gruesa antes y después de la aplicación del traje terapéutico a 56 niños que asistieron a un centro de neurorehabilitación en Cali, Colombia entre Junio de 2008 a Diciembre de 2014. Los niños se encontraban entre 3 -13 años de edad y en niveles I-V según la Clasificación de la Función Motora Gruesa. Se usó el test de Wicolxon para comparar las medianas de los puntajes de las mediciones con la Gross Motor Function Measure de 88 ítems. Resultados: Se observaron cambios positivos después de la aplicación del traje en los puntajes totales de la Gross Motor Function Measure (p= 0). Se hallaron diferencias positivas en todas las edades (dif. = 2 a 2,5 p<0,05), mayor en los niños de 11 a 13 años. Conclusiones: Los cambios observados después de aplicar el traje terapéutico a niños con parálisis cerebral sugieren que el entrenamiento motor con este enfoque terapéutico es efectivo para el logro de habilidades motoras gruesas. El cambio es más visible en niños severamente comprometidos y con espasticidad(AU)

Introduction: The therapeutic suit or Therasuit is a complementary therapy used in rehabilitation for intensive training of motor patterns in people with cerebral palsy. Objective: To describe the changes in the motor function in a pediatric population with different types of cerebral palsys. Methods: Observational, longitudinal and retrospective study in which the gross motor functions were measured before and after trying the therapeutic suit in 56 children admitted in the Center of Neurorehabilitation in Cali, Colombia from June 2008 to December 2014. The 56 participants had ages from 3 to 13 years, and levels from I to V according to the Classification of Gross Motor Function (GMFCS). Wicolxon test was used to compare the median scores of the 88-item Gross Motor Function Measure (GMFM-66) scale scores applied to children before and after the treatment with the suit. Results: After the application of the suit in children with CP, the differences in the measurements of GMFM-88 were effective (p= 0). Stratification of the population studied by age registered positive differences (dif. = 2 a 2,5 p<0,05) in all ages and greater in children aged 11 to 13 years in the total scores. Conclusions: The positive changes observed after applying the therapeutic suit to children with cerebral paralysis suggest that motor training with this therapeutic approach is effective for the achievement of gross motor skills. The change is more evident in children with severe manifestations and spasticity(AU)

Functional Improvement after the Gross Motor Function Measure-88 (GMFM-88) Item-Based Training in Children with Cerebral Palsy

PURPOSE: The aim of this study was to investigate applicability of the GMFM-88 in planning intervention for CP children. Specifically, this study assessed functional improvement after a four-week GMFM-88 item-based training in CP children divided into three age groups (≤24 months, 25–48 months, and >48 months) and five levels of the gross motor function classification system (GMFCS). METHODS: Subjects were 264 children with CP (mean age 32.90 months) recruited from one CP clinic. The GMFM-88 item-based training was planned for each child, after an interview with its caregiver. To investigate functional improvement after the intervention, minimum important difference (MID) and MID proportion for the change in scores of GMFM-88 were calculated. RESULTS: The GMFM-88 scores increased after the interventions in all three age groups (p<0.05). In particular, children with CP aged ≤24 months and at the GMFCS level II showed greater functional improvement after training. CONCLUSION: This study found that the GMFM-88 item-based training would be used to plan activity-oriented intervention both in clinic and home in each CP child.

Therapeutic Observation of Electroacupuncture plus Moxibustion for Infantile Cerebral Palsy / 上海针灸杂志

