- The GMFM is a standardized observational instrument designed and validated to measure change in gross motor function over time in children with cerebral palsy. The scoring key is meant to be a general guideline. However, most of the items have specific descriptors for each score.
- GMFM-66 Ability Estimator (GMAE) Software. The most accurate version of the GMFM-66 scoring program is the GMAE-3. It is included in the GMFM App+ which is available from the CanChild shop (The GMAE-2 is available at www.canchild.ca but is incompatible with newer computer operating systems.
- GMFM-66, Gross Motor Function Measure, Score sheet, GMFM 66 B&C, GMFM-66 B&C Score Sheet Created Date: 2/17/2012 2:21:19 PM.
The GMFM-88, which has 88 items, provides scores for each dimension, whereas the GMFM-66, with 66 items, provides a total score. The GMFM-66 is only used with children who have cerebral palsy, while the GMFM-88 can also be used with children who have Down Syndrome. Shortened versions of GMFM-66 have also been developed. GROSS MOTOR FUNCTION MEASURE (GMFM) SCORE SHEET (GMFM-88 and GMFM-66 scoring) ©Mac K eith Pr s, 20. The GMFM is a standardized observational instrument designed and validated to measure change in gross motor function over time in children with cerebral palsy. The scoring key is meant to be a general guideline. GROSS MOTOR FUNCTION MEASURE.
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 to adapt the Gross Motor Function Measure- 88 for Children who have both Cerebral Palsy (CP) and Cerebral Visual Impairment (CVI) and to determine the test- retest and interobserver reliability of the adapted version. The GMFM-88 detects changes in motor functioning and can be sued to measure changes in fundamental gross motor skills over time, as well as physiotheraputic intervention, for children with CP. Cerebral Visual Impairment (CVI) is a condition of central origin, defined as a deficit in visual function related to the malformation of retrogeniculate visual pathways including optic radiations, occipital cortex and visual association areas, without damage to the anterior visual pathways or other ocular disease. CVI is prevalent in approximately 30% of children diagnosed with variations of CP and is thought to play a role in disrupting the accuracy of the GMFM-88 in these patients. Thus, there evolved a need for an adaptation in the GMFM for these patients in order to generate a more accurate evaluation.
The study included 77 children aged 50 to 144 months along with 16 pediatric physical therapists who assessed them. A test-retest and interobserver reliability were conducted and administered twice within three weeks by these trained pediatric physical therapists. One of the therapists was familiar with the child and one of them was not. Seventy percent of experts agreed on the instruction portion of the GMFM-88 and most of the proposed adaptations were on the ‘crawling and kneeling' (GMFM-C) and ‘walking, running, jumping' (GMFM-E) dimensions. The believed the GMFM-E needed adaptations secondary to the complexity of jumping requiring more visual support for depth perception in varying heights. Adaptations were then made to these areas. Additionally, experts agreed that children with CVI may have difficulty visually localizing an object, may need assistance determining the height and position of stairs, and may require specific positioning of the therapist with rolling. Therefore, in accordance with GMFM-A for rolling, FMFM-B for sitting, and GMFM-D for standing, the following adaptations were made. These students should be told of the toy's location in advance, body position of the therapist with rolling should be on the side the child is rolling towards, and that these students are allowed to use their hand for orientation when climbing stairs, but not for supporting purposes.
The strengths of the article were the strong n value of 77 children, the strong test-retest reliability and interobserver reliability. Additionally, the randomization of pediatric therapists with the children they were observing. They accounted for the personal bias that may have played a role in therapy by adding a random pediatric therapist who would also observe that child. A thorough Delphi method was used to select experts who agreed on the adaptations. The test-retest reliability ICC's ranged between .94 to 1.0, mean percentages of identical scores between 29 to 71, and interobserver reliability ICC's of the adapted GMFM-88 were .99-1.0 for dimension scores. Mean percentages of the 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. Researchers deem this adaptation to be reliable and comparable to the original GMFM-88. The weaknesses of the article were that although primarily spastic CP (96%), participants with different types of CP were included with different degrees of severity were included. This may have created a more vast array of motor function between children included in the study. Similarly, Cerebral Visual Impairment also differed along a spectrum of deficit.
In conclusion, M. Salavati et. al has provided reasonable evidence to support the adaptation for CVI to be reliable and comparable to the original GMFM-88 to increase reliability of the GMFM assessment of children with CP and CVI.
Salavati, M., W. P. Krijnen, E.A. A. Rameckers, P. L. Looijestijin, C.G. B. Maathius, C.P. Van Der Schans, and B. Steenbergen. '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 ☆.' 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. Elsevier, July 2015. Web. 28 Feb. 2017.
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Gross Motor Function Measure (GMFM-66 & GMFM-88) User's Manual, 2nd edition (ebook)
Edition: 2nd
Page count: 304
£75.00(inc 20% VAT)
You can download chapters or sections from this book
Click on the link below to access your preferred format.
