Abe Hirokazu, Higashi Shuhei, Himuro Nobuaki
Department of Health Care and Child Development, Saitama Children's Medical Center, Saitama, Japan.
Department of Physical Therapy, Kitakyushu Children's Rehabilitation Center, Kitakyushu, Japan.
Dev Med Child Neurol. 2025 Nov;67(11):1421-1442. doi: 10.1111/dmcn.16465. Epub 2025 Aug 14.
To investigate the application and evaluate the measurement properties of the Gross Motor Function Measure (GMFM) in children with conditions other than cerebral palsy (CP).
A systematic review was conducted using five electronic databases to identify studies that used the GMFM in children with conditions other than CP. Methodological quality and measurement properties were evaluated using established standards for assessing outcome measures.
We identified 210 studies across various paediatric conditions. Measurement property studies examined eight conditions: acquired brain injury, spinal muscular atrophy, Fukuyama congenital muscular dystrophy, Down syndrome, osteogenesis imperfecta, acute lymphoblastic leukaemia (ALL), leukodystrophy, and Pompe disease. Evidence quality was generally low to very low owing to small sample sizes and methodological limitations. Reliability showed sufficient ratings across most conditions. Content validity was examined only for ALL and demonstrated sufficient ratings. Responsiveness and construct validity showed variable results across conditions. Clinical application analysis revealed inadequate methodological reporting and widespread use without appropriate validation.
GMFM validation for conditions other than CP remains insufficient despite widespread use. Content validity verification and enhanced methodological rigor are critically needed. Clinicians should interpret results cautiously until robust validation is established.
探讨粗大运动功能测量量表(GMFM)在脑瘫(CP)以外疾病儿童中的应用情况,并评估其测量特性。
使用五个电子数据库进行系统评价,以识别在CP以外疾病儿童中使用GMFM的研究。采用评估结局指标的既定标准对方法学质量和测量特性进行评估。
我们在各种儿科疾病中识别出210项研究。测量特性研究考察了八种疾病:获得性脑损伤、脊髓性肌萎缩症、福山型先天性肌营养不良、唐氏综合征、成骨不全症、急性淋巴细胞白血病(ALL)、脑白质营养不良和庞贝病。由于样本量小和方法学局限性,证据质量普遍较低至极低。在大多数疾病中,可靠性显示出足够的评分。仅对ALL进行了内容效度检查,结果显示评分足够。反应度和结构效度在不同疾病中的结果各异。临床应用分析显示,方法学报告不足,且在未进行适当验证的情况下广泛使用。
尽管GMFM被广泛使用,但在CP以外疾病中的验证仍然不足。迫切需要进行内容效度验证并提高方法学严谨性。在建立可靠的验证之前,临床医生应谨慎解释结果。