The purposes of this study were to compare the reliability and validity of an 88-item version of the Gross Motor Function Measure (GMFM-88) and a 66-item version of GMFM (GMFM-66) in children with cerebral palsy (CP). The GMFM was completed in 154 children with CP (age range = 6~12). The internal consistency of the GMFM was calculated by Cronbach's for judging reliability. The reliability of GMFM-88 and GMFM-66 were both above .99. The validity of measurement obtained by the GMFM was assessed by examining the unidimensionality of items and by comparing Gross Motor Function Classification System (GMFCS) levels with tests of the GMFM. Both the GMFM-88 and GMFM-66 were satisfied with unidimensionality. Discriminant validity was demonstrated on significant decreases in scores with increasing GMFCS levels in both measurements. However, GMFM-66 was a more sensitive discriminant in GMFCS level 1 and level 2 and in level 2 and level 4. This study reported a comparison of the reliability and validity of GMFM-88 and GMFM-66. The results of this study have implications for the information on the psychometric properties of two versions of GMFCS. This information will be useful for the selection of tools in clinics.

The Gross Motor Function Measure (GMFM) is an internationally widely used outcome measure. The aim of this study was to evaluate the structural properties of the Korean version of GMFM using the Rasch Model, with regard to scoring within rehabilitation centers in Korea. GMFM data for 206 children with cerebral palsy were collected from 11 outpatient rehabilitation facilities by 29 pediatric therapists. The Winsteps software was used to refine the rating scale. This study suggests that the scoring categories of the Korean version of the GMFM should be collapsed from 0 (subject does not initiate task), 1 (subject initiates task), 2 (subject partially completes task), 3 (subject completes task) to 0 (subject does not initiate task), 1 (subject initiates or partially completes task), 2 (subject completes task) for better accuracy in estimating the gross motor function of children with cerebral palsy.

목적 : 뇌성마비가 아닌 발달장애로 진단된 아동을 대상으로 GMFM과 BSID-Ⅱ 평가를 각각 실시한 후 GMFM이 BSID-Ⅱ의 하위 항목들과 상관관계가 있는지 알아봄으로써 발달장애 아동의 평가도구로써 활용가능성을 검증하고자 한다. 연구방법 : 연구의 대상은 인하대학부속병원 재활의학과에서 뇌성마비 이외의 발달장애로 진단받은 만 3세 이하의 아동 26명을 대상으로 GMFM과 BSID-Ⅱ를 평가하였다. 대상자들의 특성에 따라 조산의 유무, 출생시 체중, 역연령에 따라 구분한 후 각 집단간 차이 및 두 평가도구의 상관관계를 알아보았다. 결과 : 발달장애 아동 26명 중 조산의 유무와 출생시 체중에 따라 각 집단간 GMFM, BSID-Ⅱ 정신척도, BSID-Ⅱ 운동척도의 점수를 비교한 결과 유의한 차이가 없었으며, 교정연령에 따른 집단에서만 유의한 차이가 있었다(p<0.05). 또한 집단간 GMFM과 BSID-Ⅱ 정신척도는 조산아(r=0.68), 만숙아(r=0.67), 저체중아(r=0.63), 평균체중아(r=0.72)에서 모두 상관관계가 있었으며, GMFM과 BSID-Ⅱ 운동척도도 조산아(r=0.57), 만숙아(r=0.89), 저체중아(r=0.65), 평균체중아(r=0.90)에서 모두 상관관계가 있었다. 전체 아동의 GMFM과 BSID-Ⅱ 정신척도의 상관계수는 0.71, GMFM과 BSID-Ⅱ 운동척도의 상관계수는 0.84로 관계가 있었으며, 교정연령 상 하위집단에서 0.56-0.85로 상관관계가 있었다. 결론 : 본 연구의 결과를 볼 때 발달장애 아동의 GMFM과 BSID-Ⅱ의 평가 결과는 모두 뚜렷한 상관관계를 나타내었으며, 발달장애 아동의 운동기능을 평가하는데 있어 GMFM의 적용가능성을 보여주는 기초 자료가 될 것으로 사료된다.

The purpose of this study was to validate the Korean version of the Gross Motor Function Measure (GMFM) using Rasch analysis. The data was obtained from the assessments of 59 children with cerebral palsy in Korea and were applied to Rasch's rating scale model to estimate the difficulty and goodness-of-fit of each item. Rasch modeling helped us to identify 76 items from the original 88-item GMFM that form an unidimensional hierarchical scale to rearrange 76 items in order of difficulty. Reliability coefficients of the 88-item and 76-item GMFM were .99 and .99, respectively. In this preliminary report, the Korean version of GMFM seems to have significant validity and reliability. These results may be useful in assessment of gross motor functions in children with cerebral palsy.

These were two main purposes of this study. The first was to research the relevance between gross motor function measurement (GMFM) and the spatiotemporal parameters of gait in children with cerebral palsy. The second was to research the relevance between gross motor performance measure (GMPM) and the spatiotemporal gait parameters. Twelve children ( years) with cerebral palsy participated in this study. GMFM and GMPM were performed and the spatiotemporal parameters of gait were measured by using WalkWay MG-1000. There were no significant correlations between the GMFM score and the stride length, step length, step width, cadence, and velocity (p>.05). The GMPM score also had no significant correlation with the spatiotemporal gait parameter (p>.05).

This paper presents the relevance between GMFM and the spatiotemporal parameters of gait in children with cerebral palsy. Twenty-one children ( months) with cerebral palsy participated in this study. GMFM was performed and spatiotemporal parameters of gait were measured by foot print gait analysis. A correlation analysis was used to investigate the correlation between GMFM scores and spatiotemporal parameters of gait. A linear regression analysis was employed to find how much each gait spatiotemporal parameters could be predicted from GMFM scores. The total GMFM scores was significantly correlated with walking speed, cadence, and stride length. Dimensions D (standing) and E (walking, running, and jumping) were more significantly correlated with gait spatiotemporal parameters than dimensions A (lying and rolling), B (sitting), and C (crawling and kneeling). The GMFM scores were useful for predicting spatiotemporal parameters. However, it is difficult to predict the status of gait development using GMFM scores because GMFM scores and gait spatiotemporal parameters are only measured as quantities not qualities. In the field, it is easily found that many children with cerebral palsy are unable to walk in any way. Consequently, gait analysis cannot be performed in many cases. Therefore, it is more reasonable to investigate the influence of GMFM on spatiotemporal parameters, rather than vice versa.