loading page

Quality Improvement Project to Implement a Systematic Assessment of Gross Motor Skills in School-Aged Children with Cystic Fibrosis
  • +1
  • Abby Good,
  • Jackie Shannon,
  • John Brinton,
  • Jordana Hoppe
Abby Good
Children's Hospital Colorado

Corresponding Author:[email protected]

Author Profile
Jackie Shannon
Children's Hospital Colorado
Author Profile
John Brinton
Colorado School of Public Health Department of Biostatistics & Informatics
Author Profile
Jordana Hoppe
University of Colorado Anschutz Medical Campus Department of Pediatrics
Author Profile


Introduction: Limited data exist on the gross motor abilities of children with cystic fibrosis (CF). The objective of this quality improvement project was to implement a systematic gross motor assessment in children with CF ages 4-12 years. Methods: Physical therapists aimed to evaluate at least 50% of eligible children at our CF Center over 1 year using the Bruininks-Oseretsky Test of motor Proficiency, second edition (BOT-2), a norm referenced assessment for gross motor skills, with delays defined by scores less than 18 th percentile. Demographic and clinical data including body mass index, hospitalizations, genotype, and comorbidities were collected. Basic descriptive statistics summarized patient information. Parametric and non-parametric methods compared groups of interest. Linear regression assessed associations between BOT-2 measures and clinical characteristics. Results: Of the 105 eligible children, 72 (69%) completed the BOT-2 over 1 year. Forty-five (62.5%) scored below average in at least one category. Impaired strength (22.2%) was most common, followed by impaired balance (16.7%), running speed and agility (15.3%), and bilateral coordination (8.3%). Eleven (15.5%) scored below average on their total motor composite score (TMC). Increased age, comorbidities and hospitalizations were associated with a lower TMC. Conclusions: The BOT-2 was successfully implemented as part of routine CF care to screen for gross motor delays. Results suggest that a high percentage of children with CF, especially older children with comorbid conditions or a history of hospitalization, have impaired gross motor function. These findings support the need for routine gross motor evaluations and physical therapy interventions within pediatric CF clinics.
21 Sep 2023Submitted to Pediatric Pulmonology
21 Sep 2023Assigned to Editor
21 Sep 2023Submission Checks Completed
21 Sep 2023Review(s) Completed, Editorial Evaluation Pending
02 Oct 2023Reviewer(s) Assigned
24 Oct 2023Editorial Decision: Revise Major