Objective To observe the clinical efficacy of electroacupuncture plus moxibustion in treating infantile cerebral palsy. Method Eighty eligible patients with infantile cerebral palsy were randomized into a treatment group of 42 cases and a control group of 38 cases. The control group was intervened by physiotherapy (PT), while the treatment group was given electroacupuncture at scalp acupoints, body acupuncture, and moxibustion along the Governor Vessel in addition to the treatment given to the control group. The two groups were treated once a day, 6 months in total. The comprehensive ability and the Gross Motor Function Measure (GMFM) were evaluated before and after the interventions in the two groups, and the clinical efficacies were compared.Result After 6-month treatment, the total effective rate was 92.9% in the treatment group versus 78.9% in the control group, and the total effective rate of the treatment group was superior to that of the control group (P<0.05). The motor function and activities of daily living were significantly improved in both groups after the interventions (P<0.05,P<0.01); after the treatment, there were significant differences in comparing the motor function and activities of daily living between the two groups (P<0.05). The GMFM scores of each domain were significantly changed after the treatment in both groups (P<0.05); after the treatment, there were significant differences in comparing the GMFM scores of each domain between the two groups (P<0.05).Conclusion Compared with being used alone, conventional PT can more significantly benefit the improvement of motor function of cerebral palsy patients when electroacupuncture and moxibustion were added.

Therapeutic Observation of Electroacupuncture plus Rehabilitation for Cerebral Palsy / 上海针灸杂志

Objective To observe the clinical efficacy of electroacupuncture plus rehabilitation in treating cerebral palsy.Method A total of 104 patients with cerebral palsy were randomized into a treatment group and a control group, 52 cases in each group. The two groups both received routine medications, based on which, the treatment group was given electroacupuncture plus rehabilitation training while the control group was given rehabilitation training alone. Before and after the treatment, the Gross Motor Function Measure (GMFM), muscle tension, comprehensive capability, development quotient (DQ) and cerebral haemodynamics were observed, and the clinical efficacies were compared between the two groups.Result The total effective rate was 94.2% in the treatment group versus 71.2% in the control group, and the between-group difference was statistically significant (P<0.05). After the treatment, the scores of item D and E of GMFM-88 were significantly increased (P<0.01) and the muscle tension scores were significantly decreased in both groups (P<0.01); the scores of item D and E of GMFM-88 and muscle tension in the treatment group were significantly different from those in the control group (P<0.05). The comprehensive capability score and DQ were markedly increased in both groups after the treatment (P<0.01); after the treatment, the comprehensive capability score and DQ in the treatment group were significantly different from those in the control group (P<0.01). The cerebral artery mean flow velocity (Vm) increased significantly (P<0.05), and pulsatility index (PI) and resistance index (RI) decreased significantly after the treatment in both groups (P<0.05); after the treatment, the cerebral artery Vm, PI and RI in the treatment group were significantly different from those in the control group (P<0.05).Conclusion Electroacupuncture plus rehabilitation is an effective approach in treating cerebral palsy, and it can obviously improve the limb dysfunction, DQ, and cerebral haemodynamics of the patients.

Effect of hippo therapy on balance and function in children with spastic diplegia.

Introduction: Hippo therapy is a form of physical, occupational and speech therapy in which a therapist uses the characteristic movements of a horse. The horse's pelvis has a similar three dimensional movement to the human's pelvis at the walk. This movement provides physical and sensory input which is variable, rhythmic and repetitive which leads to improvement in spasticity and balance. Objective: The study aimed to find the effect of hippo therapy on balance and function in children with spastic diplegia Material and methods: A quasi-experimental study was conducted at College of Physiotherapy, Ahmadabad. Sixteen children (8 in control group (A) and 8 in experimental group (B) with spastic cerebral palsy, aged 3 to 10 years with GMFCS level 1, 2, body weight less than 35 kg were include. Children with history of botulism toxin injection within 6 months, selective dorsal rhizotomy or orthopedic surgery within 1 year, moderate to severe intellectual disability, uncontrolled seizures, and poor visual or hearing acuity were exclude. Both groups were given neuro developmental technique (NDT), group B was given additional hippo therpy (riding on horse with minimal support as required) for 15 minutes twice a week. Outcome measures were Pediatric balance scale (PBS), GMFM 66, 88, Modified Ashworth scale. Level of significance was kept at 5%. Result: Within group, analysis did not show significant difference in PBS score ( W2.214, p = 0.027). Within group analysis for group B showed significant difference in both GMFM score (W= 2.207, p = 0.027) and PBS score (W = 2.214, p = 0.027). Between group analysis for GMFM score showed significant difference (U = 0.500, p = 0.005). But there was no significant difference in between group analysis for PBS score (U = 12.00, p = 0.321). Conclusion: Hippo therapy and NDT both have similar effect for improving balance in spastic diplegic children. But Hippo therapy has an additional effect for improving gross motor function.

