Classifi cation of motor function and functional performance in children with cerebral palsy

Objective: To classify children with cerebral palsy (CP) using classifi cation systems for mobility and manual function; to compare groups of children with CP regarding gross motor function and functional performance outcomes; and to evaluate associations between the functional classifi cations and the scores obtained in the outcomes that were investigated. Methods: Thirty children with CP were classifi ed using the Gross Motor Function Classifi cation System (GMFCS) and the Manual Abilities Classifi cation System (MACS), and were divided into three groups, based on their classifi cation (mild, moderate or severe) in each of these systems. Gross motor function was documented using the Gross Motor Function Measure (GMFM-66) test, while functional abilities and the caregiver’s assistance regarding self-care and mobility were documented using the Pediatric Evaluation of Disability Inventory (PEDI). Results: One-way ANOVA showed that the groups were signifi cantly different regarding the GMFM-66 and PEDI results. Post-hoc comparison tests (Scheffé) revealed that the children with moderate impairment (GMFCS) had functional abilities and caregiver support that were similar to those of the mildly impaired children. However, the moderate children (MACS) were not different from the severe children. Spearman rank correlations showed strong and signifi cant inverse associations between the functional classifi cations and the results from the PEDI and GMFM-66 tests. Conclusions: The results suggest that the MACS and GMFCS functional classifi cations are good indicators of the manual function and mobility of children with CP. These classifi cations may be useful in the processes of evaluation and intervention planning.