Research Reports - Gross Motor Function Measure-66 trajectories in children recovering after severe acquired brain injury

Dev Med Child Neurol. 2015 Mar;57(3):241-7

Kelly G(1), Mobbs S, Pritkin JN, Mayston M, Mather M, Rosenbaum P, Henderson R,
Forsyth R

AIM: To explore the appropriateness of using the interval-scale version of the
Gross Motor Function Measure (GMFM-66) in paediatric acquired brain injury (ABI),
and to characterize GMFM-66 recovery trajectories and factors that affect them.
METHOD: An observational study of gross motor recovery trajectories during
rehabilitation at a single specialist paediatric in-patient rehabilitation centre
using repeated GMFM-66 observations. The cohort comprised children rehabilitating
after severe ABI of various causes.
RESULTS: A total of 287 GMFM observations were made on 74 children (45 males, 29
females; age-at-injury range 0.3-17.3y, median age 11.3y, interquartile range
6.6-15.0y). Differences in item-difficulty estimates between this sample and the
cerebral palsy population in which the GMFM-66 was initially developed are not
detectable at this sample size. Changes in GMFM over time show lag-exponential
forms. Children sustaining hypoxic-ischaemic injuries made the slowest and least
complete recoveries. Older children made faster gross motor recoveries after
controlling for aetiology. The time at which gross motor ability began to rise
coincided approximately with admission to the rehabilitation facility.
INTERPRETATION: Aetiology is strongly associated with gross motor recovery after
ABI. Younger age at injury was associated with slower recovery. Comparable
item-difficulty scores in this sample and in the cerebral palsy population
suggest comparable sequences of gross motor ability reacquisition.

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