Effects of electrical stimulation on abdomen- posterior back muscles in children with cerebral palsy / Монголын Анагаах Ухаан

Background. Cerebral palsy (CP), which is the most commonly encountered neuromuscular disorder of childhood, causes permanent physical deficits and sometimes intellectual deficits. Despite advances in the diagnosis and treatment of CP, the incidence of that disorder has not declined; it parallels the increased survival rates of premature infants. The children with CP may not have trunk control because they have spasticity and weakness in their trunk control. Goal. This study aimed to investigate the efficiency of functional electrical stimulation (FES) application on the abdomen-posterior back muscles in children with Cerebral palsy (CP). Materials and Methods. However 40 children with spastic CP, being treated in physical therapy, were selected by the way of random-sampling in the study, some of children were excluded by exclusion criteria and then 30 children have completed the study. The participants were randomly divided into two groups FES (n=15) and control groups (n=15). The control group received physical therapy 3 days a week in 45 minute for 6 weeks. The children in the FES group received physical therapy in addition to function electrical stimulation. FES was applied 5 days a week for 6 weeks to abdomen-posterior back muscles in 30 minute-long sessions. To evaluate the score of gross motor function measurement (GMFM) and to evaluate the trunk asymmetry in sitting, radiographic measurements were used. Result. The comparisons of the measurements of the two groups before and after the treatment showed that the GMFM standing score were statistical significantly (p<0.001) increased, and Cobb angles were decreased both groups, but the decrease in the control group was not statistically significant (p=0.128), and FES group was statistically significant (p=0.033). The comparison between groups GMFM standing score increased higher in the FES group than in the control group. Cobb angles after the treatment were statistically significant higher in the FES group than in the control group. Conclusion: To improve gross motor developing for children with CP, FES applied on abdomenposterior back muscles along with physical therapy is more effective than physical therapy alone.

Effectiveness of resistance training exercises in spastic diplegia cerebral palsy: a review

Cerebral Palsy presents itself in a clinical form of spastic diplegia, where neurological sequels are predominant in the lower limbs and substantially affects the capacity to walk. Traditional methods of physiotherapy intervention emphasize the techniques of neurological rehabilitation at the expense of progressive resistance exercises.The goal of the present research is to fulfill a bibliographic review concerning the period of 1985 to 2012 about studies that investigated the effect of resistance exercises applied to cerebral palsy children carrying spastics’ diplegia. The Scielo, MEDLINE, PubMed, EMBASE, CINAHL, Sports Discus, DARE, PsychInfo, ERIC, Ausport-Med, AMI, Cochrane and PEDro databases were used to conduct a literature search using keywords without restrictions. In this systematization, a search was conducted using the keywords: cerebral palsy, progressive resistance exercise, diplegia, gross motor function measure (GMFM). Literature have shown that the restrict capacity to generate force is as debilitating or more than it is the muscle spasticity, potentially causing more restriction to the movement than the spasticity itself. Children with normal motor development, as well as carrying spastic diplegia increase their capacity to generate strength when submitted to a resistive training, not only on lower limbs, but also on upper limbs. Furthermore, several studies have shown that diplegic cerebral palsy children improve their motor ability due to strength training, thought it still remains to be proved that strength training leads to a substantial change for the better allowing that there is ascension of category for functional capacity.

