• 한국전문물리치료학회지
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• 제17권3호
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• pp.40-47
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• 2010

The purposes of this study were to compare the reliability and validity of an 88-item version of the Gross Motor Function Measure (GMFM-88) and a 66-item version of GMFM (GMFM-66) in children with cerebral palsy (CP). The GMFM was completed in 154 children with CP (age range = 6~12). The internal consistency of the GMFM was calculated by Cronbach's ${\alpha}$ for judging reliability. The reliability of GMFM-88 and GMFM-66 were both above .99. The validity of measurement obtained by the GMFM was assessed by examining the unidimensionality of items and by comparing Gross Motor Function Classification System (GMFCS) levels with tests of the GMFM. Both the GMFM-88 and GMFM-66 were satisfied with unidimensionality. Discriminant validity was demonstrated on significant decreases in scores with increasing GMFCS levels in both measurements. However, GMFM-66 was a more sensitive discriminant in GMFCS level 1 and level 2 and in level 2 and level 4. This study reported a comparison of the reliability and validity of GMFM-88 and GMFM-66. The results of this study have implications for the information on the psychometric properties of two versions of GMFCS. This information will be useful for the selection of tools in clinics.

• The Journal of Korean Physical Therapy
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• 제30권3호
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• pp.90-95
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• 2018

Purpose: To investigate the relationship between gross motor capacity and neuromuscular function in children with cerebral palsy (CP) through a short-term intensive intervention. Methods: Twenty-four children younger than 6 years of age (17 boys, 7 girls, mean $age{\pm}standard$ deviation, $42.71{\pm}14.43months$) who were diagnosed with CP underwent short-term intensive treatment for 8 weeks. An evaluation of gross motor function capacity using the gross motor function measure (GMFM-66 and GMFM-88) was performed to measure muscle strength, selective motor control (SMC), and spasticity, factors related to neuromusculoskeletal function. Changes in spasticity, strength, range of motion, selective motor function, and exercise intensity scores were evaluated in terms of the gross motor function classification system (GMFCS) and ages. Results: The GMFM-88 and GMFM-66 scores significantly increased, by $4.32{\pm}4.04$ and $2.41{\pm}1.51%$, respectively, following the 8-week intervention. The change in the GMFM-66 score did not reflect a statistically significant difference in the GMFCS level. However, there was a statistically significant difference in the GMFM-88 score change in individuals at GMFCS Level III, the strength and spasticity of subjects at GMFCS Levels I-II did not significantly differ (p<0.05). The changes in the GMFM-66 scores for strength, SMC, range of motion (ROM), and spasticity significantly differed according to age (p<0.05) in children aged 36 months and older. Overall, there was a statistically significant difference in strength, SMC, and spasticity (p<0.05) before and after intensive short-term treatment. Conclusion: The 8-week short-term intensive care intervention improved the motor function score of study participants, emphasizing the need for early intervention and additional research in this area.

• 한국전문물리치료학회지
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• 제28권4호
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• pp.245-250
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• 2021

Background: The International Classification of Functioning, Disability, and Health-Child and Youth version (ICF-CY) is designed to record the characteristics of developing children and examine the influence of a child's environment on their health. Objects: This study was designed to determine the relationship between the clinically extracted ICF-CY items and The Pediatric Evaluation of Disability Inventory (PEDI) and Gross Motor Function Measure (GMFM) items. Methods: Thirty patients (17 males and 13 females) who were hospitalized in a pediatric and youth patient unit of a rehabilitation hospital were included in the study. Four health professionals (two physical therapists and two occupational therapists) working independently linked the PEDI and GMFM-66 items to the activity and participation domains of the ICF-CY. Results: There were strong negative correlations between the ICF-CY subdomains and the PEDI subdomains (r = 0.76-0.95; p < 0.05). There were positive strong correlations between the ICF-CY subdomains and the GMFM-66 (r = 0.76-0.95; p < 0.05). Conclusion: The extracted ICF codes were a valid tool for evaluating the mobility and selfcare conditions of cerebral palsy in the pediatric rehabilitation area.

