Freya is a 6-year-old girl with ataxic cerebral palsy. She moved to California from Iowa last month and has been prescribed six months of physical therapy. Freya’s parents are concerned; she has been having difficulty going down the front stairs of their new home. As her physical therapist, do you have a standardized test that will measure her initial gross motor function? In six months, how will you determine whether Freya has made progress?
GMFM-66 Quick Facts:
- 5mo-16 years
- Cerebral palsy or Down Syndrome
- Test re-test reliability GMAE-scoring method: 0.9932
- Most sensitive to change in children 5 years and younger
- Motor growth curves link
My Gross Motor Function Measure User’s Manual is tattered. I could not work without the GMFM! Like all things that are well designed, the creators have taken a complex concept and made it logical and simple. The GMFM is an evaluative measure that assesses change in motor function over time. I can test Freya in January, provide PT 1x/week and then retest in July to determine if she has made significant progress. In addition, I won’t overlook Freya’s inability to reach across midline while I am heavily focused on her stair skills; the test covers all domains from lying and rolling up to running and jumping, with each skill being incrementally harder than the last (in the GMFM-66). Continue reading “How to Use the Gross Motor Function Measure (GMFM-66)”
The International Classification of Functioning, Disability and Health-Children & Youth (ICF-CY) is a framework for describing and organizing information on functioning and disability. The ICF is a useful tool in the field of pediatric physical therapy, where the child defines how they want to use their function within the context of their own life.
In my opinion, the Participation category is the most fun part of the ICF! This is really where we begin to see the whole child, their likes and their interests and well as what they want to do with their skills. Participation is using an activity to interact with others or with the environment. When the activity is walking, participation is walking on the beach with friends, or walking in the grocery store to help with the shopping. Participation is one of the most motivating and satisfying levels of functioning. New activities should be put into participation as soon as possible to build motor control. These happen in many different environments: Home, friends’ homes, schools, libraries and parks. Continue reading “Exploring the ICF-CY: What is Participation?”
The International Classification of Functioning, Disability & Health- Children & Youth (ICF-CY) is a framework for describing and organizing information on functioning and disability.
In this post we explore another category of the ICF-CY….activity! This is the heart and soul of physical therapy, at least in the clinic or during a home visit. The activity section of the ICF-CY describes what a person can do in a standard environment or their regular environment. Activity is defined as the execution of a task or action. The activity section includes the following:
- developmental skills that babies learn in the first year of life,
- gross motor skills at any age
- fine motor skills at any age
- activities of daily living/self-care
Continue reading “Exploring the ICF-CY: What is Activity?”