Inter-rater Reliability of the K-GMFM-88 and the GMPM for Children with Cerebral Palsy

OBJECTIVE: To examine inter-rater reliability of the Korean version Gross Motor Function Measure (K-GMFM-88) and the Gross Motor Performance Measure (GMPM) based on the video clips. METHOD: We considered a sample of 39 children (28 boys and 11 girls; the mean age=3.50+/-1.23 years) with cerebral palsy (CP). Two pediatric physical therapists assessed the children based on video recordings. RESULTS: For the K-GMFM-88, the intraclass correlation coefficient (ICC3, 1) ranged from .978 to .995, and Spearman's correlation coefficient ranged from .916 to .997. For the GMPM, ICC3, 1 ranged from .863 to .929, and Spearman's correlation coefficient ranged from .812 to .885. With the gross motor function classification system classified according to the functional level (GMFCS I-II vs. III-V), the ICCs were .982 and .994 for the K-GMFM-88 total score and .815 and .913 for the GMPM total score. There were good or high correlations between the subscales of the two measures (r=.762-.884). CONCLUSION: The K-GMFM-88 and GMPM are reliable tools for assessing the motor function of children with CP. These two methods are highly correlated, which adds more reliability on them. Thus, it is advisable to use K-GMFM-88 and GMPM for children with CP to assess gross motor function.

Análisis comparativo de puntajes GMFM-66 según sistema de clasificación de la función motora gruesa GMFFCS en Instituto Teletón Santiago 2006-2010 / Comparative analysis of GMFM-66 scores and GMFCS in Teletón Santiago Institute, 2006-2010

Introduction: The gross Motor Measure (GMFM), and two validated scales that measure gross motor developmental changes in children with cerebral palsy (CP), and are utilized to quantify therapeutic intervention results. Objetive: To analyze gross motor function scores (GMFM-66), across condiction severity levels (GMFCS), considering age, type, and CP topographical distribution, at Santiago's Teletón Institute, from 2006 to 2010. Comparison of results with that obtained in the literature, and evaluate the eventual prognostic value of both scales. Methodology: A descriptive retrospective review study of a GMFM database was conducted. A total of 397 children with CP met the inclusion criteria. GMFM-66 scores and GMFCS levels were associated according to the selected variables, and were compared to the literature. Results: 63.2 percent of the children are under 6 years of age. Hemiplegic and diplegic patients concentrate 76.6 percent of cases. According to type, 84.9 percent of patients with spastic CP. Independently from the analyzed variable, the mediam values of GMFM-66 decrease two to four time as the severity of the pathology increases from level I to level IV. Quadriplegic children are distributed among levels III and IV. No hemiplegic patients were found at level V. Compared to other studies, no significant differences were found in GMFM-66 scores across GMFCS levels. Visually, the score diagram by GMFCS levels and age is similar to Rosenbaum's. Conclusion: GMFM-66 score distribution across GMFCS levels turns out as described in the literature, however caution is suggested if used as a predictive value for individual cases.

Introducción: Gross Motor Function Measure (GMFM) Y Gross Motor Function Classification System (GMFCS) son escalas validadas que miden cambios en el desarrollo motor grueso del niño con parálisis cerebral (PC); se utilizan para cuantificar resultados de las intervenciones terapéuticas. Objetivo: Analizar puntajes de función motora gruesa (GMFM-66) por nivel de severidad de la patología (GMFCS), según edad, tipo y distribución topográfica de PC del Instituto Teletón Santiago 2006-2010, comparar con resultados obtenidos en literatura y evaluar el eventual pronóstico de ambas escalas. Metodología: Estudio descriptivo, retrospectivo de revisión a base de datos del GMFM. Un total de 397 niños con PC cumplen con requisitos de inclusión. Se relacionan puntajes de GMFM-66 por niveles de GMFCS según variables consideradas y se compara con bibliografía. Resultados: 63,2 por ciento de los niños son menores de 6 años. Pacientes con diplejía y hemiplejía concentran 76,6 por ciento. Según tipo, el 84,9 por ciento son espásticos. Independientemente de la variable analizada, los valores de las medianas de GMFM-66 disminuye entre 2 y 4 veces a medida que aumenta la severidad de la patología de nivel I a V. Los niños con cuadriplejía se distribuyen de nivel III a V; no se observan diferencias significativas de puntajes GMFM-66 por niveles de GMFCS; visualmente, el diagrama de puntajes por nivel de GMFCS y edad sería similar a Rosenbaum. Conclusión: La distribución de puntajes obtenidos en GMFM-66 por nivel de GMFCS guarda relación con estudios descritos en la literatura, pero se sugiere cautela al usarlos como valor predictivo para los casos individuales.

