The stability of the Manual Ability Classification System over time
Article first published online: 25 NOV 2013
© 2013 Mac Keith Press
Developmental Medicine & Child Neurology
Volume 56, Issue 2, pages 185–189, February 2014
How to Cite
Öhrvall, A.-M., Krumlinde-Sundholm, L. and Eliasson, A.-C. (2014), The stability of the Manual Ability Classification System over time. Developmental Medicine & Child Neurology, 56: 185–189. doi: 10.1111/dmcn.12348
- Issue published online: 13 JAN 2014
- Article first published online: 25 NOV 2013
- Manuscript Accepted: 11 OCT 2013
- Promobilia Foundation
- Stiftelsen Frimurare Barnhuset i Stockholm
- Swedish Research Council. Grant Numbers: K2009-63X14534-07-3, K2012-69X-14534-10-2
- Care Sciences at Karolinska Institutet
To evaluate the stability over time of the Manual Ability Classification System (MACS) levels.
The study group comprised 1267 children with cerebral palsy (746 males, 521 females) who were followed from 2005 to 2010 with two or more registered MACS classifications rated at least 1 year apart. Thirty-five percent of the children (n=445) had four MACS registrations. The children were between 4 and 17 years old at their first rating, The stability over time was also compared between children who were younger (4y of age) or older (≥10y) at the time of their first classification.
An excellent stability was found between two ratings at 1-year intervals with an intraclass correlation coefficient (ICC) of 0.97 (95% CI 0.97–0.97) and 82% agreement (n=1267). The stability was also excellent for two ratings performed 3 to 5 years apart (ICC 0.96; 95% CI 0.95–0.97) with an agreement of 78% (n=445). Across four ratings, 70% of the children remained at the same level. The results were similar for younger and older children, indicating that stability was not influenced by age.
This study provides evidence that MACS levels are stable over time and that the classification has predictive value.