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A comparative assessment of motor function using the expanded and revised gross motor function classification system
E E Eseigbe1, J O Anyiam, R D Wammanda
1Department of Paediatrics, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Northern Nigeria.
Insights
The Gross Motor Function Classification System-Expanded and Revised (GMFCS-E&R) and Manual Ability Classification System (MACS) show significant differences in classifying motor function in children with Cerebral Palsy (CP). This highlights the complexity of assessing CP motor function.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- Assessing motor function in children with Cerebral Palsy (CP) is crucial for managing mobility.
- Standardized classification systems aid in understanding functional levels.
Purpose of the Study:
- To compare the classification outcomes of the Gross Motor Function Classification System-Expanded and Revised (GMFCS-E&R) and the Manual Ability Classification System (MACS).
- To evaluate the consistency in assessing motor function in children with CP using these two systems.
Main Methods:
- A retrospective review of motor activity in children with CP.
- Data collected from January 2005 to December 2009 at Ahmadu Bello University Teaching Hospital.
- Analysis of 28 children (4-12 years) with CP, focusing on predisposing factors and clinical types.
Main Results:
- GMFCS-E&R identified more children in higher motor function levels (I & II) compared to MACS (46.43% vs 14.29%, p=0.02).
- MACS identified more children in lower motor function levels (IV & V) than GMFCS-E&R (57.14% vs 21.43%, p=0.00).
- No significant difference was found for Level III classification (GMFCS-E&R: 32.14%, MACS: 28.57%, p=0.77).
- Overall correlation between GMFCS-E&R and MACS was poor (Kappa=0.00).
Conclusions:
- GMFCS-E&R and MACS significantly differentiate motor function levels in children with CP.
- The observed disparities indicate the complexity of assessing motor function in this population.
- These findings suggest the need for careful consideration when utilizing these systems for clinical decision-making.
Background:
Assessment of motor function in children with Cerebral Palsy (CP) is vital to the identification and management of their mobility needs.
Objective:
To compare the Expanded and Revised Gross Motor Function Classification System (GMFCS-E&R) and Manual Ability Classification System (MACS) in the assessment of motor function in children with CP.
Methods:
A review of motor activity in children with CP documented at the Departments of Paediatrics and Physiotherapy, Ahmadu Bello University Teaching Hospital, Shika, Zaria, between January 2005 and December 2009.
Results:
A total of 28 children (16M: 12 F, 1.3:1) with an age range of 4 to 12 years (mean 6.2 ± 2.4 years) were studied. Birth asphyxia (46.43%) and Spastic Hemiplegia (71.43%) were the main identified predisposing factor and clinical type of CP respectively. The GMFCS-E&R identified 13 (46.43%) children with higher levels (I & II) of gross motor function against 4 (14.29%) children identified in the MACS higher levels (p=0.02). Also 6 (21.43%) of the children were identified as being in the GMFCS-E&R lower levels (IV & V) against 16 (57.14%) in MACS lower levels (p=0.00). The difference in the number of children identified as being in level III for GMFCS-E&R 9 (32.14%) and MACS 8 (28.57%) was not significant (p=0.77). Overall correlation between GMFCS-E&R and MACS levels was poor using Kappa statistics (Kappa=0.00).
Conclusion:
The GMFCS-E&R and MACS significantly identified higher and lower levels of motor functions respectively in the same children. The disparity underscores the complexity in assessing the motor function of children with CP.