Multilevel botulinum toxin type a as a treatment for spasticity in children with cerebral palsy: a retrospective study

INTRODUCTION: Cerebral palsy is the most common cause of physical disability in children. Spasticity is a disabling clinical symptom that is prevalent among patients suffering from cerebral palsy. The treatment of spasticity with botulinum toxin type A (BTX-A) is a well-established option in the interdisciplinary management of spasticity, providing focal reductions in muscle tone in cerebral palsy patients. OBJECTIVE: The aim of this retrospective study was to describe the effect of multilevel BTX-A injections in the lower extremities, focusing mainly on gross motor function and functional status in cerebral palsy patients. METHODS: Data from 71 cerebral palsy patients (64 percent male, 36 percent female, mean age 6.7 ±3.2 years) were analyzed retrospectively. We used the Ashworth and Tardieu scales to evaluate the degree of spasticity. Motor function was measured by the Gross Motor Function Measure (GMFM-88), and functional status was classified by the Gross Motor Function Classification System (GMFCS I-V). Multilevel BTX-A injections were applied after sedation and with electrostimulation guidance. The evaluations were repeated every three months, and the patients were followed for six months. RESULTS: We found that the Ashworth and Tardieu scores decreased significantly at the three-month evaluation (p<0.05) but not at the six-month evaluation (p>0.05). Although the improvement in spasticity was not maintained at the six-month evaluation, GMFM-88 scores increased significantly at the three- and six-month assessments. GMFSC levels showed no change in the three- and six-month assessments. CONCLUSION: We believe that a single multilevel BTX-A injection reduces spasticity and improves motor function in children with cerebral palsy.

The Analysis of Postural Control of Children with Spastic Diplegic Cerebral Palsy in Unstable Sitting

OBJECTIVE: To investigate differences in the dynamic postural control in unstable sitting position between children with spastic diplegic cerebral palsy (CP) and normally developing children. METHOD: Sixteen children with spastic diplegic CP who could sit alone and walk independently and sixteen age- matched normally developing children were included. The evaluation system for postural control consisted of unstable platform, force plate, frame, safety harness, monitor and computer. Force plate on unstable platform measured center of pressure (COP) of the subject. COP sway, COP maintaining time and COP moving time were recorded in both groups. In diplegic CP group, Gross Motor Function Measure (GMFM) was evaluated. RESULTS: In COP sway, the distance away from central location was significantly increased and time maintaining on circle at center decreased significantly in diplegic CP group (p<0.05). The children with diplegic CP showed significant decrease in maintaining time and significant increase in moving time in all directions. COP sway was significantly correlated with GMFM. CONCLUSION: Postural control in children with spastic diplegic CP walking independently was revealed to be significantly worse compared to normal age-matched children. Further studies are necessary to find out whether the training for seated postural control could improve the motor function.

Comparação do parâmetro motor de crianças com paralisia cerebral: aplicação da escala gmfm versus entrevista com os pais / Comparison of motor parameter of children with cerebral palsy: aplication of gmfm scale versus parents's interview

