scholarly journals Minimum Clinically Important Difference of Gross Motor Function and Gait Endurance in Children with Motor Impairment: A Comparison of Distribution-Based Approaches

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Fabio Alexander Storm ◽  
Maurizio Petrarca ◽  
Elena Beretta ◽  
Sandra Strazzer ◽  
Luigi Piccinini ◽  
...  
Keyword(s):  
Motor Function ◽  
Motor Impairment ◽  
Minimum Clinically Important Difference ◽  
Gait Training ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Clinically Important Difference ◽  
Gross Motor Function Measure ◽  
The Impact ◽  
First Time

Objective. The minimum clinically important difference (MCID) is a standard way of measuring clinical relevance. The objective of this work was to establish the MCID for the 6-minute walking test (6minWT) and the Gross Motor Function Measure (GMFM-88) in pediatric gait disorders. Methods. A cohort, pretest-posttest study was conducted in a hospitalized care setting. A total of 182 patients with acquired brain injury (ABI) or cerebral palsy (CP) performed 20 robot-assisted gait training sessions complemented with 20 sessions of physical therapy over 4 weeks. Separate MCIDs were calculated using 5 distribution-based approaches, complemented with an anonymized survey completed by clinical professionals. Results. The MCID range for the 6minWT was 20-38 m in the ABI cohort, with subgroup ranges of 20-36 m for GMFCS I-II, 23-46 m for GMFCS III, and 24-46 m for GMFCS IV. MCIDs for the CP population were 6-23 m, with subgroup ranges of 4-28 m for GMFCS I-II, 9-19 m for GMFCS III, and 10-27 m for GMFCS IV. For GMFM-88 total score, MCID values were 1.1%-5.3% for the ABI cohort and 0.1%-3.0% for the CP population. For dimension “D” of the GMFM, MCID ranges were 2.3%-6.5% and 0.8%-5.2% for ABI and CP populations, respectively. For dimension “E,” MCID ranges were 2.8%-6.5% and 0.3%-4.9% for ABI and CP cohorts, respectively. The survey showed a large interquartile range, but the results well mimicked the distribution-based methods. Conclusions. This study identified for the first time MCID ranges for 6minWT and GMFM-88 in pediatric patients with neurological impairments, offering useful insights for clinicians to evaluate the impact of treatments. Distribution-based methods should be used with caution: methods based on pre-post correlation may underestimate MCID when applied to patients with small improvements over the treatment period. Our results should be complemented with estimates obtained using consensus- and anchor-based approaches.

scholarly journals Overground Robot-Assisted Gait Training for Pediatric Cerebral Palsy

Sensors ◽  
2021 ◽  
Vol 21 (6) ◽  
pp. 2087
Author(s):  
Seung Ki Kim ◽  
Dongho Park ◽  
Beomki Yoo ◽  
Dain Shim ◽  
Joong-On Choi ◽  
...  
Keyword(s):  
Oxygen Consumption ◽  
Motor Function ◽  
Gait Training ◽  
Walk Test ◽  
Wearable Robot ◽  
Robot Assisted ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Gross Motor Function Measure ◽  
Function Measure

The untethered exoskeletal robot provides patients with the freest and realistic walking experience by assisting them based on their intended movement. However, few previous studies have reported the effect of robot-assisted gait training (RAGT) using wearable exoskeleton in children with cerebral palsy (CP). This pilot study evaluated the effect of overground RAGT using an untethered torque-assisted exoskeletal wearable robot for children with CP. Three children with bilateral spastic CP were recruited. The robot generates assistive torques according to gait phases automatically detected by force sensors: flexion torque during the swing phase and extension torque during the stance phase at hip and knee joints. The overground RAGT was conducted for 17~20 sessions (60 min per session) in each child. The evaluation was performed without wearing a robot before and after the training to measure (1) the motor functions using the gross motor function measure and the pediatric balance scale and (2) the gait performance using instrumented gait analysis, the 6-min walk test, and oxygen consumption measurement. All three participants showed improvement in gross motor function measure after training. Spatiotemporal parameters of gait analysis improved in participant P1 (9-year-old girl, GMFCS II) and participant P2 (13-year-old boy, GMFCS III). In addition, they walked faster and farther with lower oxygen consumption during the 6-min walk test after the training. Although participant P3 (16-year-old girl, GMFCS IV) needed the continuous help of a therapist for stepping at baseline, she was able to walk with the platform walker independently after the training. Overground RAGT using a torque-assisted exoskeletal wearable robot seems to be promising for improving gross motor function, walking speed, gait endurance, and gait efficiency in children with CP. In addition, it was safe and feasible even for children with severe motor impairment (GMFCS IV).

