“How should I apply this information?”
Measures of functional performance of children with cerebral palsy may provide more meaningful information on daily life for caregivers and families. The Manual Ability Classification System (MACS) focuses on performance of manual tasks during daily life, not on manual abilities in structured or ideal settings (ie, capacity). This review study provides evidence of increased use of the MACS in research. It encourages therapists to clinically apply this standardized, functional tool. Compared with the popularity of the Gross Motor Function Classification System, which is commonly used in the clinic, the MACS is primarily used in research. Therapists, other professionals (eg, physicians and special educators), and caregivers need to understand this 5-level classification system and use it to describe the manual abilities of children with cerebral palsy in the clinic. Similar to the Gross Motor Function Classification System, the 5 levels in the MACS can be used to measure manual abilities after intervention and make prognoses. It is a convenient, reliable, and valid tool to scale the functional manual performances over time. The results of this study may facilitate the process of translating the use of the MACS to clinical practice.
“What should I be mindful in applying this information?”
The differences among levels II, III, and IV of the MACS need clarification. The MACS level identification chart provided by the development team assists users in determining the 5 levels. It distinguishes between the first 2 levels and the next 3 levels. Levels III and IV require modified activities and adapted environment. Simple examples of the levels would benefit clinicians and caregivers. This would result in a more user-friendly version for clinical use. Further research with more details for each level is needed to enhance knowledge translation and support the clinical applicability of the MACS.
Hsiang-han Huang, ScD, OT
Chang Gung University, Taoyuan City, Taiwan
Hwei-tau Huang, BS, OT
Rehabilitation Department, Linkou Chang Gang Memorial Hospital, Taoyuan City, Taiwan