Relationship between the gross motor function classification system and functional outcomes in children with cerebral palsy

Abstract

Background/Objectives: The purpose of this study was to investigate the relationship between the Gross Motor Function Classification System (GMFCS) levels and functional outcomes in children with Cerebral Palsy (CP). Methods/Statistical analysis: 217 children with CP were took part in this study. To collect the data, the GMFCS, the Pediatric Evaluation of Disability Inventory (PEDI) self-care and mobility scaled scales and the Gross Motor Function Measure (GMFM) were employed. The Spearman correlation coefficient was calculated to evaluate the relationship between GMFCS levels and functional outcomes and Receiver Operating Characteristic Curve (ROC) was used to investigate the cut-offvalues for functional outcomes by GMFCS levels. Results: The mean age was 9.86 years. Spastic, dyskinetic, hypotonic, and ataxic CP were noted in 71.9%, 12.0%, 8.8%, and 7.36% of the cases, respectively. The proportions of children at each GMFCS level, from level I to V were 15.2%, 13.4%, 11.1%, 14.3%, and 46.1%, respectively. The significant correlation of the GMFCS level with the GMFM total score and PEDI self-care and mobility scaled scores were detected (p < 0.001). The GMFM total scores and scaled scores of self-care and mobility domain in PEDI showed significant differences according to the GMFCS levels in analyzing one-way analysis of variance (p < 0.05). The cut-offvalues for the GMFM and scores of self-care and mobility domain in PEDI for GMFCS level I were 81.48, 53.48, and 75.43, respectively; for GMFCS level IV, the cut-offvalues were 40.92, 34.94, and 33.05, respectively. Conclusion/Application: Understanding of the relationship between GMFCS level and functional outcomes, especially cut-offpoints according to the GMFCS levels is useful for making inference of the functional outcomes of children with CP in the clinical setting.