KABA MOTOR FONKSİYON SINIFLANDIRMA SİSTEMİ AİLE RAPORUNUN (GMFCS-FR) TÜRKÇE’YE UYARLANMASI, GÜVENİRLİĞİNİN BELİRLENMESİ VE AİLE VE FİZYOTERAPİSTİN KABA MOTOR FONKSİYON SEVİYE BELİRLEMESİNDEKİ TUTARLILIĞININ ARAŞTIRILMASI

Year 2026, Volume: 4 Issue: 1, 6 - 13, 23.01.2026

Esra Incesu Oral , Mintaze Kerem Günel

Abstract

Amaç: Bu çalışmanın amacı, Serebral Palsili (SP) bireylerin kaba motor fonksiyon düzeylerini değerlendirmek amacıyla geliştirilen “Kaba Motor Fonksiyon Sınıflandırma Sistemi Aile Raporu”nun (GMFCS-FR) Türkçe’ye uyarlanması, güvenilirliğinin incelenmesi ve farklı değerlendiriciler arasındaki tutarlılığın belirlenmesi idi. Yöntem: Çalışma, 2–18 yaş aralığında SP tanısı almış 100 bireyin annelerinin, babalarının, fizyoterapistlerinin ve bilişsel düzeyi iyi olan bireylerin kendilerinin katılımıyla yürütüldü. GMFCS-FR, kültürlerarası geçerlik ilkelerine uygun olarak ileri-geri çeviri yöntemiyle Türkçe’ye uyarlandı. Ölçeğin güvenilirliği anneler, babalar ve bilişsel düzeyi iyi bireylerin test-tekrar test analiziyle; anneler, babalar ve bilişsel düzeyi iyi olan bireylerle fizyoterapistler arası tutarlılık ise Kappa katsayısı ile değerlendirildi.
Bulgular: Test-tekrar test analizlerinde anne ve babaların değerlendirmelerinin ICC değerleri tüm yaş gruplarında 0,961 ile 1,000 arasında bulunmuş, bu da GMFCS-FR’nin Türkçe versiyonunun yüksek düzeyde güvenilir olduğunu göstermiştir. Benzer şekilde 12–18 yaş grubundaki bilişsel düzeyi iyi olan bireylerin kendi değerlendirmeleri de güvenilir bulunmuştur (ICC = 0,964, p<0,001). Gözlemciler arası tutarlılık, özellikle 2–6 yaş grubunda yüksek, ileri yaş gruplarında ise orta düzeyde saptanmıştır. Genç bireyler ile fizyoterapistler arasında da iyi düzeyde uyum gözlenmiştir (κ = 0,715).
Sonuç: GMFCS-FR Türkçe versiyonunun SP’li bireylerin rehabilitasyonunda aile merkezli yaklaşımı destekleyen, güvenilir ve tutarlı bir araç olduğunu göstermektedir. Ailelerin rehabilitasyon sürecine aktif katılımı için önemli bir kaynak olacağı düşünülmektedir.

Keywords

GMFCS-FR , serebral palsi , aile merkezli yaklaşım

Adapting The Gross Motor Function Classification System Family Report (GMFCSFR) Into Turkish, Determining Its Reliability, and Investigating the Consistency of Family and Physiotherapist in Determining Gross Motor Function Levels

Abstract

Purpose: The aim of this study is to adapt the Gross Motor Function Classification System Family Report (GMFCS-FR) to Turkish, to examine its reliability, and to determine the consistency between different raters.
Methods: The study was conducted with the participation of mothers, fathers, physiotherapists and individuals with good cognitive levels of 100 individuals diagnosed with CP between the ages of 2 and 18. GMFCS-FR was adapted to Turkish with the principles of cross-cultural validity. The reliability of the questionnaire was assessed with test-retest analysis of mothers, fathers and individuals with good cognitive levels; and the consistency between mothers, fathers, individuals with good cognitive levels and physiotherapists was assessed with the Kappa coefficient.
Results: In the test-retest analyses, the ICC values of the assessments of mothers and fathers were found to be between 0.961 and 1.000 in all age groups, indicating that the Turkish version of the GMFCS-FR is highly reliable. Similarly, the self-assessments of individuals with good cognitive levels in the 12–18 age group were also found to be reliable (ICC = 0.964, p<0.001). Inter-observer consistency was particularly high in the 2–6 age group. Good agreement was also observed between young individuals and physiotherapists (κ = 0.715).
Discussion: The results show that the Turkish version of the GMFCS-FR is a reliable and consistent tool that supports a family-centered approach in the rehabilitation of individuals with CP. It is thought that it will be an important resource for the active participation of families in the rehabilitation process.