scholarly journals Targeted Physical Therapy Combined with Spasticity Management Changes Motor Development Trajectory for a 2-Year-Old with Cerebral Palsy

2021 ◽  
Vol 11 (3) ◽  
pp. 163
Author(s):  
Corri L. Stuyvenberg ◽  
Shaaron E. Brown ◽  
Ketaki Inamdar ◽  
Megan Evans ◽  
Lin-ya Hsu ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Motor Development ◽  
Developmental Trajectory ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Gross Motor Function Measure ◽  
Essential Components ◽  
The Impact ◽  
Function Measure

Therapies for children with cerebral palsy (CP) often fail to address essential components of early rehabilitation: intensity, child initiation, and an embodied approach. Sitting Together And Reaching To Play (START-Play) addresses these issues while incorporating intensive family involvement to maximize therapeutic dosage. While START-Play was developed and tested on children aged 7–16 months with motor delays, the theoretical construct can be applied to intervention in children of broader ages and skills levels. This study quantifies the impact of a broader START-Play intervention combined with Botulinum toxin-A (BoNT-A) and phenol on the developmental trajectory of a 24 month-old child with bilateral spastic CP. In this AB +1 study, A consisted of multiple baseline assessments with the Gross Motor Function Measure-66 and the Assessment of Problem Solving in Play. The research participant demonstrated a stable baseline during A and changes in response to the combination of BoNT-A/phenol and 12 START-Play sessions during B, surpassing the minimal clinically important difference on the Gross Motor Function Measure-66. The follow-up data point (+1) was completed after a second round of BoNT-A/phenol injections. While the findings suggest the participant improved his gross motor skills with BoNT-A/phenol and START-Play, further research is needed to generalize these findings.

Training Users in the Gross Motor Function Measure: Methodological and Practical Issues

1994 ◽  
Vol 74 (7) ◽  
pp. 630-636 ◽  
Author(s):  
Dianne J Russell ◽  
Peter L Rosenbaum ◽  
Mary Lane ◽  
Carolyn Gowland ◽  
Charles H Goldsmith ◽  
...  
Keyword(s):  
Motor Function ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Gross Motor Function Measure ◽  
Function Measure

The Relationship between Aquatic Independence and Gross Motor Function in Children with Neuro-Motor Impairments

2006 ◽  
Vol 23 (4) ◽  
pp. 339-355 ◽  
Author(s):  
Miriam Getz ◽  
Yeshayahu Hutzler ◽  
Adri Vermeer
Keyword(s):  
Motor Function ◽  
Motor Performance ◽  
Motor Impairments ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Gross Motor Function Measure ◽  
Scale Scores ◽  
The Relationship ◽  
Pearson Correlations ◽  
Function Measure

The purpose of this study was to investigate the relationship between motor performance in the aquatic setting as measured by the Aquatic Independence Measure (AIM) to motor performance on land as measured by the Gross Motor Function Measure (GMFM) and the Pediatric Evaluation of Disability Inventory (PEDI). Fourty- nine children with neuro-motor impairments ages 3 to 7 participated in the study. Pearson correlations were applied to determine the relationships between the AIM and the GMFM, PEDI, and Gross Motor Function Classification System (GMFCS). Significant correlations were found between the total AIM and GMFM scores (r = 69, p < .01) and PEDI self-care sub-scale (r = .79, p < .01) as well as the PEDI mobility sub-scale scores (r = .35, p < .05). The water adjustment sub-scale as measured by the AIM showed the strongest relationship to motor performance on land as measured by the GMFM and PEDI in our sample of 49 children.

