Gross Motor Function Measure (GMFM)

GMFM-88 (1990) / GMFM-66 (2002)

Dianne Russell, Peter Rosenbaum, Lisa Avery, Mary Lane

PURPOSE:
The Gross Motor Function Measure (GMFM) is a standardized observational instrument
designed to measure change in gross motor function over time in children with cerebral
palsy. The GMFM assesses motor function (how much of a task the child can do) rather
than the quality of the motor performance (how well the child performs the task). The
GMFM-88 is the original version, and tests 88 items. The GMFM-66 is a newer version,
which was reduced to 66 items by Rasch Analysis.

The GMFM is a criterion-referenced test.

POPULATION:
The GMFM- 66 can be used to assess children with cerebral palsy age 5 months to
16years.

The GMFM-88 (NOT 66) can be used for children with CP, osteogenesis imperfecta,
lymphoblastic leukemia, Down Syndrome.

A therapist may choose to use the GMFM-88 for children with CP for the following
reasons:
 If wanting more detailed information on motor skills, especially in the lying and
rolling dimension).
 For assessing the effect of aides and orthoses
 If no access to a computer

TEST MATERIAL:
GMFM manual, GMFM kit (red wheeled cart)

TIME TO ADMINISTER:
45-60 minutes; the GMFM-66 may be shorter.

TEST COMPONENTS:
The GMFM tests activities in 5 dimensions: lying and rolling, sitting, crawling and
kneeling, standing, and walking, running and jumping.

ADMINSTRATION:
 Decide whether to use the GMFM-66 or 88.
 Have the child perform the test items (as appropriate). Testing done without
shoes; shorts and T-shirt is ideal.
 Score each item according to the following system: 0= child unable to initiate the
task, 1= child initiates the task, 2= child partially completes the task, 3= child
 completes the task, NT=Not tested. Consult the manual for specific criteria
required for each item
 GMFM-88: perform scoring procedures according to the score sheet (may require
calculator)
 GMFM-66: enter the scores into the computer program “Gross Motor Ability
Estimator” for analysis. Use the total score and item map in your interpretation.

STRENGTHS:
 Comprehensive evaluation of foundational gross motor skills
 Responsive to change (eg. Use as a pre/post measure)
 GMFM is most responsive to change in children with CP under 5 years of age
 Useful for setting goals and planning interventions in therapy (especially using
item maps from GMFM-66).
 Advantages of the GMFM-66:
o Computer scoring is easy to use, and can be used to track scores over time
and generate graphs.
o Not all items have to be administered (but the more items completed will
give you a more accurate score).
o Item maps can tell you which skills the child is likely to achieve next.

LIMITATIONS:
 Does not assess quality of movement
 Takes time and preparation
 GMFM-88: all items must be administered
 GMFM-66: requires computer access
 Not as responsive in school-age children

STANDARDIZATION:
 Results of the GMFM-66 (NOT 88) can be compared to the Motor Growth
Curves for the child’s GMFCS Level to determine an approximate percentile for
their gross motor skills.

VALIDITY:
 Responsiveness established:
 Gradient of change: pre-school children without CP > children with ABI >
children with CP
 Children with CP who were young & mild > older & more severe
 Change over 6 months as judged by parents, therapists, and a masked video
analysis was correlated with change scores on the GMFM-88
 GMFM-88 has been validated in other populations: osteogenesis imperfecta,
lymphoblastic leukemia, Down Syndrome

RELIABILITY:
 Test-retest reliability ICC= 0.99
 Inter-rater reliability ICC= 0.99