Serebral Palsili Çocuklarda Kaba Motor Fonksiyon Ölçütünün Uzun (Kmfö-88) ve Kısa (Kmfö-66) Formunun Türkçeye Uyarlanması, Güvenilirlik ve Geçerliliğinin Araştırılması ve Klinik Tiplere Göre İncelenmesi

Abstract

Purpose of the study was adapting the 88-item form, which is the long version of the Gross Motor Function Measurement (GMFM), and the short version 66-item form, to Turkish and for this Turkish version of both forms to study a validity and reliability analysis of children with cerebral palsy (CP). It was also aimed to investigate reliability and validity differed in different types. 100 children with CP aged 5-18 years were included in the study. As the first step of the study, GMFM was adapted into the Turkish with its long version of 88 items and 66 with a short version, and was approved by the original authors. With choosing 10 children for each GMFCS Levels, a test-retest application was performed in 50 children. Cronbach Alpha coefficient for subdimensions of GMFM-88 A, B, C, D, E and their total were found respectively 0,999; 0,999; 0,999; 0.993; 1.00; 0.999. For GMFM-66, it was found to be 0.999 because only the total score was taken into account. The Gross Motor Function Classification System (GMFCS) was used as the gold standard for validity analysis. For reliability there was a strong negative correlation between GMFCS and GMFM-88 sub-dimensions and GMFM-66 total score (p <0.05) and it was found that Turkish GMFM-88 and GMFM-66 could make functional separation; highest correlation was found in walking, running and jumping subscales for GMFM-88 (p <0.05). For construct validity, the sub-dimensions and total score of GMFM-88 and the total score of GMFM-66 were found to be strong and perfectly correlated with each other (p <0.05). In the explanatory factor analysis, items of GMFM-88 and GMFM-66 were collected under a single factor and this result was as expected from the criteria. Turkish GMFM-88 and GMFM-66 was determined to be valid and reliable for children with CP. In spastic, dyskinetic and ataxic cases, Cronbach Alfa, which was taken as an intra-observation reliability value in both the subdimensions and total score of GMFM-88 and in the total score of GMFM-66, was between 0.998 and 1.00. ICC values ranged between 0.977 and 1.00 and there was no difference between them. In terms of validity, all sub-dimensions of GMFM-88 between the types and negative score between the total score of GMFM-66 and the total score of GMFM-66 and GMFCS were negative but the same relationship with each other (p <0.05). We think that GMFM-88 and 66, which are used as the gold standard in the evaluation of motor functions and motor development in CP, will be an important contribution to the field of Turkish pediatric rehabilitation and will allow the use of Turkish GMFM in the future studies in line with its recommendation in the World Health Organization.