Upper limb function and deformity in cerebral palsy: a review of classification systems

McConnell, Karen; Johnston, Linda; Kerr, Claire

doi:10.1111/j.1469-8749.2011.03953.x

Cited by 46 publications

(26 citation statements)

References 50 publications

(220 reference statements)

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“…MHC evaluates the 3 categories of hand function (reaching, grasping and manipulating objects) and represents the best capacity of each hand. In a previous study, MHC was recommended as a reliable tool to classify upper limb function in children with CP 3. In the present study, we identified a strong relation between MHC and MACS in children with bilateral CP.…”

Section: Discussionsupporting

confidence: 65%

“…The Gross Motor Function Classification System (GMFCS) is widely used to assess the gross motor function in children with CP, and the Manual Ability Classification System (MACS) was developed to evaluate a child's typical manual performance in daily life 1,2. GMFCS is now universally accepted as a valid and reliable means of classifying gross motor function in children with CP 3. However, MACS has recently gained attention as a valid and reliable classification system for upper extremity functions in children with CP aged 4 to 18 years 1,4.…”

Section: Introductionmentioning

confidence: 99%

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Relation among the Gross Motor Function, Manual Performance and Upper Limb Functional Measures in Children with Spastic Cerebral Palsy

et al. 2013

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PurposeThe objective of this study was to describe hand function in relation with gross motor function and subtype of spastic cerebral palsy and to investigate the relationships among gross motor function, bimanual performance, unimanual capacity and upper limb functional measures in children with spastic cerebral palsy (CP).Materials and MethodsWe collected upper extremity data of 140 children with spastic CP. The Gross Motor Functional Classification System (GMFCS) was used to assess gross motor function, Manual Ability Classification System (MACS) for bimanual performance, and Modified House Functional Classification (MHC) for the best capacity of each hand. Upper limb functions were evaluated by using the Upper Limb Physician's Rating Scale and Upper Extremity Rating Scale.ResultsThere was a good correlation between GMFCS and MACS in children with bilateral CP, but the correlation was not strong in children with unilateral CP. No significant difference between GMFCS and MACS was found in children with bilateral CP, but children with unilateral CP scored higher on GMFCS than on MACS. A strong correlation was observed between MACS and MHC in children with bilateral CP, but not in children with unilateral CP. The upper limb functional measures in each hand were highly related with MACS and MHC in bilateral CP, but not in unilateral CP.ConclusionGross motor function, bimanual performance and the best capacity of each hand are closely related with each other in children with bilateral CP, but not in children with unilateral CP.

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Section: Discussionsupporting

confidence: 65%

Section: Introductionmentioning

confidence: 99%

Relation among the Gross Motor Function, Manual Performance and Upper Limb Functional Measures in Children with Spastic Cerebral Palsy

et al. 2013

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“…In line with a previous study of McConnell et al, 81 the MACS was found to be the tool with most published evidence. It shows moderate positive levels of evidence for interrater reliability (when only considering comparisons between therapists) and test-retest reliability.…”

Section: Reliabilitysupporting

confidence: 89%

“…In comparison with previous reviews, [3][4][5]8,80,81 the current article covered a broader age range and several diagnoses. This ensured a comprehensive overview of the evidence of assessment tools used in clinical everyday life.…”

Section: Discussionmentioning

confidence: 99%

Reliability and Responsiveness of Upper Limb Motor Assessments for Children With Central Neuromotor Disorders

Gerber

Labruyère

Hedel

2015

Neurorehabil Neural Repair

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Background. To investigate the effectiveness of upper limb rehabilitation, sound measures of upper limb function, capacity, and performance are paramount. Objectives. This systematic review investigates reliability and responsiveness of upper limb measurement tools used in pediatric neurorehabilitation. Methods. A 2-tiered search was conducted up to July 2014. The first search identified upper limb motor assessments for 1-to 18-year-old children with neuromotor disorders. The second search examined the psychometric properties of the tools. Methodological quality was rated according to COSMIN guidelines, and results for each tool were assembled in a "best evidence synthesis." Furthermore, we delineated whether tools were unimanual or bimanual tests and if they measured recovery or did not distinguish between physiological and compensatory movements. Results. The first search delivered 2546 hits. Of these, 110 articles on 51 upper limb assessment tools were included. The second search resulted in 58 studies on reliability, 11 on measurement error, and 10 on responsiveness. Best evidence synthesis revealed only 2 assessments with moderate positive evidence for reliability, whereas no evidence on measurement error and responsiveness was found. The Melbourne Assessment showed moderate positive evidence for interrater and a fair positive level of evidence for intrarater reliability. The Pediatric Motor Activity Log Revised revealed moderate positive evidence for test-retest reliability. Conclusions. There is a lack of high-quality studies about psychometric properties of upper limb measurement tools in children with neuromotor disorders. To date, upper limb rehabilitation trials in children and adolescents risk being biased by insensitive measurement tools lacking reliability.

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“…The children instead of tapping at some touchscreen, must move their arms and point at a certain spot in space. According to the Manual Ability Classification System (MACS) [16] scale, our games are suitable for CP patients of level II and III. Note here that we are currently developing games that target pinch and supination rehabilitation.…”

Section: Proposed Rehabilitative Gamesmentioning

confidence: 99%

A game system for remote rehabilitation of cerebral palsy patients

Papangelis

Mouchakis

Texas³

et al. 2012

Proceedings of the 5th International Conference on PErvasive Technologies Related to Assistive Environments

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Cerebral Palsy (CP) is a condition that affects many people and causes paralysis or disability due to brain dysfunctions. Though incurable, physical rehabilitation has proven to improve the patients' quality of life. Some of them, however, may need extra motivation to go through the rehabilitation process. Thus, to engage them in rehabilitative actions, video games, virtual reality games and robots that combine rehabilitation with play have been developed. We propose a game system targeted for rehabilitation of young CP patients and a graphical Event Recognition (ER) Authoring Tool with which a therapist can define ER rules that allow monitoring the rehabilitation progress of a patient and adjusting the therapy accordingly. Our aim is to develop a remote CP rehabilitation platform, that combines rehabilitative actions with play and employs inexpensive, off the shelf technologies that can be used with minimal supervision. This platform is targeted both at young CP patients and also therapists.

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Upper limb function and deformity in cerebral palsy: a review of classification systems

Cited by 46 publications

References 50 publications

Relation among the Gross Motor Function, Manual Performance and Upper Limb Functional Measures in Children with Spastic Cerebral Palsy

Relation among the Gross Motor Function, Manual Performance and Upper Limb Functional Measures in Children with Spastic Cerebral Palsy

Reliability and Responsiveness of Upper Limb Motor Assessments for Children With Central Neuromotor Disorders

A game system for remote rehabilitation of cerebral palsy patients

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