Cerebral palsy classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Classification

Manual Ability Classification System

The Manual Ability Classification System (MACS) classifies children with cerebral palsy into five levels. The levels are based on the children’s self-initiated ability to handle objects and their need for assistance or adaptation to perform manual activities in everyday life.[1]

 
 
 
 
 
 
 
Does the child handle most kind of
daily activities independently
( during play and leisure, eating and dressing)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Yes
 
 
 
 
 
 
 
 
No
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Does the child handle even more difficult tasks
with fair speed and accuracy and
does not need alternative ways to perform
 
 
 
 
 
 
 
 
Does the child perform number of mannual tasks
which commonly need to prepared or adapted
and help is needed occasionally
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Yes
 
No
 
 
 
Yes
 
 
No
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Level 1
Handles objects easily and successfully
 
Level 2
Handles most objects with
reduced quality and speed of acheivement
 
 
 
Level 3
Handles objects with
difficulty but needs preparation
 
 
Can the child perform
easy activites with frequent support
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Yes
 
 
 
No
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Level 4
Handles easy activites
with limitations and support
 
 
 
Level 5
Cannot handle daily activites
has severely limited abilities to perform even simple actions

Gross Motor Function Classification System

The Gross Motor Function Classification System or GMFCS also classifies children with cerebral palsy into five levels. The levels are based on self-initiated movement abilities, in particular sitting and walking.[2]

References

  1. Paulson A, Vargus-Adams J (2017). "Overview of Four Functional Classification Systems Commonly Used in Cerebral Palsy". Children (Basel). 4 (4). doi:10.3390/children4040030. PMC 5406689. PMID 28441773.
  2. Carnahan KD, Arner M, Hägglund G (2007). "Association between gross motor function (GMFCS) and manual ability (MACS) in children with cerebral palsy. A population-based study of 359 children". BMC Musculoskelet Disord. 8: 50. doi:10.1186/1471-2474-8-50. PMC 1919364. PMID 17584944.

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