TRAINING USERS IN THE GROSS MOTOR FUNCTION MEASURE - METHODOLOGICAL AND PRACTICAL ISSUES

Background and Purpose. The Gross Motor Function Measure (GMFM) is a c riterion-referenced observational measure for assessing change in gros s motor function for children with cerebral palsy (CP). The purposes o f this report are to present data on the effects of training pediatric developmental therapists to administer and score the GMFM and to disc uss some practical and methodological issues associated with training. Subjects and Methods. A weighted kappa estimate pretraining and postt raining workshop was used to determine participants' agreement of scor ing a videotaped GMFM assessment against experts' scoring of the same videotaped assessment. Several children with CP, representing a spectr um of ages, severities, and levels of function, were shown on the vide otape. Results. There was a significant improvement in agreement from a mean kappa of .58 to .82 (t = 15.38, df = 75, P < .001) for the firs t group and from .81 to .92 (t = 10.91, df = 72, P < .001) for the sec ond group following training. Conclusion and Discussion. Although ther e are a number of advantages to using videotapes to train test users a nd to assess scoring reliability, this method does not evaluate partic ipants' ability to administer the measure. Further work is needed to d etermine whether reliability is maintained in a clinical situation in which it is necessary to both administer and score the GMFM. [Russell DJ, Rosenbaum PL, Lane M, et al. Training users in the Gross Motor Fun ction Measure: methodological and practical issues. Phys Ther. 1994;74 :630-636.]