Dergiler / Acta Orthopaedica et Traumatologica Turcica / 2010 / Cilt: 44 - Sayı: 1
Investigation of interobserver reliability of the Gillette Functional Assessment Questionnaire in children with spastic diparetic cerebral palsy
- Sayfa
- 63–69
- DOI
- —
Özet
Amaç: Beyin felçli (BF) çocuklarda ortopedik girişimler ve uzun süreli rehabilitasyon sonrasında yürümede fonksiyonel etkinliği değerlendirmede hasta yakınlarından alınan bilgiler oldukça önemlidir. Bu çalışmada, BF’li çocuklarda Gillette Fonksiyonel Yürüme Değerlendirme Anketi (FYDA) anne ve fizyoterapiste uygulanarak anketin gözlemciler arası güvenirliği değerlendirildi. Çalışma planı: Çalışmaya spastik diparetik BF’li 52 çocuk (22 kız, 30 erkek; ort. yaş 7.8±4.4; dağılım 4-12) ve anneleri alındı. Tüm olgular Kaba Motor Fonksiyon Sınıflama Sistemi’ne (KMFSS) göre seviye 1-3 idi. Çocukların bağımsız hareket seviyelerini belirlemek için Gillette FYDA hem annelere hem de fizyoterapiste uygulandı ve Gillette FYDA’nın gözlemciler arası güvenirliği hesaplandı. Çocukların motor performansını değerlendirmek için Kaba Motor Performans Ölçütü’nün (KMPÖ) ayakta durma ve yürüme-koşma-zıplama altbölümleri, fonksiyonel bağımsızlık düzeyini belirlemek için Çocuklar İçin Fonksiyonel Bağımsızlık Ölçümü’nün (WeeFIM) transfer ve lokomosyon altbölümleri kullanıldı. Anneler tarafından ve fizyoterapist tarafından yanıtlanan FYDA’nın KMFSS, KMPÖ ve WeeFIM değerlendirmeleriyle ilişkisi araştırıldı. Sonuçlar: Gillette FYDA için gözlemciler arası güvenirlik katsayısı 0.94 (%95 güven aralığı 0.898-0.966) bulundu. Annenin yanıtları ile fizyoterapistin yanıtları arasında güçlü bir ilişki gözlendi (r=0.882, p
Abstract
Objectives: Information obtained from families is of particular importance in the evaluation of functional mobility skills of children with cerebral palsy (CP) after orthopedic interventions and long-term rehabilitation applications. This study was designed to evaluate the interobserver reliability of the Gillette Functional Assessment Questionnaire (FAQ) which was administered to the mothers and the physiotherapist for children with CP. Methods: The study included 52 spastic diparetic children with CP (22 girls, 30 boys; mean age 7.8±4.4 years; range 4 to 12 years) and their mothers. According to the Gross Motor Function Classification System (GMFCS), all the children were in level 1 to 3. The Gillette FAQ was administered to the mother and physiotherapist to determine the functional walking level of the child and the interobserver reliability of the FAQ was calculated. In addition, gross motor performance was evaluated by the standing and walking-running-jumping dimensions of the Gross Motor Performance Measure (GMPM), and functional independence level was evaluated by the transfer and locomotion dimensions of the Functional Independence Measure for Children (WeeFIM). Correlations were sought between the FAQ results of the physiotherapist and mothers and the GMFCS, GMPM, and WeeFIM. Results: The intraclass correlation coefficient for interobserver reliability of the Gillette FAQ was 0.94 (95% CI 0.898-0.966). A highly significant correlation was found between the responses of the mother and physiotherapist to the Gillette FAQ (r=0.882, p<0.01). The responses of the mother and physiotherapist to the Gillette FAQ showed a negative correlation with the GMFCS level, and positive correlations with the dimensions of the GMPM and WeeFIM studied (p<0.01). Conclusion: The Gillette FAQ can be used by the physiotherapists to determine the functional changes in spastic diparetic children with CP and can help clinicians derive important information from the families about functional walking of their children. a new comprehensive index of gait pathology. Gait Posture 2008;28:351-7. 16. Corry IS, Cosgrove AP, Duffy CM, McNeill S, Taylor TC, Graham HK. Botulinum toxin A compared with stretching casts in the treatment of spastic equinus: a randomised prospective trial. J Pediatr Orthop 1998;18:304-11. 17. Maathuis KG, van der Schans CP, van Iperen A, Rietman HS, Geertzen JH. Gait in children with cerebral palsy: observer reliability of Physician Rating Scale and Edinburgh Visual Gait Analysis Interval Testing scale. J Pediatr Orthop 2005;25:268-72. 18. Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol 1997;39:214-23. 19. Boyce WF, Gowland C, Rosenbaum PL, Lane M, Plews N, Goldsmith CH, et al. The Gross Motor Performance Measure: validity and responsiveness of a measure of quality of movement. Phys Ther 1995;75:603-13. 20. Aybay C, Erkin G, Elhan AH, Sirzai H, Özel S. ADL assessment of nondisabled Turkish children with the WeeFIM instrument. Am J Phys Med Rehabil 2007;86: 176-82. 21. Ottenbacher KJ, Msall ME, Lyon NR, Duffy LC, Granger CV, Braun S. Interrater agreement and stability of the Functional Independence Measure for Children (WeeFIM): use in children with developmental disabilities. Arch Phys Med Rehabil 1997;78:1309-15. 22. Daltroy LH, Liang MH, Fossel AH, Goldberg MJ. The POSNA pediatric musculoskeletal functional health questionnaire: report on reliability, validity, and sensitivity to change. Pediatric Outcomes Instrument Development Group. Pediatric Orthopaedic Society of North America. J Pediatr Orthop 1998;18:561-71. 23. Viehweger E, Haumont T, de Lattre C, Presedo A, Filipetti P, Ilharreborde B, et al. Multidimensional outcome assessment in cerebral palsy: is it feasible and relevant? J Pediatr Orthop 2008;28:576-83. 24. Trost JP, Schwartz MH, Krach LE, Dunn ME, Novacheck TF. Comprehensive short-term outcome assessment of selective dorsal rhizotomy. Dev Med Child Neurol 2008;50:765-71. 25. Amichai T, Harries N, Dvir Z, Patish H, Copeliovitch L. The effects of femoral derotation osteotomy in children with cerebral palsy: an evaluation using energy cost and functional mobility. J Pediatr Orthop 2009;29:68-72. 26. Tervo RC, Azuma S, Stout J, Novacheck T. Correlation between physical functioning and gait measures in children with cerebral palsy. Dev Med Child Neurol 2002; 44:185-90.