Children/adolescents with cancer can develop adverse effects impacting gross motor function. There is a lack of gross motor function assessment tools that have been validated for this population. The aim of this multicenter cross-sectional study was to preliminary validate the 88-item Gross Motor Function Measure (GMFM-88) for use in children/adolescents with cancer, exploring internal consistency and floor/ceiling effect. Inclusion criteria regarded children/adolescents diagnosed with cancer on treatment or <1 year off therapy. The internal consistency was assessed using Cronbach’s α, and the floor–ceiling effects were calculated through percentage. This study involved 217 participants with heterogeneous neoplasm conditions. Internal consistency was good, with a Cronbach’s α of 0.989. Floor–ceiling effect analysis reveals that several items obtained a dichotomous scoring distribution in each of the five sub-scales of the GMFM-88. This can be explained by the heterogeneous clinical characteristics of the target population. The preliminary validation of GMFM-88 in a group of children/adolescents affected by cancer suggests that some items are not able to discriminate between different gross motor function levels, and therefore it does not represent an informative tool to measure gross motor function in children with cancer. Future research is needed to define which ones could be more useful for clinical practice.
Background/Objectives: Functional abilities are fundamental for social participation. However, functional abilities assessment tools validated for children and adolescents undergoing cancer treatment are lacking. A preliminary validation of the Gross Motor Function Measure-88 (GMFM-88) scale for children with cancer found that some items are unable to discriminate or distinguish between different gross motor function levels. This study aims to develop and validate the Functional Abilities Assessment in Paediatric Oncology (FAAP-O), starting with GMFM-88. Methods: This multicentre study (ClinicalTrials.gov Identifier: NCT04862130) involved children and adolescents (6 months–18 years old) diagnosed with cancer, in any phase of treatment or less than 1 year off therapy. A multiphase mixed-methods design was employed. The content validity of each item of GMFM-88 for the paediatric oncology population was calculated with the Content Validity Ratio (CVR). Items with a CVR score ≥ 0.70 were included in the FAAP-O scale. Other items with a score between 0 and 0.69 were selected for their relevance by consensus with five focus groups and a plenary meeting. The FAAP-O items set was organised in five dimensions by exploratory factor analyses. The calculation of FAAP-O internal consistency was made using Cronbach’s α while inter/intra-rater reliability was assessed by intraclass correlation coefficients (ICCs). Results: The study involved 217 subjects. The FAAP-O included 36 items; its internal consistency was good in each dimension (0.90 ≤ α ≤ 0.96) and its inter/intra-rater reliability was excellent (ICC > 0.90). Conclusions: A new specifically validated scale to assess functional abilities in children and adolescents with cancer is provided. Validated tools are necessary for specific, objective rehabilitation assessments, which are fundamental in clinical practice and research.
Background/Objectives: Early motor intervention is increasingly recognized as a critical component in the management of infants with, or at high risk of, cerebral palsy (CP). This systematic review aimed to synthesize recent evidence on early motor interventions in infants aged 0–2 years and to identify current gaps in knowledge. Methods: We performed a systematic literature review across PubMed, Embase, CINAHL, and Scopus. Studies published between 1 January 2020 and 5 October 2024 were included. Eligible studies were Randomized Controlled Trials (RCTs), non-randomized trials, and cohort studies that involved infants aged 0–2 years diagnosed with CP or classified as at high risk of CP who received early motor interventions targeting motor outcomes. Study selection and data extraction were executed by two independent reviewers following standardized protocols. The Rob2 Checklist was used to assess the risk of bias. This systematic review protocol was registered on PROSPERO with the ID 506784. Results: Six articles representing four RCTs were included. Although intervention protocols varied, shared therapeutic principles emerged across studies. Most participants were approximately 12 months old; only one study included infants younger than 3 months, highlighting limited evidence in the earliest detectable risk period. No consistent superiority of experimental interventions over standard care was observed; however, notable within-group improvements in motor and developmental domains were reported across both study arms. Major limitations included heterogeneity of outcome measures, limited use of CP-specific standardized tools, and insufficient assessment of functional and goal-based outcomes. Conclusions: Current evidence indicates a shift toward meaningful, family-centered early motor interventions, emphasizing active participation and parental involvement. Five core principles were identified: early initiation, task specificity, active experience, guided support, and engagement of both the child and caregivers. Future research should focus on earlier intervention timing, standardized outcome measures, and caregiver-related outcomes to optimize early intervention strategies during critical developmental windows.