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Form Structure: GROSS MOTOR FUNCTION MEASURE (GMFM) 66 and 88 Score Short Name: GMFM66and88Score Description: 'The Gross Motor Function Measure (GMFM) is a standardized assessment of physical function and change in physical function in children with cerebral palsy. Gross Motor Function Measure (GMFM) - GMFM 66 score GMFM 66 score, as part. The GMFM-66 is a 66 item subset of the original 88 items identified through Rasch analysis to best describe the gross motor function of children with cerebral palsy of varying abilities. It has a unidimensional scale providing interval scaling rather than the ordinal scaling of the GMFM-88.
Rehabilitation treatment of spastic cerebral palsy with radial extracorporeal shock wave therapy and rehabilitation therapy article summary
The purpose of this article is to examine the use of radial extracorporeal shock wave therapy (rESWT) and rehabilitation therapy for the treatment of spastic cerebral palsy. Cerebral Palsy has a prevalence of 2.0-3.5 births out of every 100. This is prospective randomized control study. This study consisted of 82 children between the ages of 6 years to 12 years, this study was performed over the course of 3 years (2014-2017). Inclusion criteria consisted of 1) being between the ages of 6 and 12, 2) having spastic cerebral palsy, and 3) received multi-stage surgical strategy in the hospital for 6 weeks after lower extremity lysis operation, and 4) were able to participate in shock wave and routine rehabilitation. The participants were split into two groups the treatment group (n=43) and the control group (n=39). Both groups, treatment and control, underwent regular treatment including physical therapy, speech therapy, occupational therapy, and…
Article Review: Selective motor control and gross motor function in bilateral cerebral palsy
Purpose: Investigate the relationship between the Selective Control Assessment of the Lower Extremity (SCALE), muscle volume, Gross Motor Function Measure (GMFM-66), and the Modified Ashworth Scale (MAS) in individuals with cerebral palsy. Study Population: The population recruited for this study included 11 male participants between the age of 12 to 25 years old with a diagnosis of bilateral spastic CP and were a level I-IV on the Gross Motor Function Classification System. Those who had underwent surgery, serial casting, or had been given botox injections in the past year were excluded. Methods/Intervention: In order to obtain muscle volume, all participants underwent a magnetic resonance image (MRI) of both lower extremities to obtain imaging for 18 muscles in each lower extremity. Muscle volumes were averaged between both lower extremities and normalized to body mass. The measurements were obtained by two examiners, and inter-rater reliability was established. Outcome Measures: On the same…
Gross Motor Function Measure Article Summary
Purpose: The purpose of the study was to assess gait changes over time after children diagnosed with cerebral palsy received a botulinum toxin type A (BTX-A) injection. Study population: The study included nine children between the ages of 4 and 8 years old diagnosed with wither hemiplegic or diplegic cerebral palsy, of which the gross motor functional classification system (GMFCS) was used to assess the severity. Each participant had previously received BTX-A treatment 2-15 times, one of which had been in the last 3-6 months. Methods and Intervention: BTX-A injections were placed in the following muscles, different per participant: hip adductor muscle, rectus femoris, hamstrings, gastrocs, soleus, tibialis posterior and upper limb muscles. Measurements were taken before the injection, and at 4-weeks, 8-weeks and 12 weeks post-injection. Outcome measures: The participants were brought in to have measurements performed four times throughout the study: before BTX-A injection, 4 weeks post-injection, 8…
Comparing quality of life and habitual physical activity in children with cerebral palsy.
