Changes over years in gross motor function of 3-8 year old children with cerebral palsy: Using the gross motor function measure (GMFM-88)

Background: In the developing child the nervous system undergoes a maturation process. The development and organization of any motor ability is the naturally adopted preference among the possibilities and constraints. The motor behavior of children with cerebral palsy is a personal automatic preference based on such constraints. One of the clinical measures designed for measuring the function of children with CP is the Gross Motor Function Measure. Motor development curves for children with CP have been established based on the GMFM instrument and Gross Motor Function Classification System. Objectives: To examine the change over time in gross motor function for children with CP attending a special education school for handicapped children in Israel. Method: We conducted a retrospective review of the medical records of children at various ages and with varying degrees of severity who were being treated by a multidisciplinary team. The study population comprised 106 children aged 3-8 years with CP who were attending the school of special education at Assaf Harofeb Medical Center. The GMFM-88 test was performed annually for the study children over a 7 year period (1995-2001). Results: During the study period the GMFM scores improved significantly. The rate of improvement and top achievements over the years differed according to the severity of the motor impairment. The gross motor development reached a plateau at the age of 6-7 years. Conclusions: The changes in gross motor development of the study population were similar to the profile of changes in the developmental process of children who develop normally. The nature of the curves of gross motor change for the children with CP should be borne in mind when designing individual treatment goals and strategies for a child.