The Gross Motor Function Measure (GMFM) has become the best evaluative measure of motor function designed for quantifying change in the gross motor abilities of children with cerebral palsy. The measure is very widely used internationally and is now the standard outcome assessment tool. This second edition builds on the wide success of the first edition; new details of the measure are presented, its short forms and how to use the updated software. It also includes two abbreviated methods of estimating GMFM-66 scores using the GMFM-66-Item sets and the GMFM-66-Basal & Ceiling.
Readership
Physical therapists and other health professionals working with children, youth and adults with cerebral palsy; clinical and health services researchers; any clinician who is assessing and describing current gross motor function and evaluating its change over time.
Gross Motor Function Classification System Video
Video shared with permission from CanChild.
Software
The GMFM software can be purchased directly from CanChild. For further information, please visit their website.
Clinics in Developmental Medicine
Dianne J Russell is Research and Knowledge Exchange Specialist with CanChild Centre for Childhood Disability Research. She has been a health services researcher for over 20 years and a key individual in the development, evaluation and dissemination of clinical outcome measures such as the Gross Motor Function Measure (GMFM). Her current focus is on facilitating the use of research evidence in practice by engaging with research users throughout the research process and by making research results easily accessible in multiple formats to families, service providers, and policy decision-makers.
Peter L Rosenbaum is a Developmental Paediatrician, health services researcher, teacher, writer and editor. His career has been devoted to childhood disability, and all his roles have involved work with, or about, children with impairments and their families. He has held over 75 research grants and has contributed to almost 300 peer-reviewed papers, book chapters, editorials and invited commentaries in his field.
Marilyn Wright is a physiotherapist at McMaster Children's Hospital. She is Assistant Clinical Professor at McMaster University, Hamilton, Ontario, Canada.
Lisa M. Avery is an independent statistician and founder of Avery Information Services. She provides statistical consulting and analysis services to various academic institutions and is primarily involved in paediatric disability research. Her primary interests are outcome measurement and causation modelling.
- AUTHORS' APPOINTMENTS vii
- PREFACE TO THE SECOND EDITION viii
- PREFACE TO THE FIRST EDITION x
- ACKNOWLEDGEMENTS TO THE FIRST EDITION xi
- ACKNOWLEDGEMENTS TO THE SECOND EDITION xiii
- DISCLAIMER xiv
- 1. OVERVIEW OF THE GROSS MOTOR FUNCTION MEASURE (GMFM) 1
- 2. CONCEPTUAL BACKGROUND 4
- 3. DEVELOPMENT AND VALIDATION OF THE GMFM-88 12
- with Niina Kolehmainen
- 4. DEVELOPMENT AND VALIDATION OF THE GMFM-66 25
- with Niina Kolehmainen
- 5. GMFM-66: TWO SHORT FORMS OF ADMINISTRATION 46
- 6. ADMINISTRATION AND SCORING GUIDELINES
- FOR THE GMFM-88 AND GMFM-66 61
- with Mary Lane
- 7. INTERPRETATION AND USES OF THE GMFM-88 AND GMFM-66 137
- 8. APPLICATIONS OF THE GMFM: WHAT HAVE WE
- LEARNED AND WHERE CAN WE GO NEXT? 183
- REFERENCES 190
- GLOSSARY OF TERMS 196
- APPENDIX 1. METHODS OF DISPLAYING ITEM DIFFICULTY 201
- APPENDIX 2. DISPLAY OF ITEM DIFFICULTIES USING
- THURSTONE THRESHOLDS 207
- APPENDIX 3. GROSS MOTOR ABILITY ESTIMATOR-2 (GMAE-2)
- SCORING PROGRAM TUTORIAL FOR THE GMFM-66 210
- APPENDIX 4. CASE SCENARIOS OF TWO CHILDREN WHO MISFIT
- THE GMFM-66 ITEM DIFFICULTY MODEL 231
- APPENDIX 5. GMFM-66 ITEM SET SCORE SHEET 237
- APPENDIX 6. GMFM-66 BASAL & CEILING SCORE SHEET 244
- APPENDIX 7. GROSS MOTOR FUNCTION CLASSIFICATION SYSTEM-EXPANDED & REVISED (GMFCS-E&R) 247
- APPENDIX 8. GMFM-88 AND GMFM-66 SCORE SHEET 251
- APPENDIX 9. GMFM-66 AND GMFM-88 CROSS-SECTIONAL
- AND CHANGE SCORES 257
- APPENDIX 10. STANDARD ERROR OF MEASUREMENT 262
- APPENDIX 11. CASE SCENARIO OF TREVOR 263
- APPENDIX 12. ADDITIONAL EXAMPLES OF THE USE OF THE MOTOR
- MEASURES WITH CHILDREN WITH CEREBRAL PALSY
- IN PHYSICAL THERAPY PRACTICE 270
- Doreen J Bartlett and Laura K Brunton
- APPENDIX 13. ONTARIO MOTOR GROWTH CURVES 280
- INDEX 287
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 to adapt the Gross Motor Function Measure- 88 for Children who have both Cerebral Palsy (CP) and Cerebral Visual Impairment (CVI) and to determine the test- retest and interobserver reliability of the adapted version. The GMFM-88 detects changes in motor functioning and can be sued to measure changes in fundamental gross motor skills over time, as well as physiotheraputic intervention, for children with CP. Cerebral Visual Impairment (CVI) is a condition of central origin, defined as a deficit in visual function related to the malformation of retrogeniculate visual pathways including optic radiations, occipital cortex and visual association areas, without damage to the anterior visual pathways or other ocular disease. CVI is prevalent in approximately 30% of children diagnosed with variations of CP and is thought to play a role in disrupting the accuracy of the GMFM-88 in these patients. Thus, there evolved a need for an adaptation in the GMFM for these patients in order to generate a more accurate evaluation.
