Inter-relationships of functional status in cerebral palsy: analyzing gross motor function, manual ability, and communication function classification systems in children.
OBJECTIVE
To investigate the relationships among the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS) in children with cerebral palsy (CP).


METHODS
Using questionnaires describing each scale, mothers reported GMFCS, MACS, and CFCS levels in 222 children with CP aged from 2 to 17 years (94 females, 128 males; mean age 8 y, SD 4). Children were referred from pediatric developmental/behavioral, physiatry, and child neurology clinics, in the USA, for a case-control study of the etiology of CP. Pairwise relationships among the three systems were assessed using Spearman's correlation coefficients (r(s) ), stratifying by age and CP topographical classifications.


RESULTS
Correlations among the three functional assessments were strong or moderate. GMFCS levels were highly correlated with MACS levels (r(s) = 0.69) and somewhat less so with CFCS levels (r(s) = 0.47). MACS and CFCS were also moderately correlated (r(s) = 0.54). However, many combinations of functionality were found. Of the 125 possible combinations of the three five-point systems, 62 were found in these data.


CONCLUSIONS
Use of all three classification systems provides a more comprehensive picture of the child's function in daily life than use of any one alone. This resulting functional profile can inform both clinical and research purposes.
Department of Speech-Language Pathology, University of Central Arkansas, Conway, AR 72035-0001, USA. mjchidecker@uca.edu
Mary Jo Cooley
MJ
Hidecker
Nhan Thi
NT
Ho
Nancy
N
Dodge
Edward A
EA
Hurvitz
Jaime
J
Slaughter
Marilyn Seif
MS
Workinger
Ray D
RD
Kent
Peter
P
Rosenbaum
Madeleine
M
Lenski
Bridget M
BM
Messaros
Suzette B
SB
Vanderbeek
Steven
S
Deroos
Nigel
N
Paneth
D000293:Adolescent; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000145:classification* / Q000175:diagnosis / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires / Q000592:standards*