title: Clusters of daily functioning and classification levels: agreement of information in children with cerebral palsy.
abstract: OBJECTIVE
  To analyze the agreement between gross motor and hand function levels and clusters of functional performance in children with cerebral palsy (CP).
  
  
  METHODS
  The sample consisted of 129 children with CP aged 4 to 13~years. Children's gross motor and hand function were classified with the gross motor classification system (GMFCS) and manual ability classification system (MACS). Their daily functioning on self-care and mobility was assessed with the Pediatric Evaluation of Disability Inventory (PEDI). Cluster analyses grouped children with similar repertoires on self-care and mobility skills using the agglomerative hierarchical technique. The associations across self-care and mobility clusters with daily living skills were tested with Chi-Square tests. The level of agreement was quantified with the Kappa coefficient.
  
  
  RESULTS
  Four groupings of children's functional skills in self-care (R2 = 0.92) and mobility (R2 = 0.95) were identified. These groupings were associated with hand function (χ2 = 145.43; p< 0.001) and mobility levels (χ2 = 198.13; p < 0.001), respectively. The agreement between MACS and self-care skills was 61.7% (Kappa=0.47; p< 0.001) and between GMFCS and mobility skills was 64.4% (Kappa=0.54; p< 0.001).
  
  
  CONCLUSIONS
  The findings support the adequacy of functional classifications and functioning repertoires. The magnitude of agreement reinforces the importance of the concomitant use of functional classification and assessments.
authors.affiliation: Associação Mineira de Reabilitação, Belo Horizonte, MG, Brazil Universidade FUMEC, Belo Horizonte, MG, Brazil.
authors.forename: Marina
authors.initials: M
authors.lastname: de Brito Brandão
authors.forename: Shirley
authors.initials: S
authors.lastname: de Cássia Gonçalves
authors.forename: Lívia A S R P
authors.initials: LA
authors.lastname: Carvalho
authors.forename: Patrícia Vieira
authors.initials: PV
authors.lastname: Crepaldi
authors.forename: Leonardo Cury
authors.initials: LC
authors.lastname: Abrahão
authors.forename: Juliana Vaz
authors.initials: JV
authors.lastname: de Melo Mambrini
authors.forename: Marisa Cotta
authors.initials: MC
authors.lastname: Mancini
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D002547:Cerebral Palsy / Q000145:classification* / Q000175:diagnosis / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006225:Hand / Q000503:physiopathology; D006801:Humans; D008124:Locomotion; D008297:Male; D009048:Motor Skills / Q000145:classification*; D012648:Self Care / Q000145:classification