Gross Motor Function Classification System (GMFCS)
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Type of Measure: The Gross Motor Function Classification System (GMFCS) is a 5 level classification system that describes the gross motor function of children and youth with cerebral palsy on the basis of their self-initiated movement with particular emphasis on sitting, walking, and wheeled mobility. via GMFCS homepage
The GMFCS measures what children do in their typical settings (performance), not what they are able to do in an ideal environment (capability). The GMFCS is one of the most widely-used classification systems for individuals with cerebral palsy, as it is used in clinical examinations, research, and population-based studies. The GMFCS is compatible with the World Health Organization’s International Classification of Functioning, Disability, and Health.
Trained clinicians can evaluate a child’s GMFCS level in a matter of minutes. There is also a newly developed GMFCS Family and Self Report Questionnaire, which incorporates parent-report in the determination of a child’s GMFCS level.
The CanChild Group has a handy FAQ (scroll down) that covers many details.
Target Population: Originally for children with cerebral palsy, but has been applied to other conditions. Separate criteria are available for four age groups: 2 to 4 years, 4 to 6 years, 6 to 12 years, and 12 to 18 years.
Measurement properties and previous use: The GMFCS has been used in hundreds of studies (if not more), and has been extensively evaluated–particularly by the CanChild group.
Previous studies have established the reliability in assessing GFMCS levels (kappa=0.75 for children 2-12 years old; Palisano 1997) The GMFCS is also informative for prognosis of gross motor progress and outcomes and longitudinal gross motor function curves and percentiles have been shown to correspond to GMFCS levels. (Rosenbaum et al 2002) Also of particular importance is the demonstration of content validity (Palisano et al 2008). Other groups have also demonstrated the reliability of assessing GMFCS levels through chart review (Benedict et al 2011)
Languages: Developed in English, but has been translated into many languages including Arabic, Czech, Chinese (Simplified), Chinese (Traditional), Danish, Dutch, French, German, Hebrew, Icelandic,Italian, Japanese, Korean, Norwegian, Persian, Portuguese (Brazil), Portuguese (Portugal), Romanian, Russian, Spanish,Swedish, Thai, and Turkish
They also provide guidelines for translation into new languages.
Authors and Citation: Palisano, R., Rosenbaum, P., Bartlett, D., Livingston, M. (2008). Content validity of the expanded and revised Gross Motor Function Classification System. Developmental Medicine & Child Neurology, 50 (10), 744-50.
Rosenbaum, P., Walter, S., Hanna, S., Palisano, R., Russell, D., Raina, P., Wood, E., Bartlett, D., & Galuppi, B. (2002).Prognosis for gross motor function in cerebral palsy: Creation of motor development curves. Journal of the American Medical Association, 288 (11), 1357-1363.
Palisano, R., Rosenbaum, P., Walter, S., Russell, D., Wood, E., & Galuppi, B. (1997). Development and reliability of a system to classify gross motor function in children with cerebral palsy. Developmental Medicine & Child Neurology, 39, 214-223.
Licence: via GMFCS website: The GMFCS - E&R brochure can be downloaded at no cost for personal, non-commercial use. Distribution of the GMFCS - E&R has been made possible through a grant from the United Cerebral Palsy Research and Education Foundation in the United States.
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