The gross motor function measure™ is a valid and sensitive outcome measure for spinal muscular atrophy

2006 ◽  
Vol 16 (6) ◽  
pp. 374-380 ◽  
Author(s):  
Leslie Nelson ◽  
Hollis Owens ◽  
Linda S. Hynan ◽  
Susan T. Iannaccone ◽  
AmSMART Group
Keyword(s):  
Spinal Muscular Atrophy ◽  
Motor Function ◽  
Outcome Measure ◽  
Muscular Atrophy ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Gross Motor Function Measure ◽  
Function Measure

scholarly journals Functional Gains in Children With Spastic Hemiplegia Following a Tendon Achilles Lengthening Using Computerized Adaptive Testing—A Pilot Study

2018 ◽  
Vol 5 ◽  
pp. 2329048X1881145 ◽  
Author(s):  
Eli Saleh ◽  
Noémi Dahan-Oliel ◽  
Kathleen Montpetit ◽  
Thierry Benaroch ◽  
Rita Yap ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Pilot Study ◽  
Data Collection ◽  
Motor Function ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Gross Motor Function Measure ◽  
Data Collection Instrument ◽  
Spastic Hemiplegia ◽  
Function Measure

Purpose: This pilot study evaluated the outcomes of tendon Achilles lengthening in 12 children (mean age: 11.2 years) with spastic hemiplegia. Methods: Cerebral Palsy Computer Adaptive Tests, the timed up-and-go, the Gross Motor Function Measure, the Gillette Functional Assessment Questionnaire, and the Pediatric Outcomes Data Collection Instrument were administered at baseline and at 6, 12, and 24 months postsurgery. Results: Significant improvement at the latest follow-up (12-24 months following surgery) was seen in all domains of the Cerebral Palsy Computer Adaptive Test: activity ( P = .017), lower extremity ( P = .005), global ( P = .005), pain ( P = .005), and fatigue ( P = .028), as well as in the Gross Motor Function Measure-standing domain ( P = .02) and the mobility domain of the Pediatric Outcomes Data Collection Instrument ( P = .04). Conclusion: These findings indicate that the tendon Achilles lengthening improved functional outcome in these children as measured by tests of physical function, walking speed, and activity performance.

scholarly journals Psychometric properties of trunk impairment scale in children with spastic diplegia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Vedasri Dasoju ◽  
Rakesh Krishna Kovela ◽  
Jaya Shanker Tedla ◽  
Devika Rani Sangadala ◽  
Ravi Shankar Reddy
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Concurrent Validity ◽  
Reliability And Validity ◽  
Spastic Diplegia ◽  
Gross Motor ◽  
Rater Reliability ◽  
Gross Motor Function ◽  
Gross Motor Function Measure ◽  
Function Measure

AbstractThe Trunk Impairment Scale (TIS) is a valid and reliable tool to assess trunk impairment in children with heterogeneous cerebral palsy. The purpose of this study was to determine the reliability and validity of the TIS in assessing children with spastic diplegic cerebral palsy. The sample was a total of 30 subjects (15 = boys, 15 = girls). All subjects underwent an assessment of the sitting component of the Gross Motor Function Measure-88 and TIS by rater 1. Rater one observed video recordings within 24 h and scored TIS for intra-rater reliability, while rater two did likewise after 48 h for inter-rater reliability. The mean and standard deviation of the TIS and sitting components of the Gross Motor Function Measure-88 were 15.66 ± 4.20 and 52.36 ± 6.26, respectively. We established intra-rater and inter-rater reliability of the TIS with Intra Class Correlation Coefficient 0.991 and 0.972, respectively. The concurrent validity of the TIS with the sitting component of the Gross Motor Function Measure-88 was good, with an r-value of 0.844 (p < 0.001). This study showed the excellent intra-rater and inter-rater reliability and high concurrent validity of the TIS in assessing children with spastic diplegic cerebral palsy.

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