Morris Christopher, Galuppi Barbara E, Rosenbaum Peter L
National Perinatal Epidemiology Unit, Institute of Health Sciences, University of Oxford, UK.
Dev Med Child Neurol. 2004 Jul;46(7):455-60. doi: 10.1017/s0012162204000751.
The aim of this study was to determine the reliability of family reports for the Gross Motor Function Classification System (GMFCS), a condition-specific discriminative measure of severity of movement disability for children with cerebral palsy (CP). We conducted a cross-sectional survey using a short questionnaire with families of children with CP for whom we already had ratings of GMFCS level made by a health professional. We assessed the potentially confounding effect of whether the family had discussed the GMFCS with a professional. Two hundred and one questionnaires were posted to families of which 97 (48%) were completed and returned. Mean age of the children (53 males, 40 females) was 9 years 5 months (SD 1 year 1 month), range 6 to 11 years. Children of the families who responded encompassed the spectrum of types and distribution of impairment and severity of movement disability. The intraclass correlation coefficient (ICC) of agreement between professionals and families who had discussed their child's GMFCS level with a health professional (n=35) was 0.97 (95% confidence interval [CI] 0.96 to 0.98); for those who had not (n=52) the ICC was 0.92 (95% CI 0.91 to 0.93); and for the whole sample (n=93) the ICC was 0.94 (95% CI 0.90 to 0.96). Stability between ratings made by health professionals for children when they were in the 4 to 6 year age band of the GMFCS and ratings made by families for the same children when they were in the 6 to 12 year age band (n=35) was ICC=0.96 (95% CI 0.95 to 0.97). The excellent agreement demonstrated in this study suggests that family reports of the GMFCS made by using our questionnaire provide a reliable method for measuring gross motor function in children between 6 and 12 years old. This might be more efficient for observational studies of large populations, experimental research, or community health administration than direct observation, particularly when professional assessment is not feasible.
本研究旨在确定家庭报告对于粗大运动功能分类系统（GMFCS）的可靠性，GMFCS是一种针对脑瘫（CP）儿童运动残疾严重程度的特定病情判别指标。我们使用简短问卷对CP儿童家庭进行了横断面调查，这些儿童的GMFCS水平已有健康专业人员给出的评级。我们评估了家庭是否与专业人员讨论过GMFCS这一潜在混杂因素的影响。向家庭发放了201份问卷，其中97份（48%）填写并返回。儿童的平均年龄（53名男性，40名女性）为9岁5个月（标准差1岁1个月），年龄范围为6至11岁。回复家庭的儿童涵盖了损伤类型、分布以及运动残疾严重程度的范围。与健康专业人员讨论过孩子GMFCS水平的专业人员和家庭之间的组内相关系数（ICC）（n = 35）为0.97（95%置信区间[CI] 0.96至0.98）；未讨论过的（n = 52）ICC为0.92（95%CI 0.91至0.93）；整个样本（n = 93）的ICC为0.94（95%CI 0.90至0.96）。健康专业人员在儿童处于GMFCS的4至6岁年龄组时给出的评级与家庭在儿童处于6至12岁年龄组时给出的相同儿童的评级之间的稳定性（n = 35）为ICC = 0.96（95%CI 0.95至0.97）。本研究中显示的高度一致性表明，使用我们的问卷进行的GMFCS家庭报告为测量6至12岁儿童的粗大运动功能提供了一种可靠的方法。对于大人群的观察性研究、实验研究或社区卫生管理而言，这可能比直接观察更有效，尤其是在专业评估不可行时。
