Reliability of the modified Gross Motor Function Measure-88 (GMFM-88) for children with both Spastic Cerebral Palsy and Cerebral Visual Impairment: A preliminary study.

PURPOSE: The aims of this study were to adapt the Gross Motor Function Measure-88 (GMFM-88) for children with Cerebral Palsy (CP) and Cerebral Visual Impairment (CVI) and to determine the test-retest and interobserver reliability of the adapted version. METHOD: Sixteen paediatric physical therapists familiar with CVI participated in the adaptation process. The Delphi method was used to gain consensus among a panel of experts. Seventy-seven children with CP and CVI (44 boys and 33 girls, aged between 50 and 144 months) participated in this study. To assess test-retest and interobserver reliability, the GMFM-88 was administered twice within three weeks (Mean=9 days, SD=6 days) by trained paediatric physical therapists, one of whom was familiar with the child and one who wasn't. Percentages of identical scores, Cronbach's alphas and intraclass correlation coefficients (ICC) were computed for each dimension level. RESULTS: All experts agreed on the proposed adaptations of the GMFM-88 for children with CP and CVI. Test-retest reliability ICCs for dimension scores were between 0.94 and 1.00, mean percentages of identical scores between 29 and 71, and interobserver reliability ICCs of the adapted GMFM-88 were 0.99-1.00 for dimension scores. Mean percentages of identical scores varied between 53 and 91. Test-retest and interobserver reliability of the GMFM-88-CVI for children with CP and CVI was excellent. Internal consistency of dimension scores lay between 0.97 and 1.00. CONCLUSION: The psychometric properties of the adapted GMFM-88 for children with CP and CVI are reliable and comparable to the original GMFM-88.

An interdisciplinary model for the rehabilitation of visually impaired and blind people: application of the ICIDH concepts.

In rehabilitation centres for visually impaired and blind people the need for a common, conceptual framework was felt by the various disciplines working there. As a consequence an interdisciplinary model has been developed. This article gives a brief description of the two elements of the model: the concepts of the ICIDH and the path of rehabilitation. The classifications of the ICIDH have been adapted to suit our purposes better. The concepts of impairment, disability, and handicap can serve as a framework during an interdisciplinary consultation. In this context a visual profile, which contains information gained from the assessments done by the various disciplines, will be discussed. The visual profile makes it possible to gain general insight into the client's visual problems from all perspectives, which enables the team to draw up an interdisciplinary rehabilitation diagnosis. At present the model is being tested by practical experience in three regional rehabilitation centres for visually impaired and blind people. The model gives an outline of the application of the ICIDH concepts, and leaves open the possibility of working on the various aspects in more detail.