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Introduction of the gross motor function classification system in Venezuela - a model for knowledge dissemination

机译：委内瑞拉引入总运动功能分类系统-知识传播模型

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A current worldwide common goal is to optimize the health and well-being of children with cerebral palsy (CP). In order to reach that goal, for this heterogeneous group, a common language and classification systems are required to predict development and offer evidence based interventions. In most countries in Africa, South America, Asia and Eastern Europe the classification systems for CP are unfamiliar and rarely used. Education and implementation are required. The specific aims of this study were to examine a model in order to introduce the Gross Motor Function Classification System (GMFCS-E&R) in Venezuela, and to examine the validity and the reliability. Children with CP, registered at a National child rehabilitation centre in Venezuela, were invited to participate. The Spanish version of GMFCS-E&R was used. The Wilson mobility scale was translated and used to examine the concurrent validity. A structured questionnaire, comprising aspects of mobility and gross motor function, was constructed. In addition, each child was filmed. A paediatrician in Venezuela received supervised self-education in GMFCS-E&R and the Wilson mobility scale. A Swedish student was educated in GMFCS-E&R and the Wilson mobility scale prior to visiting Venezuela. In Venezuela, all children were classified and scored by the paediatrician and student independently. An experienced paediatric physiotherapist (PT) in Sweden made independent GMFCS-E&R classifications and Wilson mobility scale scorings, accomplished through merging data from the structured questionnaire with observations of the films. Descriptive statistics were used and reliability was presented with weighted Kappa (Kw). Spearman’s correlation coefficient was calculated to explore the concurrent validity between GMFCS-E&R and Wilson mobility scale. Eighty-eight children (56 boys), mean age 10?years (3–18), with CP participated. The inter-rater reliability of GMFCS-E&R between; the paediatrician and the PT was Kw?=?0.85 (95?% CI: 0.75-0.88), the PT and student was Kw?=?0.91 (95?% CI: 0.86-0.95) and the paediatrician and student was Kw?=?0.85 (95?% CI: 0.79-0.90). The correlations between GMFCS-E&R and Wilson mobility scale were high rs =0.94-0.95 (p?
机译：当前全球范围内的共同目标是优化脑瘫（CP）儿童的健康和福祉。为了实现该目标，对于这个异类群体，需要使用通用的语言和分类系统来预测发展并提供基于证据的干预措施。在非洲，南美，亚洲和东欧的大多数国家，CP的分类系统并不熟悉，很少使用。需要教育和实施。这项研究的具体目的是检查模型，以便在委内瑞拉引入大运动功能分类系统（GMFCS-E＆R），并检验其有效性和可靠性。邀请了在委内瑞拉国家儿童康复中心注册的患有CP的儿童参加。使用了西班牙语版本的GMFCS-E＆R。威尔逊流动性量表被翻译并用于检验并发有效性。构造了一个结构化的问卷，包括机动性和总运动功能的方面。此外，每个孩子都被拍摄了。委内瑞拉的儿科医生接受了GMFCS-E＆R和Wilson迁移量表的监督自我教育。在访问委内瑞拉之前，一名瑞典学生接受了GMFCS-E＆R和Wilson迁移量表的教育。在委内瑞拉，所有儿童均由儿科医生和学生分别分类和评分。瑞典一位经验丰富的儿科物理治疗师（PT）通过将结构化问卷中的数据与影片的观察结果进行合并，对GMFCS-E＆R进行了独立分类，并对Wilson迁移量表进行了评分。使用描述性统计数据，并用加权Kappa（Kw）表示可靠性。计算Spearman的相关系数，以探索GMFCS-E＆R与Wilson迁移量表之间的并发有效性。 88名儿童（56名男孩），平均年龄10岁（3-18岁），有CP。 GMFCS-E＆R之间的评估者间可靠性;儿科医生和PT为Kw？=？0.85（95％CI：0.75-0.88），PT和学生为Kw？=？0.91（95 %% CI：0.86-0.95），儿科医生和学生为Kw？= 0.81（95％CI：0.86-0.95）。 ＝ 0.85（95％CI：0.79-0.90）。 GMFCS-E＆R与Wilson迁移量表之间的相关性较高，rs = 0.94-0.95（p <0.001）。在一个没有GMFCS-E＆R知识的环境中，带有教育，监督自我教育和实践的模型是有效的，并具有很好的可靠性和有效性。

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