Keywords

GMFCS-FR , cerebral palsy , family-centered approach

References

• 1. Rosenbaum P, King S, Law M, King G, Evans J. Family-centred service: A conceptual framework and research review. Physical & Occupational Therapy in Pediatrics. 1998;18(1):1-20.
• 2. King S, Teplicky R, King G, Rosenbaum P, editors. Family-centered service for children with cerebral palsy and their families: a review of the literature. Seminars in pediatric neurology; 2004: Elsevier.
• 3. Rosenbaum P, King S, Law M, King G, Evans J. Family-centred service: A conceptual framework and research review. Family-Centred Assessment and Intervention in Pediatric Rehabilitation. 2014:1-20.
• 4. Dunst CJ, Trivette CM, Hamby DW. Meta‐analysis of family‐centered helpgiving practices research. Mental retardation and developmental disabilities research reviews. 2007;13(4):370-8.
• 5. Kearney PM, Pryor J. The international classification of functioning, disability and health (ICF) and nursing. Journal of advanced nursing. 2004;46(2):162-70.
• 6. Trabacca A, Vespino T, Di Liddo A, Russo L. Multidisciplinary rehabilitation for patients with cerebral palsy: improving long-term care. Journal of multidisciplinary healthcare. 2016:455-62.
• 7. Mutlu A, Kara OK, Gunel MK, Karahan S, Livanelioglu A. Agreement between parents and clinicians for the motor functional classification systems of children with cerebral palsy. Disability and rehabilitation. 2011;33(11):927-32.
• 8. Wiart L, Ray L, Darrah J, Magill-Evans J. Parents' perspectives on occupational therapy and physical therapy goals for children with cerebral palsy. Disabil Rehabil. 2010;32(3):248-58.
• 9. Morris C, Bartlett D. Gross Motor Function Classification System: impact and utility. Dev Med Child Neurol. 2004;46(1):60-5.
• 10. Morris C, Galuppi BE, Rosenbaum PL. Reliability of family report for the Gross Motor Function Classification System. Dev Med Child Neurol. 2004;46(7):455-60.
• 11. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000;25(24):3186-91.
• 12. Palisano RJ, Cameron D, Rosenbaum PL, Walter SD, Russell D. Stability of the gross motor function classification system. Dev Med Child Neurol. 2006;48(6):424-8.
• 13. Palisano RJ, Rosenbaum P, Bartlett D, Livingston MH. Content validity of the expanded and revised Gross Motor Function Classification System. Dev Med Child Neurol. 2008;50(10):744-50.
• 14. Akpinar P, Tezel CG, Eliasson AC, Icagasioglu A. Reliability and cross-cultural validation of the Turkish version of Manual Ability Classification System (MACS) for children with cerebral palsy. Disabil Rehabil. 2010;32(23):1910-6.
• 15. Park MS, Kang KJ, Jang SJ, Lee JY, Chang SJ. Evaluating test-retest reliability in patient-reported outcome measures for older people: A systematic review. International Journal of Nursing Studies. 2018;79:58-69.
• 16. Morris C, Kurinczuk JJ, Fitzpatrick R, Rosenbaum PL. Who best to make the assessment? Professionals' and families' classifications of gross motor function in cerebral palsy are highly consistent. Arch Dis Child. 2006;91(8):675-9.
• 17. Ramrit S, Yonglitthipagon P, Janyacharoen T, Emasithi A, Siritaratiwat W. The Gross Motor Function Classification System Family Report Questionnaire: reliability between special-education teachers and caregivers. Dev Med Child Neurol. 2017;59(5):520-5.
• 18. Anderson R, Aaronson N, Wilkin D. Critical review of the international assessments of health-related quality of life. Quality of Life Research. 1993;2(6):369-95.
• 19. JE Jr W. Evaluating instruments used cross-nationally: methods from the IQOLA project. Quality of life and pharmacoeconomics in clinical trials. 1996.
• 20. Gandek B, Ware Jr JE. Methods for validating and norming translations of health status questionnaires: the IQOLA project approach. Journal of clinical epidemiology. 1998;51(11):953-9.
• 21. Mutlu A, Kara OK, Gunel MK, Karahan S, Livanelioglu A. Agreement between parents and clinicians for the motor functional classification systems of children with cerebral palsy. Disabil Rehabil. 2011;33(11):927-32.
• 22. Ramrit S, Yonglitthipagon P, Janyacharoen T, Emasithi A, Siritaratiwat W. The Gross Motor Function Classification System Family Report Questionnaire: reliability between special‐education teachers and caregivers. Developmental Medicine & Child Neurology. 2017;59(5):520-5.
• 23. Lewis C, Lamb ME. Fathers’ influences on children’s development: The evidence from two-parent families. European journal of psychology of education. 2003;18(2):211-28.
• 24. Moon M, Hoffman CD. Mothers' and fathers' differential expectancies and behaviors: Parent x child gender effects. The Journal of genetic psychology. 2008;169(3):261-80.
• 25. Baumrind D. Effective parenting during the early adolescent transition. Family transitions: Routledge; 2013. p. 111-63.
• 26. Bandura A, Locke EA. Negative self-efficacy and goal effects revisited. J Appl Psychol. 2003;88(1):87-99.
• 27. Majnemer A, Shevell M, Law M, Poulin C, Rosenbaum P. Level of motivation in mastering challenging tasks in children with cerebral palsy. Dev Med Child Neurol. 2010;52(12):1120-6.