Relationship among the Manual Ability Classification System (MACS), the Gross Motor Function Classification System (GMFCS), and the functional status (WeeFIM) in children with spastic cerebral palsy
- 1.4k Downloads
The aim of this study was to investigate the relationship among functional classification systems, the Manual Ability Classification System (MACS), the Gross Motor Function Classification System (GMFCS), and the functional status (WeeFIM) in children with spastic cerebral palsy (CP). One hundred and eighty-five children with spastic CP (101 males, 84 females), 65 (35.1%) diparetic, 60 (32.4%) quadriparetic, and 60 (32.4%) hemiparetic children, ranging from 4 to 15 years of age with a median age of 7 years, were included in the study. The children were classified according to the GMFCS for their motor function and according to the MACS for the functioning of their hands when handling objects in daily activities. The functional status and performance were assessed by using the Functional Independence Measure of Children (WeeFIM). A good correlation between the GMFCS and MACS was found in all children (r = 0.735, p < 0.01). There was also a correlation between the GMFCS and WeeFIM subscales according to subtypes and all parameters were correlated at the level of p < 0.01, the same as the MACS. There was no difference in the MACS scores among the age groups of 4–7, 8–11, and 12–15 years (p > 0.05). The use of both the GMFCS and MACS in practice and in research areas will provide an easy, practical, and simple classification of the functional status of children with CP. The adaptation of both of these scales and WeeFIM and using these scales together give the opportunity for a detailed analysis of the functional level of children with spastic CP and reflect the differences between clinical types of CP.
KeywordsCerebral palsy WeeFIM GMFCS MACS Rehabilitation
The authors would like to thank Christin Elliason for the support during the revision of the manuscript and Dr. Levent Eker for helping with the data analyses. We also thank all of the participants of this study and their families.
Conflict of interest statement
The authors declare that they have no conflict of interest.
- 1.Altman DG (1991) Practical statistics for medical research. Chapman and Hall, LondonGoogle Scholar
- 3.Arner M, Eliasson AC, Rösblad B, Rosenbaum PL, Beckung E, Krumlinde-Sundholm L (2008) Manual Ability Classification System for children with cerebral palsy. Home page at: http://www.macs.nu
- 8.Damiano DL, Abel MF, Romness M, Oeffinger DJ, Tylkowski CM, Gorton GE 3rd, Bagley AM, Nicholson DE, Barnes D, Calmes J, Kryscio R, Rogers S (2006) Comparing functional profiles of children with hemiplegic and diplegic cerebral palsy in GMFCS Levels I and II: are separate classifications needed? Dev Med Child Neurol 48:797–803PubMedCrossRefGoogle Scholar
- 9.Eliasson AC, Krumlinde-Sundholm L, Rösblad B, Beckung E, Arner M, Öhrvall A-M, Rosenbaum PL (2006) The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Dev Med Child Neurol 48:549–554PubMedCrossRefGoogle Scholar
- 15.Mayston MJ (2001) The Bobath concept today. Synapse, Spring edition, pp 32–34Google Scholar
- 20.Oeffinger DJ, Tylkowski CM, Rayens MK, Davis RF, Gorton GE 3rd, D’Astous J, Nicholson DE, Damiano DL, Abel MF, Bagley AM, Luan J (2004) Gross Motor Function Classification System and outcome tools for assessing ambulatory cerebral palsy: a multicenter study. Dev Med Child Neurol 46:311–319PubMedCrossRefGoogle Scholar
- 27.World Health Organization (WHO) (2001) International classification of functioning, disability and health (ICF). WHO, Geneva. Home page at: http://www.who.int/classifications/icf/en/