Jahnsen Reidun, Aamodt Geir, Rosenbaum Peter
Section for Child Neurology, Rikshospitalet University Hospital, Norway.
Dev Med Child Neurol. 2006 Sep;48(9):734-8. doi: 10.1017/S0012162206001575.
The present study investigated the reliability of self-reported rating of Gross Motor Function Classification System (GMFCS) levels compared with professional rating, and changes in gross motor function over time, in adults with cerebral palsy. Twenty-nine females and 33 males aged between 18 years 5 months and 62 years 11 months (mean age 34y 7mo [SD 10y 6mo]) participated in the study. Participants rated their current gross motor function using the GMFCS and reported their judgement of their gross motor function at age 10 to 12 years. The project leader, a physical therapist, also classified participants' current GMFCS levels and conducted a chart review on all accessible medical records of participants' gross motor function when they were 10 to 12 years old, rating the GMFCS level accordingly. Intraclass correlation coefficients (ICC) between self-reported and professional ratings showed excellent agreement (ICC=0.93-0.95, 95% confidence interval [CI] 0.89-0.97). More than half the participants experienced a stable gross motor function from the age of 10 to 12 years to the present. Those at GMFCS Levels II and III at the age of 10 to 12 years (according to the professional rating) had significant change for the worse in gross motor function over time, with odds ratios of 9.30 (95% CI 1.2-73.0, p=0.03) and 7.00 (95% CI 1.1-43.0, p=0.04) respectively. Interview data on circumstances regarding changes in gross motor function since childhood are also reported. Changes in GMFCS level were mostly associated with physical or social environmental factors.
本研究调查了脑瘫成人自我报告的粗大运动功能分类系统（GMFCS）水平与专业评定相比的可靠性，以及粗大运动功能随时间的变化情况。29名女性和33名男性参与了研究，年龄在18岁5个月至62岁11个月之间（平均年龄34岁7个月[标准差10岁6个月]）。参与者使用GMFCS对自己当前的粗大运动功能进行评定，并报告他们10至12岁时对自己粗大运动功能的判断。项目负责人是一名物理治疗师，他也对参与者当前的GMFCS水平进行分类，并对参与者10至12岁时所有可获取的粗大运动功能医疗记录进行图表审查，据此评定GMFCS水平。自我报告评定与专业评定之间的组内相关系数（ICC）显示出极佳的一致性（ICC = 0.93 - 0.95，95%置信区间[CI] 0.89 - 0.97）。超过一半的参与者从10至12岁到现在粗大运动功能保持稳定。10至12岁时GMFCS水平为II级和III级（根据专业评定）的参与者，其粗大运动功能随时间有显著变差的变化，优势比分别为9.30（95% CI 1.2 - 73.0，p = 0.03）和7.00（95% CI 1.1 - 43.0，p = 0.04）。还报告了关于自童年以来粗大运动功能变化情况的访谈数据。GMFCS水平的变化大多与身体或社会环境因素有关。
