Manual Ability Classification System

Medical diagnostics
Purpose| assess 4-18 years old individuals with cerebral palsy ability to use hands

The Manual Ability Classification System (MACS) is a medical classification system used to describe how children aged from 4 to 18 years old with cerebral palsy use their hands with objects during activities of daily living, with a focus on the use of both hands together. Like the Gross Motor Function Classification System (GMFCS), there are five levels - level I being the least impaired, only finding difficulty in tasks needing speed and accuracy, and level V being the most impaired, not being able to handle objects and having severely limited abilities for even simple actions.

## Contents

* 1 Medical use
* 2 Development
* 3 Alternatives
* 4 Mini-MACS
* 5 See also
* 6 References
* 7 External links

## Medical use

It is mostly used as a way of describing a sample population and as an independent variable. Occasionally it is used as a dependent variable. MACS levels are stable over time and so they can be used as part of a prognosis for individuals. Although MACS was not designed for adults, it has been used with a good measure of reliability in young adult populations ranging in ages from 18-24. Although it has a good level of reliability when used for children between 2 and 5 years of age, there is less evidence for using it with children younger than 2.[1] Unlike the GMFCS, there are no age bands for the MACS.[2] Assessment is typically done by asking questions of the parent or therapist of the child to see where the child fits.[3] MACS has had some studies demonstrating good to excellent inter-rater reliability.[4] As of 2015, the MACS is used worldwide except in Africa.[1] It is not recommended to use the MACS to detect change.[5]

## Development

The widespread adoption of the GMFCS inspired the development of the MACS.[6]

## Alternatives

Alternative classification systems used for children with CP include: ABILHAND, AHA, CHEQ, CPQOL, House, MUUL, PedsQLCP, and SHUEE.[7]

## Mini-MACS

A version of the test for children under the age of four years old, the Mini-MACS, was developed in 2016. It has similar tiers to the MACS, with descriptions that are more relevant for the toddler age group, and has good inter-rater reliability.[8]

## See also

* Childhood development of fine motor skills
* Communication Function Classification System \- a similar system describing communication.
* International Classification of Functioning, Disability and Health

## References

1. ↑ 1.0 1.1 Jeevanantham, Deepa; Dyszuk, Emily; Bartlett, Doreen (2015). "The Manual Ability Classification System". Pediatric Physical Therapy 27 (3): 236–241. doi:10.1097/PEP.0000000000000151. PMID 26020598.
2. ↑ Rethlefsen, Susan A.; Ryan, Deirdre D.; Kay, Robert M. (October 2010). "Classification Systems in Cerebral Palsy". Orthopedic Clinics of North America 41 (4): 457–467. doi:10.1016/j.ocl.2010.06.005. PMID 20868878.
3. ↑ Öhrvall, Ann-Marie; Eliasson, Ann-Christin (27 February 2010). "Parents' and therapists' perceptions of the content of the Manual Ability Classification System, MACS". Scandinavian Journal of Occupational Therapy 17 (3): 209–216. doi:10.3109/11038120903125101. PMID 19707950.
4. ↑ McConnell, Karen; Johnston, Linda; Kerr, Claire (September 2011). "Upper limb function and deformity in cerebral palsy: a review of classification systems". Developmental Medicine & Child Neurology 53 (9): 799–805. doi:10.1111/j.1469-8749.2011.03953.x. PMID 21434888.
5. ↑ Piscitelli, Daniele; Ferrarello, Francesco; Ugolini, Alessandro; Verola, Sofia; Pellicciari, Leonardo (November 2021). "Measurement properties of the Gross Motor Function Classification System, Gross Motor Function Classification System‐Expanded & Revised, Manual Ability Classification System, and Communication Function Classification System in cerebral palsy: a systematic review with meta‐analysis". Developmental Medicine & Child Neurology 63 (11): 1251–1261. doi:10.1111/dmcn.14910.
6. ↑ Eliasson, Ann-Christin; Krumlinde-Sundholm, Lena; Rösblad, Birgit; Beckung, Eva; Arner, Marianne; Öhrvall, Ann-Marie; Rosenbaum, Peter (19 June 2006). "The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability". Developmental Medicine & Child Neurology 48 (7): 549–54. doi:10.1111/j.1469-8749.2006.tb01313.x. PMID 16780622.
7. ↑ Wagner, Lisa V.; Davids, Jon R. (20 September 2011). "Assessment Tools and Classification Systems Used For the Upper Extremity in Children With Cerebral Palsy". Clinical Orthopaedics and Related Research 470 (5): 1257–1271. doi:10.1007/s11999-011-2065-x. PMID 21932104.
8. ↑ Paulson, Andrea; Vargus-Adams, Jilda (24 April 2017). "Overview of Four Functional Classification Systems Commonly Used in Cerebral Palsy". Children 4 (4): 30. doi:10.3390/children4040030. PMID 28441773.

## External links

* Official website

* v
* t
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Cerebral palsy (ICD-10: G80; ICD-9: 343)

Spasticity|

* Upper motor neuron lesion: Spastic cerebral palsy
* Scissor gait
* Spastic diplegia
* Spastic hemiplegia
* Spastic quadriplegia

Ataxia and others|

* Ataxic cerebral palsy
* Dyskinetic cerebral palsy

Diagnosis|

General movements assessment (3 months post-term)

Measurement scales|

* Gross Motor Function Classification System - Expanded & Revised (gross motor function)
* Manual Ability Classification System (manual dexterity)
* Communication Function Classification System (communication)
* Modified Ashworth scale (spasticity)

Management|

* Management of cerebral palsy
* Selective percutaneous myofascial lengthening
* Rhizotomy

Other|

* People with cerebral palsy
* Cerebral palsy organizations
* Works about cerebral palsy and other paralytic syndromes

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