Gross Motor Function Measure
The Gross Motor Function Measure (GMFM) is an observational clinical tool designed to evaluate change in gross motor function in children with cerebral palsy. There are two versions of the GMFM - the original 88-item measure (GMFM-88) and the more recent 66-item GMFM (GMFM-66) (1)
The objective of Gross Motor Function Measure is to evaluate the gross motor functions in children with cerebral palsy (CP).The evaluation of motor function is essential to monitor and adjust therapies to optimize the effect of rehabilitation of children with cerebral palsy (CP).
Children with cerebral palsy (CP) aged between 5 months to 16 years whose motor skills is delayed compared to those who has the same age. Some evidence said that GMFM can be used for children with Down syndrome.
Method of Use:
The GMFM-88 item scores can be summed to calculate raw and percent scores for each of the five GMFM dimensions of interest, selected goal areas and a total GMFM-88 score .For the GMFM-66 a free computer program, the Gross Motor Ability Estimator (GMAE), is required to calculate total scores.
The scoring system of the GMFM is a four-point scale divided into five categories (lying and rolling; sitting; crawling and kneeling; standing; walking, running).Specific descriptors for scoring items are detailed in the administration and scoring guidelines .A 5-year old child without motor disabilities is able to reach the maximum score 1.
Administering the GMFM-88 may take approximately 45 to 60 minutes for someone familiar with the measure, depending on the skill of the assessor, the ability of the child and the child’s level of the cooperation and understanding. the GMFM-66 should take less time to administer as there are fewer items (1).
Required Qualifications: The GMFM was designed for use by pediatric therapists who are familiar with assessing motor skills in children. Users should familiarize themselves with the GMFM guidelines and score sheet prior to assessing children.
Physiotherapy gym (e.g mat, bench, toys).Access to stairs (with at least 5 steps) is also necessary .
The GMFM show sufficient validity, responsiveness, and reliability for assessment of motor skills of children with cerebral palsy undergoing rehabilitation 2.
Reliability refers to dependability, consistency, and stability of scores on an assessment tool. Both versions of GMFM were shown to be highly reliable, with ICCs of greater than .98 (95% confidence interval=0.965-0.994) and both of them can be used in clinical practice or research.
Validity and Responsiveness: Validity includes responsiveness, which is defined as the ability to differentiate clinically important differences.Both versions of GMFM also demonstrated high levels of validity, with an ICC of .99 (95% confidence interval=0.972-0.997), reflecting associations with the GMFM-66.
Evaluating child abilities and the level of difficulty using the GMFM can be useful in identifying the impairments in motor skills and in evaluating the improvement as a result of intervention thereby providing much more information to assist with realistic goal setting 2.
1_Reliability and Responsiveness of the Gross Motor Function Measure-88 in Children With Cerebral Palsy (PDF Download Available). Available from: https://www.researchgate.net/publication/233385239_Reliability_and_Responsiveness_of_the_Gross_Motor_Function_Measure-88_in_Children_With_Cerebral_Palsy [accessed Aug 12, 2017].
2_Russell DJ, Rosenbaum PL, Avery LM, Lane M. Gross Motor Function Measure (GMFM-66 and GMFM-88) User’s Manual. London, United Kingdom: Mac Keith Press; 2002
Original Editor - User:Darine Mohieldeen