Using GMFM (Gross Motor Function Measure) to assess pattern of motor dysfunction in athetoid and spastic diplegic cerebral palsy children

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Using GMFM (Gross Motor Function Measure) to assess pattern of motor dysfunction in athetoid and spastic diplegic cerebral palsy children

 

Author: Wong, Ching-yin
Title: Using GMFM (Gross Motor Function Measure) to assess pattern of motor dysfunction in athetoid and spastic diplegic cerebral palsy children
Year: 1999
Subject: Cerebral palsied children
Movement disorders in children
Motor ability in children -- Testing
Hong Kong Polytechnic University -- Dissertations
Department: Multi-disciplinary Studies
Dept. of Rehabilitation Sciences
Pages: xii, 166 leaves : ill. (some col.) ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1479911
URI: http://theses.lib.polyu.edu.hk/handle/200/2604
Abstract: Athetoid and spastic diplegia are major categories of cerebral palsy (CP), with both neurological damage and impairment in gross motor function. To date, their gross motor dysfunctions have not been clearly investigated. Without such knowledge, base clinical intervention for these groups of children can only based on postulations and subjective judgement. This prompts the present study as an attempt to investigate and compare the pattern of motor dysfunction between these two related but distinct pathological entities. The neuro-facilitation approaches and the recent system-based approach are two models of neuro-rehabilitation. They hold different basic assumptions and have different implications for clinical intervention. Comparison of the two groups of clients would be based on the above two models to investigate their best prediction of gross motor function characteristics. The Gross Function Measure (GMFM), as a well-documented standardized outcome measure in gross motor function for cerebral palsied children, was used as the measuring instrument in this study. Analysis and comparison of the pattern of motor dysfunction were carried out with 18 children with spastic diplegic cerebral palsy and 19 children with athetoid cerebral palsy group respectively. T-test were administered to test if there was differences between the two groups. The first part of this study investigated the discrepancy in mean scores between items testing motor task involving upper limbs and those items testing motor task not involving upper limbs. The t-value was found to be significantly higher in the spastic diplegic group than that in the athetoid group(p=0.012). The result seemed to suggest that the relative weakness of athetoid CP in gross motor tasks using upper limbs. Clinical solution to enhance their function in this aspect was thus discussed. Similarly a comparison in testing items related to dynamic motor task and static motor task was carried out in the second part of the study. However, no significant difference was found. These findings suggested that the pattern of gross motor dysfunction of the selected subjects did not follow the postulation made by the 'traditional' neuro-facilitation approaches. They stated that 'spastic diplegia children performed better in static activity and poorer in dynamic activity while athetoid children performed just the reverse'. The result was also compared with findings from previous researches that further supported the recent system-based approach and may imply non-existing that direct and simple relation between muscle tone and function. Intervention based on this recent model like the motor learning framework of treatment was finally discussed.

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