Analysis of the scales of motor function in children with cerebral palsy: literature revision

Priscila do Val Piovezan
Departamento de ortopedia e traumatologia - UNIFESP

*Vanessa Costa Monteiro
Departamento de ortopedia e traumatologia - UNIFESP

*Heloise Cazangi Borges
Departamento de ortopedia e traumatologia - UNIFESP

*Danilo Masiero
Departamento de ortopedia e traumatologia - UNIFESP

*Therezinha Rosane Chamlian
Departamento de ortopedia e traumatologia - UNIFESP

     Full text: Not available
     Last modified: March 15, 2007

Abstract
Abstract

Cerebral palsy belongs to a group of cerebral disorders due to an injury in the immature brain during the first years of life, causing motor alterations responsible for compromising the performance of functional activities. The instruments used to evaluate the motor function in children with cerebral paralysis were: GMFM, PEDI, Melbourne Assessment, Jebsen-Taylor and GMFCS, were applied with the purpose to optimize the definition of the intervention objectives, compare the effectiveness of treatment and to facilitate communication of the interdisciplinary team.

Objective: The purpose of this study was to verify, through literature revision, the effectiveness of the evaluation scales of motor function in children with cerebral palsy and to analyze its properties critically.

Methods: The research and choice of articles were carried out utilizing databases of the Medline, Lilacs, PubMed, Cochrane and Scielo, from 1969 to 2006, through the describers of cerebral palsy and motor activity. The enclosed studies have been related to the instruments of evaluation of motor function in children with cerebral palsy and the ones that compared its psychometric properties. The ones that used instruments for some specific intervention were excluded.


Results: We found 72 articles, and 13 had been enclosed in the revision. The studies relate on psychometric properties of the instruments and compare the scales between themselves. Most of them, seven (7) are on the GMFM, followed by PEDI and GMFCS while few authors mention the Melbourne Assessment and Jebsen-Taylor.

Discussion: The GMFM is a method used world-wide, and there are many studies that confirm its properties. The PEDI is reliable validation and it is the only one adapted to Brazilian culture that evaluates the motor function of different forms of the GMFM. Both are distinct methods that applied together complement themselves resulting in a wide range evaluation and a possible prognosis if associated to the GMFCS. The other methods consist in a reduced number of studies, however, sufficient enough to define the psychometric properties and its use in clinical practice.

Conclusion: All the instruments are effective in investigating the motor function in children with cerebral palsy. The GMFM and PEDI are instruments used in world-wide literature, however only one method cannot serve all the groups, leaving the physical therapist responsible for choosing which method is more indicated for the objectives of his patient.