The study included 77 children aged 50 to 144 months along with 16 pediatric physical therapists who assessed them. A test-retest and interobserver reliability were conducted and administered twice within three weeks by these trained pediatric physical therapists. One of the therapists was familiar with the child and one of them was not. Seventy percent of experts agreed on the instruction portion of the GMFM-88 and most of the proposed adaptations were on the ‘crawling and kneeling' (GMFM-C) and ‘walking, running, jumping' (GMFM-E) dimensions. The believed the GMFM-E needed adaptations secondary to the complexity of jumping requiring more visual support for depth perception in varying heights. Adaptations were then made to these areas. Additionally, experts agreed that children with CVI may have difficulty visually localizing an object, may need assistance determining the height and position of stairs, and may require specific positioning of the therapist with rolling. Therefore, in accordance with GMFM-A for rolling, FMFM-B for sitting, and GMFM-D for standing, the following adaptations were made. These students should be told of the toy's location in advance, body position of the therapist with rolling should be on the side the child is rolling towards, and that these students are allowed to use their hand for orientation when climbing stairs, but not for supporting purposes.
The strengths of the article were the strong n value of 77 children, the strong test-retest reliability and interobserver reliability. Additionally, the randomization of pediatric therapists with the children they were observing. They accounted for the personal bias that may have played a role in therapy by adding a random pediatric therapist who would also observe that child. A thorough Delphi method was used to select experts who agreed on the adaptations. The test-retest reliability ICC's ranged between .94 to 1.0, mean percentages of identical scores between 29 to 71, and interobserver reliability ICC's of the adapted GMFM-88 were .99-1.0 for dimension scores. Mean percentages of the 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. Researchers deem this adaptation to be reliable and comparable to the original GMFM-88. The weaknesses of the article were that although primarily spastic CP (96%), participants with different types of CP were included with different degrees of severity were included. This may have created a more vast array of motor function between children included in the study. Similarly, Cerebral Visual Impairment also differed along a spectrum of deficit.
In conclusion, M. Salavati et. al has provided reasonable evidence to support the adaptation for CVI to be reliable and comparable to the original GMFM-88 to increase reliability of the GMFM assessment of children with CP and CVI.
Salavati, M., W. P. Krijnen, E.A. A. Rameckers, P. L. Looijestijin, C.G. B. Maathius, C.P. Van Der Schans, and B. Steenbergen. '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 ☆.' 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. Elsevier, July 2015. Web. 28 Feb. 2017.
Leave a Reply
You must be logged in to post a comment.
Gross Motor Function Measure (GMFM-66 & GMFM-88) User's Manual, 2nd edition (ebook)
Edition: 2nd
Page count: 304
£75.00(inc 20% VAT)
You can download chapters or sections from this book
Click on the link below to access your preferred format.
The Gross Motor Function Measure (GMFM) has become the best evaluative measure of motor function designed for quantifying change in the gross motor abilities of children with cerebral palsy. The measure is very widely used internationally and is now the standard outcome assessment tool. This second edition builds on the wide success of the first edition; new details of the measure are presented, its short forms and how to use the updated software. It also includes two abbreviated methods of estimating GMFM-66 scores using the GMFM-66-Item sets and the GMFM-66-Basal & Ceiling.
Readership
Physical therapists and other health professionals working with children, youth and adults with cerebral palsy; clinical and health services researchers; any clinician who is assessing and describing current gross motor function and evaluating its change over time.
Gross Motor Function Classification System Video
Video shared with permission from CanChild.
Software
The GMFM software can be purchased directly from CanChild. For further information, please visit their website.
