Expanded and revised gross motor function classification system: study for Chinese school children with cerebral palsy

Abstract

Purpose: To determine the reliability and validity of the Chinese version of Expanded and Revised Gross Motor Function Classification System (GMFCS-ER) for cerebral palsy (CP) and to explore if there existed differences between parents and the other raters. Method: The GMFCS-ER was translated into Chinese. Children with CP age 6 to 18 years from two special education schools were assessed by 6 physiatrists, 21 physiotherapists, 15 teachers and parents. Inter-rater reliability was analyzed with inter-rater correlation coefficients (ICC). Validity was assessed using Gross Motor Function Measure (GMFM) score as the criterion standard. Results: Mean (SD) age of the 130 children (93 boys, 37 girls) was 11.5 (2.8) years. Overall ICCs ranged between 0.84 and 0.92. Reliabilities between physiatrists, physiotherapists and teachers (ICCs from 0.86 to 0.92) were higher than those between parents and the other raters (ICCs from 0.80 to 0.84) in 6-to-12 year age band. The overall correlation for criterion-related validity was −0.83. Conclusion: The Chinese version of the GMFCS-ER is a valid measure of functional ability in school children with CP and reliable enough for use by Chinese healthcare providers and parents. Effects of environmental and personal factors should be considered when practicing GMFCS-ER assessment.

Implications for Rehabilitation

• Cerebral palsy.

• Research about GMFCS-ER is needed to promote a more extensive use of GMFCS-ER in China for school children with CP.

• The Chinese version of the GMFCS-ER is a valid measure of functional ability in school children with CP and reliable enough for use by Chinese healthcare providers.

• Effects of environmental and personal factors should be considered when performing the GMFCS-ER assessment.

• Cerebral palsy
• expanded and revised gross motor function classification system
• motor function
• reliability
• validity

Acknowledgements

We appreciate the great support of all participants and their families. We thank many teachers for their help.

Declarations of interest

This study was supported by The National Natural Science Funds of China (project number 81273088) and Award Number 12GWZX0301. There are no financial benefits to the authors. As to the content of this article, there are no conflicts of interest.