A criança com paralisia cerebral (PC) estará envolvida com uma gama de profissionais, e normalmente os pais são os mediadores entre a criança e a equipe, alem de auxiliá-la e orientá-la no ambiente familiar. Dessa forma, a aproximação entre os pais e a reabilitação é imprescindível, e devem caminhar juntas; para tanto, os profissionais de saúde precisam conhecer como é a criança em casa e o tipo de influência que os pais exercem sobre ela, e os pais precisam saber o real potencial neuro-sensório-motor de seu filho. Este trabalho teve o intuito de comparar as reais concepções motoras da criança, a partir da aplicação de uma escala de mensuração motora, a Gross Motor Function Measure (GMFM), e da expressão dos pais captada per entrevistas semi-estruturadas, para que a criança seja trabalhada de maneira equivalente em locais diferentes, potencializando a sua melhora global. Esse segmento consistiu de 10 crianças com PC, de todos os tipos, com idades entre 3 e 12 anos. Todas as avaliações foram filmadas e as entrevistas, gravadas. Observamos que 70% dos pais subestimaram o potencial motor da criança. Muitos pais tem grande interesse em relação ao tema proposto, embora justifiquem o resultado obtido pela falta de tempo e excesso de trabalho.

The child with cerebral palsy will be involved in a range of professionals, and normally the parents are the mediators between the child and the team as well as provide assistance and orientation related to family atmosphere. The approach between parents and rehabilitation team is significant and must go on together, so that the health professionals know how the child is at home and the type of influence the parents cause on the child, and the parents know the real neuro-sensorio-motor potential of their child. This study compared the real motor concept of the child by the Gross Motor Function Measure (GMFM) and the parent's expression from semi- structured interviews, so the child can be worked in the same way in different places, giving potential in his global improvement. We evaluated 10 children with all types of cerebral palsy, with age between 3 and 12 years old. All the evaluations and interviews were registered. We observed that 70% of the parents subestimated the motor potential of their child. Many parents have a great interest in this proposed study, but a lot of them justified this result by the lack of time and excessive work.

Estudo de transferência e locomoção em crianças de 4 a 6 anos com paralisia diparética espástica nível motor III / Study about transfer and locomotion in 4 to 6 years-old children with motor level III spastic diplegig cerebral palsy

Este estudo objetivou traçar o perfil funcional de crianças com paralisia cerebral diparética espástica nível motor III, quanto ao desempenho de atividades de mobilidade – transferência e locomoção –, a fim de direcionar estratégias terapêuticas de avaliação e de intervenção nesta população. O estudo teve a participação de oito crianças que frequentavam o Setor de Fisioterapia Infantil da Associação de Assistência à Criança Deficiente (AACD). As crianças foram avaliadas pelo teste funcional PEDI, sendo utilizada apenas a escala de mobilidade das três partes que o compõem, que teve como referencial de comparação o GMFM. Os resultados demonstraram maior dificuldade dessas crianças nas atividades de locomoção, comparadas com as de transferência. Há necessidade de adequar a assistência do cuidador e as modificações do ambiente para promover maior independência e funcionalidade às crianças.

Establishing the functional profile of children with motor level III spastic diplegic cerebral palsy, regarding the performance of mobility activities – transfer and locomotion – in order to direct therapeutic strategies for evaluating and intervening in this population was the goal of this study. Eight children who attended the Children’s Physical Therapy Department of the Associação de Assistência à Criança Deficiente (AACD) took part in this study. These children were evaluated by the functional test PEDI – only the mobility scale of the three parts that compose the test was used, and had the GMFM as a comparison reference. The results have showed that children have greater difficulty in locomotion compared to transfer. There is the need to adequate caretaker assistance and to adapt the environment to promote higher independency and functionality to the children.

Adulto jovem com paralisia cerebral / Young adult with cerebral palsy

Este estudo considerou os aspectos envolvidos no adulto com paralisia cerebral em relação aos vários sistemas do corpo e analisou o aspecto motor e a presença de dor. Também enfocou as alternativas para o adulto jovem para a continuidade de habilitação, prevenção ou minimização dos efeitos secundários da paralisia cerebral e da idade avançada. Para tanto, foram avaliados nove jovens adultos (18 a 28 anos) e um adulto (51 anos) durante período de dois anos, utilizando-se a Medição da Função Motora Grossa (GMFM). Durante esse período os indivíduos participaram de terapias individuais baseadas no Conceito Bobath, e de terapias em grupo também baseadas no Conceito Bobath, mas associado com aspectos da Educação Condutiva (Método Petõ). Noventa por cento apresentaram ganhos no resultado final do GMFM que variaram de 1,5% a 15,1 %, com média de ganho de 6,2%. Os resultados, portanto, demonstraram que a continuidade de atividade dirigida a mobilidade, controle de postura e dos movimentos integradas a atividades funcionais permitem que o processo de deterioração seja contido ou minimizado para adultos jovens com paralisia cerebral.

