SEREBRAL PALSİLİ ÇOCUKLARDA GİLLETTE FONKSİYONEL YÜRÜME DEĞERLENDİRME ANKETİNİN GÖZLEMCİ İÇİ GÜVENİRLİK VE GEÇERLİĞİNİN ARAŞTIRILMASI

Öz

Amaç: Serebral palsili (SP) çocuklarda motor ve duyusal bozukluklar nedeni ile yürüyüş etkilenmektedir. Tedavi boyunca yürüme fonksiyonunun geliştirilmesi ve normalleştirilmesi için yürüyüş değerlendirilmelidir. Bu çalışmada amacımız klinikte yaygın olarak kullanılan Gillette Fonksiyonel Yürüme Değerlendirme Anketi (Gillette-FYDA)’nin gözlemci içi güvenirliğini ve geçerliğini incelemekti.

Yöntem: Bu çalışmaya 5-18 yaş arasında 70 SP’li çocuk dahil edildi. Gözlemci içi güvenirlik değerlendirilmesi için Gillette-FYDA 15 gün ara ile iki defa aileye sorularak yapıldı. Yapısal geçerlik için Kaba Motor Fonksiyon Ölçütü’nün (GMFM-88) D ve E alt başlıkları ile Pediatrik Fonksiyonel Bağımsızlık Ölçeği (WeeFIM) kullanıldı. Eş-zamanlı geçerlilik için Kaba Motor Fonksiyon Sınıflama Sistemi (GMFCS) kullanıldı. Cronbach alfa (a) katsayısı hesaplandı.

Sonuçlar: Çocukların ortalama yaşları 8,15±3,81 yıldı. Çocukların %72,9’u spastik, %20’si diskinetik, %5,7’si ataksik ve %1,4’ü hipotonik tip SP’li idi. Gillette-FYDA’nın gözlemci içi güvenirliğinde sınıf içi korelasyon (ICC) değeri 0,993 (0,988-0,996) bulundu ve Croanbach a değeri 0,993’tü. Gillette-FYDA ile GMFM alt bölümleri (r_D=0,940 ve r_E=0,945, p<0,01) ve WeeFIM (r_Motor=0,910, r_Toplam=0,883, p<0,01) puanları arasında pozitif güçlü ilişkiler bulundu. Tek yönlü ANOVA sonuçları, farklı GMFCS seviyelerinde yer alan çocukların Gillette-FYDA skorlarının da farklı olduğunu gösterdi (p<0,05). Post-hoc analize göre GMFCS seviyelerinin düşmesi ile Gillette-FYDA puanları yükseldi (p<0,05).

Tartışma: Gillette-FYDA,SP’li çocukların fonksiyonel yürüyüşünün değerlendirilmesinde ve rehabilitasyon programı sonuçlarının belirlenmesinde güvenilir ve geçerli bir yöntemdir. 

Anahtar Kelimeler

• Serebral Palsi,Yürüyüş,Fonksiyon,Değerlendirme

AN INVESTIGATION OF INTRA-OBSERVER RELIABILITY AND VALIDITY OF THE GILLETTE FUNCTIONAL GAIT ASSESSMENT QUESTIONNAIRE IN CHILDREN WITH CEREBRAL PALSY

Abstract

Purpose: Gait is affected by sensorial and motor impairments in Cerebral Palsy (CP). Apropriate gait must be evaluated for improving and normalizing gait function during treatment. In this study, our purpose is to investigate the intrarater validity and reliability of the Gillette Functional Gait Assessment Questionaire (Gilette-FAQ) commonly used in clinically.

Methods: 70 children between 5 and 18 years were included in this study. Gilette-FAQ was asked to family twice fifteen days interval for intrarater-reliability. Gross Motor Function Measure (GMFM-88) D and E sub-dimensions and pediatric functional independence measurement (WeeFIM) were used for construct validity and Gross Motor Function Classification System (GMFCS) was used concurrent validity. Cronbach alpha (a) coefficient  was calculated. Alpha was accepted as enough between 0.70 and 0.95.

Results: The mean age was 8.15±3.81 years. 72.9% of children was spastic,  20% was dyskinetic, 5.7 %  was ataxic and 1.4% was hypotonic type of CP.  Intra-class correlation (ICC) value was found 0.99 in test-retest reliability and internal consistency of Gilette-FAQ. There were positive strong correlations between Gilette-FAQ and GMFM-D, E (r=0.94, r=0.94, p<0.01); Gilette-FAQ and WeeFIM motor and total score (r=0.91, r=0.88, p<0.01). The results of one way ANOVA showed that Gilette-FAQ scores of GMFCS levels were different (p<0.05). Statistical difference was found between GMFCS levels in Post-hoc test (p<0.05).

Conclusion: Gilette-FAQ was valid and reliable among the parents of children with CP for evaluating functional gait and determining rehabilitation results according to results.

Keywords

• Cerebral Palsy,Gait,Function,Assessment

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