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目的探讨粗大运动功能分级系统(GMFCS)在痉挛型脑性瘫痪患儿中的再测信度。方法收集2005年2月至2008年2月北京儿童医院治疗的痉挛型脑性瘫痪患儿83例,予以运动疗法(PT)、作业疗法(OT)、水疗(HT)、针灸及按摩治疗,在治疗前后对其采用GMFCS进行粗大运动功能分级并评估。结果 83例中1例治疗前后粗大运动功能级别发生变化,82例并未发生变化。GMFCS对于痉挛型脑性瘫痪患儿具有良好的再测信度(P<0.01),在<2岁阶段的再测信度低于其他年龄组(P<0.01)。结论 GMFCS是目前惟一针对脑性瘫痪患儿粗大运动水平进行标准化评价的工具,具良好再测信度,但在<2岁的再测信度低于其他年龄组。应进一步进行多中心合作研究,将全部类型、全部级别的脑性瘫痪患儿纳入研究以证实GMFCS在脑性瘫痪康复中作用及意义
Objective To investigate the retest reliability of GMFCS in children with spastic cerebral palsy. Methods Eighty-three children with spastic cerebral palsy who were treated in Beijing Children’s Hospital from February 2005 to February 2008 were treated with PT, OT, GMFCS was used to classify and assess gross motor function before and after treatment. Results In 83 cases, the level of gross motor function changed before and after treatment, and 82 cases did not change. GMFCS had good retest reliability (P <0.01) for children with spastic cerebral palsy and less retest reliability at <2 years old than other age groups (P <0.01). Conclusion GMFCS is the only tool for standardized evaluation of gross motor performance in children with cerebral palsy, with good retest reliability, but the retest reliability of <2 years old is lower than that of other age groups. Multi-center collaborative research should be further undertaken to include all types and grades of children with cerebral palsy in a study to confirm the role and significance of GMFCS in the rehabilitation of cerebral palsy