Related Experiment Video
Updated: Jul 4, 2026
Repeated Transcranial Magnetic Stimulation Combined with Action Observation Training in Children with Spastic Cerebral Palsy
Published on: August 9, 2024
Relationship among the Manual Ability Classification System (MACS), the Gross Motor Function Classification System
Mintaze Kerem Gunel1, Akmer Mutlu, Tulay Tarsuslu
1Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, 06100, Samanpazari, Ankara, Turkey. mintaze@hacettepe.edu.tr
Insights
The Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) strongly correlate with functional status (WeeFIM) in children with spastic cerebral palsy (CP). Using both GMFCS and MACS aids in classifying CP functional status.
Area of Science:
- Pediatrics
- Rehabilitation Medicine
- Developmental Neuroscience
Background:
- Cerebral palsy (CP) impacts motor function and daily activities.
- Standardized classification systems are crucial for assessing children with CP.
- Understanding the interplay between motor and functional abilities is key for targeted interventions.
Purpose of the Study:
- To investigate the relationships among functional classification systems: Manual Ability Classification System (MACS), Gross Motor Function Classification System (GMFCS), and functional status (WeeFIM) in children with spastic CP.
- To evaluate the utility of these systems in classifying functional status and reflecting clinical CP subtypes.
Main Methods:
- A cohort of 185 children with spastic CP (aged 4-15 years) was assessed.
- Children were classified using GMFCS for motor function and MACS for hand function.
- Functional status and performance were measured using the Functional Independence Measure for Children (WeeFIM).
Main Results:
- A significant positive correlation was found between GMFCS and MACS (r = 0.735, p < 0.01).
- Both GMFCS and MACS showed significant correlations with WeeFIM subscales across CP subtypes (p < 0.01).
- No significant differences in MACS scores were observed across different age groups (4-7, 8-11, 12-15 years).
Conclusions:
- GMFCS and MACS are reliable tools for classifying functional status in children with spastic CP.
- Combined use of GMFCS, MACS, and WeeFIM allows for detailed functional analysis and differentiation between CP clinical types.
- These classification systems offer a practical approach for both clinical practice and research in pediatric CP.
Abstract:
The aim of this study was to investigate the relationship among functional classification systems, the Manual Ability Classification System (MACS), the Gross Motor Function Classification System (GMFCS), and the functional status (WeeFIM) in children with spastic cerebral palsy (CP). One hundred and eighty-five children with spastic CP (101 males, 84 females), 65 (35.1%) diparetic, 60 (32.4%) quadriparetic, and 60 (32.4%) hemiparetic children, ranging from 4 to 15 years of age with a median age of 7 years, were included in the study. The children were classified according to the GMFCS for their motor function and according to the MACS for the functioning of their hands when handling objects in daily activities. The functional status and performance were assessed by using the Functional Independence Measure of Children (WeeFIM). A good correlation between the GMFCS and MACS was found in all children (r = 0.735, p < 0.01). There was also a correlation between the GMFCS and WeeFIM subscales according to subtypes and all parameters were correlated at the level of p < 0.01, the same as the MACS. There was no difference in the MACS scores among the age groups of 4-7, 8-11, and 12-15 years (p > 0.05). The use of both the GMFCS and MACS in practice and in research areas will provide an easy, practical, and simple classification of the functional status of children with CP. The adaptation of both of these scales and WeeFIM and using these scales together give the opportunity for a detailed analysis of the functional level of children with spastic CP and reflect the differences between clinical types of CP.
