title: The relationship between manual ability and ambulation in adolescents with cerebral palsy.
abstract: This study examined the relationship between gross motor function and manual ability in 120 adolescents with cerebral palsy (CP) (15.2, SD 2.1 years, 59.8% male). Adolescents were evaluated using the Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS). A neurologist classified CP subtype. Most adolescents were ambulatory with or without utilization of aids (GMFCS level I: 35.0%, II: 30.0%, III: 5.8%, IV: 10.8%, and V: 18.3%). MACS levels were I: 34.2%, II: 25.8%, III: 16.7%, IV: 7.5%, and V: 15.8%. Correlations between GMFCS and MACS were strong in youth with quadriplegia (r = .89, p < .001), moderate in individuals with diplegia (r = .58, p = .01), but weakly associated for adolescents with hemiplegia (r = .24, p = .23). The findings provide evidence for maintaining a clinical distinction between spastic quadriplegia and spastic diplegia. Manual ability may not be congruent with mobility in adolescents with CP and should be specifically evaluated given its importance to daily life functioning.
authors.affiliation: School of Physical and Occupational Therapy , McGill University, Montreal, Quebec, Canada.
authors.forename: Annette
authors.initials: A
authors.lastname: Majnemer
authors.forename: Keiko
authors.initials: K
authors.lastname: Shikako-Thomas
authors.forename: Michael
authors.initials: M
authors.lastname: Shevell
authors.forename: Chantal
authors.initials: C
authors.lastname: Poulin
authors.forename: Lucyna
authors.initials: L
authors.lastname: Lach
authors.forename: Mary
authors.initials: M
authors.lastname: Law
authors.forename: Norbert
authors.initials: N
authors.lastname: Schmitz
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D002547:Cerebral Palsy / Q000145:classification* / Q000503:physiopathology*; D002648:Child; D005260:Female; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D008297:Male; D009048:Motor Skills / Q000145:classification*; D011782:Quadriplegia / Q000503:physiopathology; D016037:Single-Blind Method; D016138:Walking / Q000502:physiology*