Purpose: This study examined the association between ambulatory status, based on the Gross Motor Function Classification System (GMFCS), Habitual Physical Activity (HPA), and Quality of Life (QOL) in children with Cerebral Palsy (CP) at the age of 5. Study Population: This study used children with CP at the age of 5. Participants could not have lesions that were progression or neurodegenerative. Methods, Outcome Measures, and Intervention: Participants were assessed based on Gross Motor Function Measure (GMFM) 66 item, as well as placed into ambulatory categories based on the GMFCS in five groups, Level I independent walking without restrictions, Level II independent walking with limited on uneven surfaces, Level III walking with an assistive device, Level IV limited self-mobility or use power mobility, Level V severely limited self-mobility and used wheeled mobility. HPA was determined by placing an ActiGraph triaxial accelerometer around the lower back of the child for a period…
Contributing Factors Analysis for the Changes of the Gross Motor Function in Children with Spastic Cerebral Palsy After Physical Therapy
Additional information about the GMFM: There is no overall magnitude of change for the GMFM-66 that is “clinically important.” As physical therapists, we must use our clinical judgment to determine this magnitude for each child that we encounter. CanChild Resources. Gross Motor Function Measure (GMFM). Accessed Feb 25th 2018. Article Review Contributing Factors Analysis for the Changes of the Gross Motor Function in Children with Spastic Cerebral Palsy After Physical Therapy Purpose: This study was aimed to assess different factors that may impact gross motor function in those patients with spastic cerebral palsy. Study population: The patients were children diagnosis with spastic cerebral palsy from 2 to 6 years old. This study included 24 males and 21 females (45 children total) with spastic CP. Those included were not allowed to receive botulinum toxin injection or surgery within the past 6 months. Methods: It was a retrospective study reviewing patient’s…
Factors Influencing the Gross Motor Outcome of Intensive Therapy in Children with Cerebral Palsy and Developmental Delay
Updated Information: The price of the current GMFM user manual (2nd edition, Wiley Publishing Co) has increased to $143.00 since the previous postings. The scoring program, GMAE-2, can be downloaded for free at www.canchild.ca. At this time, there are no additional updates to the information reported in the posts above. Article Summary: Title: Factors Influencing the Gross Motor Outcome of Intensive Therapy in Children with Cerebral Palsy and Developmental Delay Purpose: The purpose of this study was to identify factors that are influential in determining the effectiveness of intensive therapy programs on gross motor function in children who have cerebral palsy (CP) or various developmental delays. Study Population: The population of this study targets children with CP or developmental delays. Inclusion criteria for this study required participants to be less than 7 years old with developmental delays that required both physical and occupational therapy. Mean age at…
Gross Motor Function Measure Update and Article Summary
Updated Information: The price of the GMFM user’s manual, 2nd edition from Wiley Publishing Co. is now $119.00 for the spiral bound paperback copy. The Gross Motor Ability Estimator (GMAE-2), a computer program used for scoring the GMFM, is free for download at CanChild’s website (www.canchild.ca). Requirements for download include: Java version 7, 100MB Free Hard Disk Space is recommended for software and data storage, Windows XP and above (if using Windows), Mac OSX 10.7 and above (if using a Mac), Adobe Acrobat Reader, Unzip File utility, and a screen display resolution of at least 1024×768. Article Summary: Habitual Physical Activity in Children with Cerebral Palsy Aged 4 to 5 Years Across all Functional Abilities Purpose: The purpose of the study was to explore the impact of habitual physical activity versus sedentary time on functional abilities in preschool aged children with cerebral palsy. Also, to compare the children in…
Gross Motor Function Measure (GMFM) Update 2017
Updated Information: GMFM (GMFM-66 and GMFM-88) User’s manual, 2nd edition from Wiley Publishing Co. is $119 for a spiral bound paperback The GMFM-88 can be best utilized for children with Cerebral Palsy or Down Syndrome who are very young or whose highest motor ability is lying and rolling. The GMFM-66 is a quicker to administrate than the GMFM-88 and can only be used for children with Cerebral Palsy. The online computer system required for the GMFM-66 has been updated to the GMAE-2 which offers the ability to import data from the original GMAE program and export into CSV files, an updated tutorial, the ability to plot the child’s percentile compared to peers, score sheets, and the ability to calculate scores for the GMFM-88, GMFM-66, GMFM-IS (item set), and GMFM-66-B&C (basal and ceiling). The GMAE-2 is available for free download on the Canchild website https://canchild.ca/en/resources/191-gross-motor-ability-estimator-gmae-2-scoring-software-for-the-gmfm Article Summary: This study aimed…
GMFM update 2016
Updated Information: GMFM user’s manual, 2nd edition from Wiley Publishing Co. is $123 USD for a spiral bound paperback copy. The examiner will need a computer program entitled “Gross Motor Ability Estimator (GMAE) in order to calculate the interval level total score for the new version GMFM-66. Article Summary: Gross Motor Function Outcome After Intensive Rehabilitation in Children With Bilateral Spastic Cerebral Palsy The purpose of this study was to examine the changes in Gross Motor Function Measure (GMFM) scores for patients with bilateral spastic Cerebral palsy (CP) receiving various rehabilitation treatments. A retrospective chart review was performed for 44 children receiving physical therapy treatment from January 2011-January 2014. Participants were divided into an intensive rehab (inpatient) group of 24 patients and an intermittent rehab (outpatient) group of 20 patients. The inpatient group received 11, 30 minute sessions of PT and OT each per week for 4 weeks. The outpatient group…
Gross Motor Function Measure
Title: Gross Motor Function Test (GMFM-88, and most recent the GMFM-66), Date published, December 2002. Second edition, December 16, 2013 Authors: Dianne J. Russell, Peter L. Rosenbaum, Lisa M. Avery, Mary Lane Source: Published by Mac Keith Press, ISBN for GMFM-88 # 1 89868329 8 and ISBN for GMFM-66 # 1 89868329 8) Costs: $119 for User’s Manual, 2nd Edition through Wiley Blackwell Publishing. CanChild grants permission for printing, but does not allow the sale of the GMFCS. Go to the following website to learn more, http://motorgrowth.canchild.ca/en/GMFM/overview.asp Purpose: To evaluate change in motor function over time or with intervention for children with cerebral palsy. It has also been validated with children who have Down syndrome. Type of test: Standardized observational test Target Population and Ages: The original validation sample included children 5 months to 16 years old. The GMFM-88 is appropriate for children or adolescents with cerebral palsy or Down…
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The Gross Motor Function Measure (GMFM) is an assessment tool designed and evaluated to measure changes in gross motor function over time or with intervention in children with cerebral palsy. It was first developed in the late 1980s for use in both clinical and research settings and has evolved through advanced analytic techniques and in response to requests for more efficient testing. The GMFM user's manual is available for purchase at the Mac Keith Press website.
