Gross Motor Function Measure (GMFM) Self-Instructional Training CD-ROM.

Gross Motor Function Measure (GMFM) Self-Instructional Training CD-ROM Lane M, Russell D. London, WC1V 6RL, United Kingdom, Mac Keith Press, 2003, CD-ROM, ISBN: 1-898-68330-1, $55. [System Requirements: Pentium-based PC with CD- or DVD-ROM, Microsoft Windows '98 or higher with Windows Media Player, 32 MB of RAM, 15 MB hard disk storage, VGA-capable (or better) video card.]

The Gross Motor Function Measure Self-Instructional Training CD-ROM (a 2-disc set) is a complementary tool for the Gross Motor Function Measure (GMFM-66 & GMFM-88) User's Manual (this book was reviewed in the October 2003 issue). The Gross Motor Function Measure (GMFM) is an observation-based measurement tool that assesses change in function in children with cerebral palsy or Down syndrome. In the development and validation of the GMFM, training the users in the proper application of the test helped to ensure reliability. Workshops on administration and scoring improved clinicians' scoring reliability significantly, regardless of years of pediatric experience, against a criterion videotape.

The authors created the CD-ROM self-training program to make training more readily available internationally and to replace the workshops. Although a clinician could become proficient from reading the manual, this CD set provided a visual learning method that I found much more interesting. Despite my experience in administering the GMFM, I found this CD helpful in further clarifying my understanding of the scoring criteria. This set would be extremely useful for all new users of the test by helping them to hone observational skills at their own pace.

Following the 4 steps outlined on the first CD the software was easily installed to a PC (Dell) with a Pentium 4 processor, 38.2 GB, a DVD-ROM drive, and Windows Media Player. The operating system was Windows 2000 Professional XP. A user must know how to install and open the program to begin its use. When installation is complete, it is easy to navigate through this program's menu and prompts.

Once the program is opened, the user is instructed to click on Start to proceed to the first page of options: "Introduction," "Dimensions," or "Definitions," and going forward or backwards through the contents at any time is easy. Before using this CD, if users are not familiar with procedures to administer and score the GMFM, the authors prompt them to read chapter 5 of the manual. The "Introduction" contains useful information such as the purpose of the software and how to determine whether a potential user is adequately trained in use of the GMFM. The user may also proceed to any 1 of the 5 dimensions of the test: "Lying and Rolling," "Sitting," "Crawling and Kneeling," "Standing," or "Walking, Running, and Jumping." More options are available once the user is in a dimension. To navigate and view the last 3 dimensions, however, the second CD must be in the computer drive. If the user chooses to view the definitions of terms, both CDs must be installed first before the definitions appear.

The first page of each dimension is an explanation of that dimension with terms that are highlighted (these are identified as "hotwords"). Clicking on the hotwords takes the user to the definitions of these terms as they are used in the GMFM. The next page begins the examples of the individual functions within the dimension. Each of the pages within the dimension have the same format. The item to be tested is identified at the top of the page. Three columns appear underneath this text. The first column is the video clip and scoring criteria. The user can see a number of examples for each item, run the item (step by step or in real time), and score the item by clicking on the criteria. Alter completing the scoring, the user can immediately find out the correct answer and its rationale by clicking on the answer. The correct answer, however, is the only answer with a rationale; incorrect answers do not have an explanation for why they are incorrect. The second column is the text explaining the starting position and instructions for testing from the manual. The third column contains numbered buttons for the individual items within the dimension. The Help button is also located here. The bottom of the page is divided into 2 columns that allow the user to proceed to the "Introduction," "Dimensions," and "Definitions" pages or to the video clips for each dimension at any time. The setup of each page allows the user to explore its many options and review the clips in any order.

The quality of the video clips is very, good, providing visual clarity to the user on the role of the therapist and gradation of function. There is no audio, but it is not useful for scoring the test. Because the video clips can be run or stopped and started at any point, the user is able to learn at his or her own pace, as the developers promised. The simplicity of use, the value of the content in establishing reliability, and the options for viewing the content make this CD set an asset to any clinician's library.

Karen Kott, PT, PhD

Hampton University

Hampton, Va

Dr Kott is Associate Professor in the Department of Physical Therapy. She currently is working on the development of a pediatric functional assessment tool and has previously reviewed the GMFM manual for Physical Therapy.