For the purpose of this review, we extracted data on measures that mapped to the recently developed family of participation-related constructs. Since the publication of the ICF, there has been a lack of consensus regarding measurement tools to assess participation. In addition, we extracted data on participation, QoL, and satisfaction with surgery. We chose to extract data on gait summary scores rather than individual kinematic or kinetic variables because authors of many studies reported a large number of variables obtained from three-dimensional gait analysis. 10, – 12 When >1 summary score was reported in studies, we extracted data on the GPS. We extracted data on gait speed and summary statistics of gait (ie, the Gait Deviation Index, Gait Profile Score, or Gillette Gait Index). Although gross motor function was assessed in some studies by using the GMFCS, we did not consider the GMFCS to be a measure of gross motor function because it is primarily a classification system. We extracted data on gross motor function as measured by the Gross Motor Function Measure 66 (GMFM-66) or Gross Motor Function Measure 88, the Functional Mobility Scale (FMS), and the Gillette Functional Assessment Questionnaire (FAQ). However, the review in 2010 revealed that authors of few studies evaluate the effect of MLS across multiple domains of the ICF. When developed, it was envisaged that 1 use of the ICF would be the evaluation of interventions.
The ICF places greater emphasis on the role of the social and physical environment on functioning and conceptualizes that functioning results from a complex interaction between the person with the health condition and his or her context (consisting of personal and environmental factors). 7 Developed in 2001, the ICF is used to classify health-related domains by using the terms “body functions and structure,” “activity,” and “participation.” The ICF replaced the International Classification of Impairments, Disabilities, and Handicaps (ICIDH), which was used to conceptualize a health condition leading to impairment, disability, and handicap in a linear manner. The World Health Organization’s International Classification of Functioning, Disability, and Health (ICF) framework is useful for considering the impact of CP on the individual.
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