Interobserver Agreement of the Gross Motor Function Classification System in an Ambulant Population of Children with Cerebral Palsy

Autor/inn/en	McDowell, Brona C.; Kerr, Claire; Parkes, Jackie
Titel	Interobserver Agreement of the Gross Motor Function Classification System in an Ambulant Population of Children with Cerebral Palsy
Quelle	In: Developmental Medicine & Child Neurology, 49 (2007) 7, S.528-533 (6 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0012-1622
DOI	10.1111/j.1469-8749.2007.00528.x
Schlagwörter	Cerebral Palsy; Parents; Classification; Interrater Reliability; Psychomotor Skills; Clinical Diagnosis; Physical Mobility; Questionnaires; Computer Software; Computation; Children; Age Differences + Suchen Sie Ihr Suchwort? Hirnlähmung; Eltern; Classification system; Klassifikation; Klassifikationssystem; Interrater-Reliabilität; Psychomotorische Aktivität; Fragebogen; Child; Kind; Kinder; Age; Difference; Age difference; Altersunterschied
Abstract	Gross Motor Function Classification System (GMFCS) level was reported by three independent assessors in a population of children with cerebral palsy (CP) aged between 4 and 18 years (n=184; 112 males, 72 females; mean age 10y 10mo [SD 3y 7mo]). A software algorithm also provided a computed GMFCS level from a regional CP registry. Participants had clinical diagnoses of unilateral (n=94) and bilateral (n=84) spastic CP, ataxia (n=4), dyskinesia (n=1), and hypotonia (n=1), and could walk independently with or without the use of an aid (GMFCS Levels I-IV). Research physiotherapist (n=184) and parent/guardian data (n=178) were collected in a research environment. Data from the child's community physiotherapist (n=143) were obtained by postal questionnaire. Results, using the kappa statistic with linear weighting (K[subscript 1w]), showed good agreement between the parent/guardian and research physiotherapist (K[subscript 1w]=0.75) with more moderate levels of agreement between the clinical physiotherapist and researcher (K[subscript 1w]=0.64) and the clinical physiotherapist and parent/guardian (K[subscript 1w]=0.57). Agreement was consistently better for older children (greater than 2y). This study has shown that agreement with parent report increases with therapists' experience of the GMFCS and knowledge of the child at the time of grading. Substantial agreement between a computed GMFCS and an experienced therapist (K[subscript 1w]=0.74) also demonstrates the potential for extrapolation of GMFCS rating from an existing CP registry, providing the latter has sufficient data on locomotor ability. (As Provided).
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Update	2017/4/10