The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability

Abstract

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.

Genomic analysis identifies masqueraders of full‐term cerebral palsy

“…For each patient, demographic and clinical data were collected from the patient's chart, which included gender, age, age at diagnosis, details of pregnancy and birth, gestational weeks, birth weight, head circumference, neonatal events, type of CP, comorbidities, brain MRI findings, and functional classification scores for CP, such as the Gross Motor Function Classification Scale,10 the Manual Ability Classification System,11 and the Communication Function Classification System 12. The types of CP (spastic diplegia, ataxic type, diskinetic type, and mixed type) were classified based on previous reports,9, 13 and the brain MRI was performed as previously described 9…”

Fatiguing Effects on the Multi-Scale Entropy of Surface Electromyography in Children with Cerebral Palsy

“…The inclusion criteria of CP children participating in our research include: (1) age between 4 and 13 years old; (2) no abnormal postures or involuntary movements were shown during upper limb lifting task performance; (3) ability to independently complete tasks without some external assistance; (4) ability to sustain some extent of external loads; (5) ability to comprehend instructions from researchers; (6) no history of other kinds of pathological cause that lead to the motor function deficiency despite cerebral palsy. For each CP child, upper limb function was evaluated by manual ability classification system (MACS) proposed by Eliassen et al [32], which classifies CP children's manual ability by observing how they use their upper limbs to handle objects in daily activities. The information of all CP children was shown in Table 1.…”

Effect of Mirror Therapy on Upper Limb Function: A Single Subject Study

“…Table 1 provides the descriptive information of the study participants using pseudonyms. The Manual Ability Classification System (MACS) was used to identify the levels of interaction with objects and quality of movements [18]. Level II indicated "Handles most objects, but with somewhat reduced quality and/or speed of achievement".…”

“…Level II indicated "Handles most objects, but with somewhat reduced quality and/or speed of achievement". Level III specified "Handles objects with difficulty; needs help to prepare and/or modify activities" [18]. Spasticity was assessed by Ashworth scale.…”