It also has been validated by multiple studies, and interrater reliability has been found to be good to excellent among health care professionals and care providers for children 4 to 18 years of age. This five-level ordinal system was developed to be similar to the GMFCS but is intended to assess how a child with cerebral palsy uses his or her hands to perform activities of daily living.
#MANUAL ABILITIES CLASSIFICATION SYSTEM MANUAL#
The impact and acceptance of the GMFCS led to the introduction of the Manual Abilities Classification System (MACS) ( Table 33.3). The GMFCS has been shown to be predictive of hip dislocation. The emphasis of this scale is on self-initiated movement and walking and sitting function. It takes into account functional limitations for assistive devices, such as walkers and wheelchairs, and the quality of movement based on age.
It has since been expanded and revised to include children 12 to 18 years of age. Initially described by Palisano et al., this five-level ordinal grading system has been found to be a reliable and stable method of classification and prediction of motor function for children under the age of 12 years. The first widely accepted functional classification was the Gross Motor Function Classification System (GMFCS) ( Box 33.1). Functional classification systems are able to grade individuals based on their abilities instead of their deficiencies and promote the concepts of the World Health Organization’s International Classification of Functioning, Disability, and Health, which focuses on activity and participation. In recent years, newer classification systems have been developed based on function. Azar MD, in Campbell's Operative Orthopaedics, 2021 Functional Classification The SES does not appear to affect functional profiles.ĬFCS Cerebral palsy Functional classifications GMFCS MACS.Ĭopyright © 2014 Elsevier Ltd. The systematic evaluation of the IQ can provide useful information about a possible future outcome for every functional level. This study shows how the three functional classifications (GMFCS-E&R, CFCS and MACS) complement each other to provide a better description of the functional profile of CP. The Kruskal-Wallis test was used to determine if there were differences between the GMFCS-E&R, the CFCS and the MACS by CP type. The correlations between the IQ and the global functional disability profile were strong or moderate (GMFCS and IQ: rs=0.66, p=0.001 MACS and IQ: rs=0.58, p=0.001 CFCS and MACS: rs=0.65, p=0.001). A strong correlation was found between the three classifications: Level V of the GMFCS-E&R corresponds to Level V of the MACS (rs=0.67, p=0.001) the same relationship was found for the CFCS and the MACS (rs=0.73, p<0.001) and for the GMFCS-E&R and the CFCS (rs=0.61, p=0.001). A total of 87 children (47 males and 40 females, age range 4-18 years, mean age 8.9±4.2) were included in the study. It was also geared to verify whether there is a correlation between these classification systems and intellectual functioning (IF) and parental socio-economic status (SES). This study aimed to investigate a possible correlation between the gross motor function classification system-expanded and revised (GMFCS-E&R), the manual abilities classification system (MACS) and the communication function classification system (CFCS) functional levels in children with cerebral palsy (CP) by CP subtype.
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