title: Improved scaling of the gross motor function measure for children with cerebral palsy: evidence of reliability and validity.
abstract: OBJECTIVE
  This study examined the reliability, validity, and responsiveness to change of measurements obtained with a 66-item version of the Gross Motor Function Measure (GMFM-66) developed using Rasch analysis.
  
  
  METHODS
  The validity of measurements obtained with the GMFM-66 was assessed by examining the hierarchy of items and the GMFM-66 scores for different groups of children from a stratified random community-based sample of 537 children with cerebral palsy (CP). A subset of 228 children who had been reassessed at 12 months was used to test the hypothesis that children who are young (<5 years of age) and have "mild" CP will demonstrate greater change in GMFM-66 scores than children who are older ((5 years of age) and whose CP is more severe. Data from an additional 19 children with CP who were assessed twice, one week apart, were used to examine test-retest reliability.
  
  
  RESULTS
  The overall changes in GMFM-66 scores over 12 months and a time ( severity ( age interaction supported our hypotheses. Test-retest reliability was high (intraclass correlation coefficient=.99).
  
  
  CONCLUSIONS
  This study demonstrated that the GMFM-66 has good psychometric properties. By providing a hierarchical structure and interval scaling, the GMFM-66 can provide a better understanding of motor development for children with CP than the 88 item GMFM and can improve the scoring and interpretation of data obtained with the GMFM.
authors.affiliation: CanChild, Centre for Childhood Disability Research, Room 408, Institute for Applied Health Sciences, McMaster University, 1400 Main St W, Hamilton, Ontario, Canada. russelld@fhs.mcmaster.ca
authors.forename: D J
authors.initials: DJ
authors.lastname: Russell
authors.forename: L M
authors.initials: LM
authors.lastname: Avery
authors.forename: P L
authors.initials: PL
authors.lastname: Rosenbaum
authors.forename: P S
authors.initials: PS
authors.lastname: Raina
authors.forename: S D
authors.initials: SD
authors.lastname: Walter
authors.forename: R J
authors.initials: RJ
authors.lastname: Palisano
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D002547:Cerebral Palsy / Q000145:classification* / Q000503:physiopathology*; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality; D006801:Humans; D016015:Logistic Models; D008297:Male; D009048:Motor Skills; D011594:Psychometrics; D015203:Reproducibility of Results; D012720:Severity of Illness Index