Correlation between ICIDH handicap code and Gross Motor Function Classification System in children with cerebral palsy

Abstract

The aim of this study was to apply the International Classification of Impairments, Disabilities and Handicap (ICIDH; WHO 1980) parallel to the Gross Motor Function Classification System (GMFCS; Palisano et al. 1997) in a population-based series of children with cerebral palsy (CP). Of the 116 children studied, birth characteristics, data on gross motor function, and level of handicap at 5 to 6 years of age, were retrospectively collected from medical records and documentation made by rehabilitation team members. Low handicap scores and mild levels of gross motor disability were present in children with hemiplegic CP, moderate scores in children with diplegic CP, simple ataxia, and athetotic CP, and high scores in children with dystonic CP and tetraplegic CP. A significant correlation was found between high handicap scores as well as high levels on the GMFCS and the presence of learning disability, epilepsy, and obvious aetiology of CP. A strong correlation was found between the handicap code and the GMFCS, the strongest concerning the dimension of mobility (r = 0.95,p<0.0001). A striking similarity in the grading of disability was present between the ICIDH handicap code and the GMFCS. The GMFCS is considerably less time-consuming and can be evaluated retrospectively. The handicap code requires more detailed information and is more useful for a comprehensive profile of the child.

The International Classification of Functioning, Disability and Health: a new tool for understanding disability and health

“…For example, recent leprosy research has taken advantage of ICF to describe and grade the level of impairments associated with the disease, to map out the linkages between these impairments and characteristic capacities that patients experience, to describe features of the overall lived experience of people with the condition, and to design treatment plans and evaluate outcomes. 28 -30 The ICF has also been applied clinically, either separately or jointly with assessment instruments, to musculoskeletal disorders such as arthritis, 31, 32 cerebral palsy, 33 heart disease, 34 hearing impairment, 35 as well as a wide range of neurological disorders including polio and stroke. 36 -42 In the rehabilitation literature several trends in the application of the ICF have appeared, including functional assessment for treatment planning, 43 -48 assessing the efficacy of assistive devices, 49 treatment outcome assessment 50 -53 and, more generally, program evaluation and quality assurance for occupational and speech and language therapy.…”

Reliability and Validity of the Gross Motor Function Classification System for Cerebral Palsy

“…The GMFCS appears promising as a risk-adjustment instrument and is currently being used in studies of children who have cerebral palsy. [2][3][4] Although the findings of initial investigations of its validity and reliability are positive, 1,[5][6][7][8][9] further evaluation is warranted.…”

“…GMFCS level has been reported to be strongly correlated with the handicap code of the International Classification of Impairment, Disabilities, and Handicap (ICIDH) developed by the World Health Organization in 1980 (r ϭ 0.95, p Ͻ 0.0001). 6,7 Correlation between the GMFCS and the ICIDH demonstrated concurrent validity between two scales designed to rate disability. Because the GMFCS is purported to be a reflection of gross motor function, concurrent validity can also be evaluated by comparing the GMFCS level with established tests of gross motor skills.…”

Children With Cerebral Palsy

“…Intellectual disability has sometimes been used as part of the definition of "severe cerebral palsy." 23 Our study does not have information on all associated conditions and impairments (such as cognitive impairment) that might contribute to functional limitations.…”

“…[21][22][23][24][25][26][27][28][29] We compared the overall prevalence of cerebral palsy, the proportion of case children at each level of motor function, and the proportion of case children for whom this information was missing. The distribution of functional limitations in these studies was usually reported as the proportion of all cases with known gross motor function at a given functional level.…”