title: Exploration of the relationship between the Manual Ability Classification System and hand-function measures of capacity and performance.
abstract: OBJECTIVE
  To further investigate the construct of Manual Ability Classification System (MACS) by evaluating the relationship between children's designated MACS levels and their outcomes on two different tests of hand function, measuring capacity and performance, respectively. Another aim was to use the International Classification of Functioning, Disability and Health-Child and Youth version (ICF-CY) as a framework to explore the uniqueness of the assessments.
  
  
  METHODS
  Ninety-one children with cerebral palsy in MACS levels I-V, aged 5-17 years (mean 9.8, SD 3.0) participated. Data were collected using MACS, ABILHAND-Kids and Box and Block Test.
  
  
  RESULTS
  A strong association between MACS and ABILHAND-Kids (rs = -0.88, p < 0.05) and MACS and Box and Block Test (rs = -0.81, p < 0.05) was demonstrated. Children's performance differed significantly between the different MACS levels (ABILHAND-Kids F (4:86) = 103.86, p < 0.001, Box and Block Test F (4:86) = 59.18, p < 0.001). The content comparison with ICF-CY, as a frame of reference, showed that these instruments capture fine hand use in the activity and participation component. The linking of the instruments to various ICF-CY categories demonstrated conceptual differences between the instruments. MACS had the broadest representation of ICF-CY domains.
  
  
  CONCLUSIONS
  This study strengthens the construct, and thereby the validity, of MACS as a classification of children's hand function, expressed by the handling of objects in everyday activities in their daily environments.
  
  
  CONCLUSIONS
  • This study has strengthened the evidence of Manual Ability Classification System (MACS) as being a valid and useful classification of children's hand function. • The various MACS levels describe different degrees of hand-function impairment. • MACS give a broad description of children's manual ability in a variety of daily life domains.
authors.affiliation: Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden. ann-marie.ohrvall@ki.se
authors.forename: Ann-Marie
authors.initials: AM
authors.lastname: Öhrvall
authors.forename: Lena
authors.initials: L
authors.lastname: Krumlinde-Sundholm
authors.forename: Ann-Christin
authors.initials: AC
authors.lastname: Eliasson
mesh_terms: D000203:Activities of Daily Living / Q000145:classification; D000293:Adolescent; D002547:Cerebral Palsy / Q000145:classification* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D019988:Children with Disabilities / Q000145:classification* / Q000534:rehabilitation; D005260:Female; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D009048:Motor Skills / Q000145:classification*; D015203:Reproducibility of Results; D013647:Task Performance and Analysis