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The stability of the Manual Ability Classification System over time
Ann-Marie Öhrvall1, Lena Krumlinde-Sundholm, Ann-Christin Eliasson
1Department of Women's and Children's Health, Astrid Lindgren Children's Hospital, Karolinska Institutet, Stockholm, Sweden.
Developmental Medicine and Child Neurology
|January 15, 2014
Summary
The Manual Ability Classification System (MACS) levels demonstrate excellent stability over time in children with cerebral palsy, regardless of age at initial classification. This indicates MACS has strong predictive value for long-term functional ability.
Area of Science:
- Pediatric Rehabilitation
- Neurology
- Developmental Pediatrics
Background:
- The Manual Ability Classification System (MACS) is crucial for assessing upper limb function in children with cerebral palsy.
- Understanding the long-term stability of MACS levels is essential for effective intervention planning and prognosis.
Purpose of the Study:
- To evaluate the longitudinal stability of Manual Ability Classification System (MACS) levels in a large cohort of children with cerebral palsy.
- To determine if age at initial classification influences the stability of MACS levels over time.
Main Methods:
- A cohort of 1267 children with cerebral palsy were followed between 2005 and 2010.
- MACS classifications were recorded at least one year apart, with some children having up to four ratings.
- Stability was assessed using intraclass correlation coefficients (ICC) and percentage agreement, comparing younger and older children at first classification.
Main Results:
- Excellent stability was observed between MACS ratings one year apart (ICC=0.97, 82% agreement).
- High stability was also found for ratings 3-5 years apart (ICC=0.96, 78% agreement).
- Seventy percent of children maintained the same MACS level across four ratings, with no significant difference based on age.
Conclusions:
- MACS levels exhibit remarkable stability over extended periods in children with cerebral palsy.
- The findings support the predictive value of MACS for long-term functional ability.
- Age at initial classification does not appear to affect the stability of MACS levels.
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