• 대한한의학회지
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• 제42권4호
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• pp.61-74
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• 2021

Objectives: This study aimed to analyse: 1) the clinical effectiveness and safety of traditional Korean Medicine (TKM) and frequency of TKM therapies used and their relationship with conventional treatments. Methods: This prospective observational study enrolled children with cerebral palsy (CP) aged 6-78 months (n=126). The children who used herbal medication for >30 days or acupuncture treatment >12 sessions within 6 months were defined as the integrated rehabilitation (IR) group; the remaining participants were included in the conventional rehabilitation (CR) group. Results: Changes in the Gross Motor Function Measure-66 (GMFM-66) were greater in the IR group (6.4±6.1) than in the CR group (4.6±5.8). The reduction in the number of other health problems was greater in the IR group than in the CR group. The GMFM-66 improvement was greatest in gross motor function classification system level 1. There was no between-group difference in the frequency of rehabilitation therapy (10.9±6.6 and 12.0±9.9 in the IR and CR groups, respectively). Conclusion: TKM may offer additional benefits in terms of the GMFM-66 score and other health problems. However, there is a need for further randomized controlled trials involving a restricted CP type and a controlled treatment type and intensity to confirm these findings.

• 한국전문물리치료학회지
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• 제23권1호
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• pp.55-64
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• 2016

Background: The International Classification of Functioning, Disability, and Health-core set (ICF-core set) for children and youth (CY) with cerebral palsy (CP) provides a useful conceptual framework and a guide for health care planning and measuring the changes brought by interventions across a multitude of dimensions from body functions to personal activities, social participation, and environmental factors for them. Objects: This single case study was reported to illustrate the use of a goal directed approach in applying the ICF-core set for CY with CP from a physical therapist perspective. Methods: An eleven year old boy with spastic CP, Gross Motor Function Classification System (GMFCS) level V, and his mother participated in an evaluation of his functioning state. The intervention goal was set through an interview using the ICF-core set, Canadian Occupational Performance Measure (COPM) and Goal Attainment Scale (GAS). Physical therapy was carried out on an outpatient basis using a goal directed approach for 30 min, 1 time/week during 12 weeks and the boy's gross motor function was assessed using the Gross Motor Function Measure (GMFM)-66 version (item set 2) before and after the intervention. Results: As measured by the boy's mother, the COPM score showed a meaningful clinical change (performance=mean 3.5, satisfaction=mean 2.5) and the T-score of GAS changed 34.4 after the goal directed approach. The GMFM-66 (item set 2) score changed from 31.8 to 38.7 and evaluation using the ICF-core set displayed improvement in 6 items of activity level between before and after the intervention. Conclusion: The ICF-core set for CY with CP is useful for understanding the overall functioning of CY with this condition and provides an opportunity to share and integrate information and opinions from different disciplines. We consider it as a useful tool in the universal language for the therapy and education of CY with CP.

• 재활복지
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• 제20권3호
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• pp.125-139
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• 2016

본 연구의 목적은 뇌성마비 아동의 운동활동에 대한 3가지 개념(능력, 수행능력, 수행)을 구분하고 능력(표준화된 환경에서 할 수 있는 것), 수행능력(일상 환경에서 할 수 있는 것), 수행(일상환경에서 하는 것) 사이의 관련성을 평가하기 위한 것이다. 연구는 평균연령 6.6세의 뇌성마비 아동 40명(남자 19명, 여자 21명)의 평가 기록을 이용한 단면조사 분석으로 수행되었다. 대운동기능분류체계(GMFCS)에 따른 중증도는 1단계 13%, 2단계 10%, 3단계 43%, 4단계 33%, 4단계 3%였다. 운동활동 능력은 대동작기능평가(GMFM)를 이용하여 측정되었다. 수행능력과 수행은 소아장애평가척도(PEDI)의 2가지 척도(기능적 기술, 보호자 도움)를 사용하였다. 연구결과 능력과 수행 사이의 상관관계는 0.811(p<.05)이었고, 수행능력과 수행 사이의 상관관계는 0.845(p<.05)로 가장 높았다. 능력과 수행 사이의 상관관계는 0.711(p<.05)로 가장 낮았다. 뇌성마비 아동의 운동에 대한 능력과 수행능력은 일상생활에서의 수행을 완전히 반영하지 못한다. 수행에는 배경요인(특히, 가족기능과 같은 사회적 요인)이 영향을 미치기 때문이다. 따라서 본 연구는 뇌성마비 아동의 능력, 수행능력, 수행에 대해 명확하게 구분하여 평가하는 것이 필요하다고 제안한다.