Manual Ability Classification System
{{Infobox diagnostic
| name = Manual Ability Classification System
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| purpose =assess 4-18 years old individuals with cerebral palsy ability to use hands
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The Manual Ability Classification System (MACS) is a medical classification system used to describe how children aged from 4 to 18 years old with cerebral palsy use their hands with objects during activities of daily living, with a focus on the use of both hands together. Like the Gross Motor Function Classification System (GMFCS), there are five levels - level I being the least impaired, only finding difficulty in tasks needing speed and accuracy, and level V being the most impaired, not being able to handle objects and having severely limited abilities for even simple actions.
Medical use
It is mostly used as a way of describing a sample population and as an independent variable. Occasionally it is used as a dependent variable. MACS levels are stable over time and so they can be used as part of a prognosis for individuals. Although MACS was not designed for adults, it has been used with a good measure of reliability in young adult populations ranging in ages from 18-24. Although it has a good level of reliability when used for children between 2 and 5 years of age, there is less evidence for using it with children younger than 2.{{cite journal|last1=Jeevanantham|first1=Deepa|last2=Dyszuk|first2=Emily|last3=Bartlett|first3=Doreen|title=The Manual Ability Classification System|journal=Pediatric Physical Therapy|date=2015|volume=27|issue=3|pages=236–241|doi=10.1097/PEP.0000000000000151|pmid=26020598|s2cid=1310474 |doi-access=free}} Unlike the GMFCS, there are no age bands for the MACS.{{cite journal|last1=Rethlefsen|first1=Susan A.|last2=Ryan|first2=Deirdre D.|last3=Kay|first3=Robert M.|title=Classification Systems in Cerebral Palsy|journal=Orthopedic Clinics of North America|date=October 2010|volume=41|issue=4|pages=457–467|doi=10.1016/j.ocl.2010.06.005|pmid=20868878}} Assessment is typically done by asking questions of the parent or therapist of the child to see where the child fits.{{cite journal|last1=Öhrvall|first1=Ann-Marie|last2=Eliasson|first2=Ann-Christin|title=Parents' and therapists' perceptions of the content of the Manual Ability Classification System, MACS|journal=Scandinavian Journal of Occupational Therapy|date=27 February 2010|volume=17|issue=3|pages=209–216|doi=10.3109/11038120903125101|pmid=19707950 |s2cid=218879745 }} MACS has had some studies demonstrating good to excellent inter-rater reliability.{{cite journal|last1=McConnell|first1=Karen|last2=Johnston|first2=Linda|last3=Kerr|first3=Claire|title=Upper limb function and deformity in cerebral palsy: a review of classification systems|journal=Developmental Medicine & Child Neurology|date=September 2011|volume=53|issue=9|pages=799–805|doi=10.1111/j.1469-8749.2011.03953.x|pmid=21434888|doi-access=free}} As of 2015, the MACS is used worldwide except in Africa. It is not recommended to use the MACS to detect change.{{cite journal |last1=Piscitelli |first1=Daniele |last2=Ferrarello |first2=Francesco |last3=Ugolini |first3=Alessandro |last4=Verola |first4=Sofia |last5=Pellicciari |first5=Leonardo |title=Measurement properties of the Gross Motor Function Classification System, Gross Motor Function Classification System‐Expanded & Revised, Manual Ability Classification System, and Communication Function Classification System in cerebral palsy: a systematic review with meta‐analysis |journal=Developmental Medicine & Child Neurology |date=November 2021 |volume=63 |issue=11 |pages=1251–1261 |doi=10.1111/dmcn.14910 |doi-access=free }}
Development
The widespread adoption of the GMFCS inspired the development of the MACS.{{cite journal|last1=Eliasson|first1=Ann-Christin|last2=Krumlinde-Sundholm|first2=Lena|last3=Rösblad|first3=Birgit|last4=Beckung|first4=Eva|last5=Arner|first5=Marianne|last6=Öhrvall|first6=Ann-Marie|last7=Rosenbaum|first7=Peter|title=The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability|journal=Developmental Medicine & Child Neurology|date=19 June 2006|volume=48|issue=7|pages=549–54|doi=10.1111/j.1469-8749.2006.tb01313.x|pmid=16780622|doi-access=free}}
Alternatives
Alternative classification systems used for children with CP include: ABILHAND, AHA, CHEQ, CPQOL, House, MUUL, PedsQLCP, and SHUEE.{{cite journal|last1=Wagner|first1=Lisa V.|last2=Davids|first2=Jon R.|title=Assessment Tools and Classification Systems Used For the Upper Extremity in Children With Cerebral Palsy|journal=Clinical Orthopaedics and Related Research|date=20 September 2011|volume=470|issue=5|pages=1257–1271|doi=10.1007/s11999-011-2065-x|pmc=3314769|pmid=21932104}}
Mini-MACS
A version of the test for children under the age of four years old, the Mini-MACS, was developed in 2016. It has similar tiers to the MACS, with descriptions that are more relevant for the toddler age group, and has good inter-rater reliability.{{cite journal|last1=Paulson|first1=Andrea|last2=Vargus-Adams|first2=Jilda|title=Overview of Four Functional Classification Systems Commonly Used in Cerebral Palsy|journal=Children|date=24 April 2017|volume=4|issue=4|pages=30|doi=10.3390/children4040030|pmid=28441773|pmc=5406689|doi-access=free }}
See also
- Childhood development of fine motor skills
- Communication Function Classification System - a similar system describing communication.
- International Classification of Functioning, Disability and Health
References
{{reflist}}
External links
- [http://www.macs.nu/ Official website]
{{cerebral palsy}}