The GMFM-88 and GMFM-66
There are two versions of the GMFM. The GMFM-88 is the original 88-item measure. Items span the spectrum of gross motor activities in five dimensions.
A: Lying and Rolling,
Gmfm 66 Score Sheet Value
B: Sitting,
C: Crawling and Kneeling,
Adobe pro key generator. D: Standing, and
E: Walking, Running and Jumping.
The GMFM-66 is a 66 item subset of the original 88 items identified through Rasch analysis to best describe the gross motor function of children with cerebral palsy of varying abilities. It has a unidimensional scale providing interval scaling rather than the ordinal scaling of the GMFM-88. Items are ordered in terms of difficulty and a unit of change has the same meaning throughout the scale ranging from 0 to 100. The GMFM-66 provides information on the level of difficulty of each item thereby providing information to assist with realistic goal setting.
Abbreviated Versions of the GMFM-66
Two abbreviated versions of the GMFM-66 have been developed to facilitate the best choice of test items.
The Item Set version uses an algorithm with three decision items to determine which one of the four items sets is most appropriate for a child’s level of functioning.
The Basal & Ceiling version uses guidelines based on Gross Motor Function Classification System levels and age to determine suggested points at which to begin testing. A basal level is established when three consecutive items based on difficulty order are scored as 3. Testing continues in order of difficulty until three consecutive items are scored as 0, establishing the ceiling. A minimum of 15 items must be scored.
Both versions are reliable and valid, however, the item set version is preferable for children with unilateral cerebral palsy.
Gmfm 66 Score Sheet Chart
Choosing between the GMFM-88 and GMFM-66
The choice of which GMFM version to use depends on the purpose of the assessment. The GMFM-88 provides more descriptive information about motor function for very young children or children with more complex motor disability such as those functioning in GMFCS level V as it has more items that describe early motor skills.
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The GMFM-88 should be used if the evaluation of children using ambulatory aids and/or orthoses or shoes is of interest as the GMFM-66 scores are based on barefoot testing. The GMFM-88 also allows testing of one or more specific dimensions.
The GMFM-66 takes less time to administer compared to the GMFM-88 and it does not require all items to be assessed to get an accurate estimate of a child’s score. To document within-child change over time or to compare patterns of change among children, the GMFM-66 provides a more meaningful assessment of change because the items are ordered by level of difficulty. Furthermore, change over and above measurement error is easily determined by examining the extent of overlap of the 95% confidence intervals produced by the GMAE.
Use of the GMFM in other populations
The validation sample for the original GMFM included children 5 months to 16 years of age. The items are appropriate for those with motor skills at or below those of a 5-year-old child without any motor disability. Currently, there are no published references of use of the GMFM in adult populations however research is currently underway.
The GMFM-88 samples motor skills that are typical of normal developmental milestones and therefore may be useful for other diagnostic populations. Reliability and validity should be established prior to using it in other groups. There is some evidence for its use in children with Down syndrome, traumatic brain injury, spinal muscular atrophy, osteogenesis imperfecta, hereditary spastic paresis, and acute lymphoblastic leukemia.
Gmfm 66 Score Sheet Template
Testing Children with Down syndrome
Gmfm 66 Score Sheets
The GMFM-88 is valid for use in children with Down syndrome. Specific guidelines are available in the GMFM manual. For example, some items can be scored automatically.