Clinics in Developmental Medicine
Dianne J Russell is Research and Knowledge Exchange Specialist with CanChild Centre for Childhood Disability Research. She has been a health services researcher for over 20 years and a key individual in the development, evaluation and dissemination of clinical outcome measures such as the Gross Motor Function Measure (GMFM). Her current focus is on facilitating the use of research evidence in practice by engaging with research users throughout the research process and by making research results easily accessible in multiple formats to families, service providers, and policy decision-makers.
Peter L Rosenbaum is a Developmental Paediatrician, health services researcher, teacher, writer and editor. His career has been devoted to childhood disability, and all his roles have involved work with, or about, children with impairments and their families. He has held over 75 research grants and has contributed to almost 300 peer-reviewed papers, book chapters, editorials and invited commentaries in his field.
Marilyn Wright is a physiotherapist at McMaster Children's Hospital. She is Assistant Clinical Professor at McMaster University, Hamilton, Ontario, Canada.
Lisa M. Avery is an independent statistician and founder of Avery Information Services. She provides statistical consulting and analysis services to various academic institutions and is primarily involved in paediatric disability research. Her primary interests are outcome measurement and causation modelling.
- AUTHORS' APPOINTMENTS vii
- PREFACE TO THE SECOND EDITION viii
- PREFACE TO THE FIRST EDITION x
- ACKNOWLEDGEMENTS TO THE FIRST EDITION xi
- ACKNOWLEDGEMENTS TO THE SECOND EDITION xiii
- DISCLAIMER xiv
- 1. OVERVIEW OF THE GROSS MOTOR FUNCTION MEASURE (GMFM) 1
- 2. CONCEPTUAL BACKGROUND 4
- 3. DEVELOPMENT AND VALIDATION OF THE GMFM-88 12
- with Niina Kolehmainen
- 4. DEVELOPMENT AND VALIDATION OF THE GMFM-66 25
- with Niina Kolehmainen
- 5. GMFM-66: TWO SHORT FORMS OF ADMINISTRATION 46
- 6. ADMINISTRATION AND SCORING GUIDELINES
- FOR THE GMFM-88 AND GMFM-66 61
- with Mary Lane
- 7. INTERPRETATION AND USES OF THE GMFM-88 AND GMFM-66 137
- 8. APPLICATIONS OF THE GMFM: WHAT HAVE WE
- LEARNED AND WHERE CAN WE GO NEXT? 183
- REFERENCES 190
- GLOSSARY OF TERMS 196
- APPENDIX 1. METHODS OF DISPLAYING ITEM DIFFICULTY 201
- APPENDIX 2. DISPLAY OF ITEM DIFFICULTIES USING
- THURSTONE THRESHOLDS 207
- APPENDIX 3. GROSS MOTOR ABILITY ESTIMATOR-2 (GMAE-2)
- SCORING PROGRAM TUTORIAL FOR THE GMFM-66 210
- APPENDIX 4. CASE SCENARIOS OF TWO CHILDREN WHO MISFIT
- THE GMFM-66 ITEM DIFFICULTY MODEL 231
- APPENDIX 5. GMFM-66 ITEM SET SCORE SHEET 237
- APPENDIX 6. GMFM-66 BASAL & CEILING SCORE SHEET 244
- APPENDIX 7. GROSS MOTOR FUNCTION CLASSIFICATION SYSTEM-EXPANDED & REVISED (GMFCS-E&R) 247
- APPENDIX 8. GMFM-88 AND GMFM-66 SCORE SHEET 251
- APPENDIX 9. GMFM-66 AND GMFM-88 CROSS-SECTIONAL
- AND CHANGE SCORES 257
- APPENDIX 10. STANDARD ERROR OF MEASUREMENT 262
- APPENDIX 11. CASE SCENARIO OF TREVOR 263
- APPENDIX 12. ADDITIONAL EXAMPLES OF THE USE OF THE MOTOR
- MEASURES WITH CHILDREN WITH CEREBRAL PALSY
- IN PHYSICAL THERAPY PRACTICE 270
- Doreen J Bartlett and Laura K Brunton
- APPENDIX 13. ONTARIO MOTOR GROWTH CURVES 280
- INDEX 287
Gross Motor Function Classification System - Expanded & Revised
Video shared with permission from CanChild. For further information, please visit their website.
'The second edition of the Gross Motor Function Measure (GMFM-66 & GMFM-88): User's Manual is a wonderful resource for physical therapists and other health professional who work with children with cerebral palsy as well as for clinicians who are interested in assessing current gross motor function and monitoring change over time in both clinical and research settings.' Jennifer L McKinney, Journal of Child Neurology, 2014.
'Physical therapists and researchers who use the GMFM will find the User's Manual a valuable resource to administer and interpret the GMFM appropriately in clinical practice and research. The new case illustrations are particularly useful in selecting the most appropriate approach.' Barbara Sargent, Pediatric Physical Therapy, 2014.