The Manual Ability Classification System (MACS) has been developed to classify how children with cerebral palsy (CP) use their hands when handling objects in daily activities. The classification is designed to reflect the child's typical manual performance, not the child's maximal capacity. It classifies the collaborative use of both hands together. Validation was based on the experience within an expert group, a review of the literature, and thorough analysis of children across a spectrum of function. Discussions continued until consensus was reached, first about the constructs, then about the content of the five levels. Parents and therapists were interviewed about the content and the description of levels. Reliability was tested between pairs of therapists for 168 children (70 females, 98 males; with hemiplegia [n=52], diplegia [n=70], tetraplegia [n=19], ataxia [n=6], dyskinesia [n=19], and unspecified CP [n=2]) between 4 and 18 years and between 25 parents and their children's therapists. The results demonstrated that MACS has good validity and reliability. The intraclass correlation coefficient between therapists was 0.97 (95% confidence interval 0.96-0.98), and between parents and therapist was 0.96 (0.89-0.98), indicating excellent agreement.

The Manual Ability Classification System (MACS) has been developed to classify how children with cerebral palsy (CP) use their hands when handling objects in daily activities. The classification is designed to reflect the child's typical manual performance, not the child's maximal capacity. It classifies the collaborative use of both hands together. Validation was based on the experience within an expert group, a review of the literature, and thorough analysis of children across a spectrum of function. Discussions continued until consensus was reached, first about the constructs, then about the content of the five levels. Parents and therapists were interviewed about the content and the description of levels. Reliability was tested between pairs of therapists for 168 children (70 females, 98 males; with hemiplegia [n= 52], diplegia [n= 70], tetraplegia [n= 19], ataxia [n= 6], dyskinesia [n= 19], and unspecified CP [n= 2]) between 4 and 18 years and between 25 parents and their children's therapists. The results demonstrated that MACS has good validity and reliability. The intraclass correlation coefficient between therapists was 0.97 (95% confidence interval 0.96–0.98), and between parents and therapist was 0.96 (0.89‐0.98), indicating excellent agreement.

The aim of this study was to provide norms for grip strength in children. A total of 530 Swedish 4–16‐y‐olds was tested with the instrument Grippit®. The instrument estimates peak grip strength over a 10 s period, and sustained grip strength averaged across the 10 s. The increase in grip strength with age was approximately parallel for boys and girls until 10 y of age, after which boys were significantly stronger than girls. Strong correlations existed between grip strength and the anthropometric measures weight, height and, in particular, hand length. Right‐handed children were significantly stronger in their dominant hand, while left‐handers did not show any strength difference between the hands. It is therefore suggested that when evaluating grip strength in left‐handed children both hands should be assumed to be about equally strong, while right‐handed children are expected to be up to 10% stronger with their right hand. Sustained grip strength was consistently about 80–85% of peak grip strength, with somewhat lower values in younger children. The present normative data for peak grip strength were slightly lower than 1980s' data from the USA and Australia, probably because of divergences in age grouping and in instruments used. Conclusion: Norms for grip strength including estimates of variation were provided for children aged 4–16 y. These data will enable therapists and physicians to compare a patient's score with the scores of normally developed children according to age, gender, handedness and body measures.

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present results indicate that the expectakinematic analysis of planar reaching

This study has examined the individual movements of the body segments of a group of 10 standing adults during anterior and posterior platform displacements (3 and 6 cm amplitudes), and compared body movements to neck and ankle muscle response onset times. Differences in the kinematics of movement were observed for anterior vs. posterior platform displacements: hip, shoulder, and head began to move much earlier for posterior compared to anterior platform movements. This could explain differences in postural muscle temporal response organization for the two directions of body movement. Though anterior/posterior neck and head displacements were late in comparison to neck flexor muscle response onset, small vertical movements of the shoulder and head occurred early (40 and 67 ms after platform movement onset). These movements were consistently directed upward for anterior platform displacements and downward for posterior platform displacements. In order to determine whether neck proprioceptors were responsible for response activation in the neck we repeated the experiment using a neck stabilization device, on one of our subjects. In this condition, we found normal neck muscle response latencies. This suggests that neck proprioceptors are not the primary contributors to the early neck muscle responses seen during horizontal support surface displacements. In studying the effect of repeated exposure to horizontal platform displacements we found a diminution in the amplitude and an increase in onset latencies in neck and antagonist ankle muscle responses over the sequence of 16 trials, in many of the subjects tested. This corresponded to smaller head accelerations, and smaller displacements of the head and shoulder in later trials in the experimental sequence. The result implies that these subjects changed their postural "set" during the course of the experiment, possibly by relaxing the muscles of the body to allow the viscoelastic properties of the lower body segments to absorb more of the impact of platform displacement.