title: Using the manual ability classification system in young adults with cerebral palsy and normal intelligence.
abstract: OBJECTIVE
  The study aimed to establish whether the manual ability classification system (MACS), a valid classification system for manual ability in children with cerebral palsy (CP), is applicable in young adults with CP and normal intelligence.
  
  
  METHODS
  The participants (n = 83) were young adults with CP and normal intelligence and had a mean age of 19.9 years.
  
  
  METHODS
  In this study, inter observer reliability of the MACS was determined. We investigated relationships between the MACS level and patient characteristics (such as the gross motor function classification system (GMFCS) level, limb distribution of the spastic paresis and educational level) and with functional activities of the upper extremity (assessed with the Melbourne assessment, the Abilhand questionnaire and the domain self-care of the functional independence measure (FIM)). Furthermore, with a linear regression analysis it was determined whether the MACS is a significant determinant of activity limitations and participation restrictions.
  
  
  RESULTS
  The reliability was good (intraclass correlation coefficient 0.83). The Spearman correlation coefficients with GMFCS level, limb distribution of the spastic paresis and educational level were 0.53, 0.46, and 0.26, respectively. MACS level correlated moderately with outcome measures of functional activities (correlations ranging from -0.38 to -0.55). MACS level is, in addition to the GMFCS level, an important determinant for limitations in activities and restrictions in participation.
  
  
  CONCLUSIONS
  We conclude that the MACS is a feasible method to classify manual ability in young adults with CP and normal intelligence with a good manual ability.
authors.affiliation: Department of Rehabilitation Medicine, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands. j.vanmeeteren@erasmusmc.nl
authors.forename: Jetty
authors.initials: J
authors.lastname: van Meeteren
authors.forename: Channah
authors.initials: C
authors.lastname: Nieuwenhuijsen
authors.forename: Arthur
authors.initials: A
authors.lastname: de Grund
authors.forename: Henk J
authors.initials: HJ
authors.lastname: Stam
authors.forename: Marij E
authors.initials: ME
authors.lastname: Roebroeck
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D001076:Aptitude / Q000145:classification*; D002547:Cerebral Palsy / Q000145:classification* / Q000503:physiopathology / Q000534:rehabilitation; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007360:Intelligence; D008297:Male; D008370:Manuals as Topic; D009048:Motor Skills / Q000145:classification*; D015588:Observer Variation; D015203:Reproducibility of Results; D012648:Self Care; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D034941:Upper Extremity / Q000503:physiopathology; D055815:Young Adult