Influence of gait analysis on decision-marketing for lower extremity surgery

Correlations between Gross Motor Function Measure scores and other functional assessments in ambulatory males with Duchenne muscular dystrophy

A BAGLEY PHD A, S SIENKO THOMAS MA B, C E BUCKON MS B,
A NICORICI BS A, M D SUSSMAN MD B, C M MCDONALD MD A

  1. 1. Shriners Hospitals for Children, Sacramento, CA;
  2. 2. Portland, OR, USA

Objectives: To investigate the use of the Gross Motor Function Measure (GMFM) in ambulatory males with Duchenne muscular dystrophy (DMD) by correlation with other functional tests.

Design: Prospective cross-sectional multi-center population study.

Participants/Setting: Twenty-one males with DMD, mean age 8 years 4 months (SD 3y 4mo), from two Shriners hospitals. Inclusion criteria were confirmed diagnosis, minimum age of 4 years, and ability to ambulate. Eleven participants were on steroid treatment; 10 were not.

Methods: Participants were scored on section D (standing) and E (walking,running, and jumping) of the GMFM and performed a Timed Motor Performance (TMP) test consisting of 10m walk/run, four-stair climb, sit to stand, and supine to stand. The Pediatric Outcomes Data Collection Instrument (PODCI) was administered to the parent and the child if 11 years of age or greater. Participants were tested for maximal isometric knee extension (at 90 0) and maximum concentric isokinetic knee extension (at 60 o /s) on a Biodex System 3. Spearman Rank correlations (r s) between GMFM scores and age, TMP values (s), PODCI domain scores, and peak knee extension torque (N-m/kg) were calculated.

Results: Average GMFM scores were less than normal. Most participants could not hop, jump, or climb or descend four stairs with alternating feet. There were no significant differences in GMFM scores between the Steroid and Nonsteroid group although the variance was larger in the Steroid group. Significant relations were found between GMFM scores and age, three TMP tasks, and PODCI Transfers & Basic Mobility domain scores (p<0.05; Table SP:17).

Conclusions: Older males with DMD had poorer performance on the GMFM as expected, with the natural progression of muscle loss with the disease. TMP testing of 10m walk/run, four-stair climb, or supine to stand can be used as a simple measure of function based on correlations with GMFM scores; more time to perform these tasks reflect lower GMFM scores. Sit to stand was not correlated to GMFM and may be too simple a task in ambulatory children. PODCI Transfer scores are based on a questions that match GMFM items; stand independently, climb stairs, walk one block, sit unassisted, get on and off chair, and bend over and pick item off floor. Reported transfer ability correlated with observed function. Three TMP tasks and the PODCI Transfer domain may be useful clinical tools to apply to this population. Quantitative measurement of muscle strength about the knee did not correlate with GMFM scores (costly and time-consuming test).

Acknowledgements: Shriners Hospital for Children Grant #8951 for funding this research

 
Gallery
Gal 1 Gal 2
Supporting Organizations
 
   
   
   
 
Online Feature Partner
 
   
   
 
Locations of visitors to this page
 
 

© 2010 all rights reserved. maintained by Classic Infomedia