Manual Ability Classification System

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.

Manual Ability Classification System
Purposeassess 4-18 years old individuals with cerebral palsy ability to use hands

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] The MACS is used worldwide except in Africa.[1]

Development

The widespread adoption of the GMFCS inspired the development of the MACS.[5]

Alternatives

Alternative classification systems used for children with CP include: ABILHAND, AHA, CHEQ, CPQOL, House, MUUL, PedsQLCP, and SHUEE.[6]

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.[7]

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See also

References
  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.
  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. 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.
  6. 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. PMC 3314769. PMID 21932104.
  7. 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. PMC 5406689. PMID 28441773.
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