The relationship between the school function assessment (SFA) and the gross motor function classification system (GMFCS) in ambulatory patients with cerebral palsy

Purpose: Determine the relationship between the SFA and GMFCS in children with cerebral palsy (CP). Methods: Through correlation, regression, and ANOVA analysis, data from 103 children were examined. A regression model was used to compare SFA-predicted versus actual GMFCS levels. One-way ANOVA was utilized to determine differences between SFA subscale scores in the context of GMFCS. Results: A significant correlation between composite SFA scores and GMFCS levels (r = -0.847, p < 0.020) was observed. Subscale-SFA and GMFCS correlations included Regular Class (r = -0.338, p < 0.001), Physical Tasks Adaptation (Phys1; r = -0.340, p < 0.001) and Assistance (Phys2; r = -0.340, p < 0.001), Position (r = -0.338, p< 0.001), Recreational Movement (RecMvmt; r = -0.387, p < 0.0001), Manipulation Movement (ManMvmt; r = -0.494, p < 0.0001), and Up/Down Stairs (UDStairs; r = -0.453, p < 0.0001). Between predicated and actual GMFCS levels, no statistical difference was observed. One-way ANOVA demonstrated SFA differences at GMFCS levels: Phys1 (F = 5.32, p < 0.002), Phys2 (F = 4.54, p < 0.005), Position (F = 4.63, p < 0.004), RecMvmt (F = 7.92, p < 0.0001), ManMvmt (F = 13.50, p < 0.0001), and UDStairs (F = 6.18, p < 0.001). Conclusion: Utilizing both SFA-predicted and actual GMFCS levels may help determine if a child is performing at an expected level of daily function.