This study has considered aspects of several body systems in adults with cerebral palsy emphasizing motor and pain conditions. Options for keeping on the habilitation process, preventing from deterioration, and minimizing secondary effects of cerebral palsy in young adults were also discussed. For this purpose, nine young adult (18 to 28 years of age) and one adult (51 years of age) were assessed during two years by the aplication of the Gross Motor Function Measure (GMFM). During these two years the individuals participated in individual therapies based on Bobath approach as well as in therapeutic group activities also based on Bobath approach associated with some aspects of Conductive Education (Petõ Method). Improvements in GMFM total results varying from 1.5% to 15.1 % (mean of 6.2%) were observed in 90% of the patients. The results have shown, therefore, that the continuity of directed activity aimimg at motor control integrated with functional activities can constrict or minimize the deterioration process in young adults with cerebral palsy.

Responsiveness and precision of Gross Motor Function Measure(66 items version) / 中国康复理论与实践

@#ObjectiveTo compare the responsiveness and precision between the 66 items version of Gross Motor Function Measure(GMFM-66) and 88 items version(GMFM-88).Methods173 children with cerebral palsy(male 126,female 47) who have received twice assessments were involved.All the second assessment were performed 3.8±4.3 months later.112 children received the third assessment 3.2±2.2 months after the second assessment.The effect size and relative precision between the GMFM-66 and GMFM-88 were analyzed.ResultsThe effect size of GMFM-66 between every two assessments was nearly the same as those of GMFM-88.The precision of GMFM-66 was not lower than that of GMFM-88.ConclusionThe interval-scale GMFM-66 has satisfying responsiveness and precision.It is more useful than GMFM-88 in measuring the treating effect of children with cerebral palsy.

Applications of Gross Motor Function Measure Scale and Peabody Developmental Measure Scale-Gross Motor in the evaluation of children with cerebral palsy / 中国康复理论与实践

@#Objective To compare the advantages of two gross motor measure scales, Peabody Developmental Measure Scale Gross Motor (PDMS-GM) and Gross Motor Function Measure Scale (GMFM), in the evaluation of children with cerebral palsy (CP).Methods The gross motor functions of 29 CP children, 0-3 years old, were evaluated three times using PDMS-GM and GMFM respectively. The improvement percentile each month of PDMS-GM and GMFM were compared by t test.Results There was significant difference between the improvement percentile each month of PDMS-GM and GMFM. Conclusion The GMFM was more sensitive than PDMS-GM in the evaluation of CP children especially in the evaluation of treatment effect.

Scoring of Norms of the Gross Motor Function Measure (GMFM) in Normal Children

OBJECTIVE: We performed to obtain the normal values of Gross Motor Function Measure (GMFM) in normally developed children. We designed this study to inform the degree of gross motor functional disability or delay in children with cerebral palsy, comparing with score values of GMFM in normal children. METHOD: One hundred-sixteen normally developed children who were in the age of 12 to 47 months were recruited. Their GMFM tests were performed by a pediatric physical therapist. They were grouped by age of 6 months and the scores were compared with all of each groups. Results: The GMFM scores in normal children increased with ages. The rates of increment in scores were fast till 35 months of age and inter-individual differences of GMFM scores were greater in younger age groups (less than 36 months of age) than older groups. Even the means of GMFM scores were higher in the girls than boys, the differences between sexes were insignificant statistically. CONCLUSION: Norms of GMFM obtained in normally developed children who were in the age of 12 to 47 months. It would be helpful to assess the degree of motor functional disabilities or delay in children with physical disabilities.