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    Stability of the Manual Ability Classification System in young children with cerebral palsy

    Access Status
    Fulltext not available
    Authors
    Burgess, A.
    Boyd, Roslyn
    Ziviani, J.
    Chatfield, M.
    Ware, R.
    Sakzewski, L.
    Date
    2019
    Type
    Journal Article
    
    Metadata
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    Citation
    Burgess, A. and Boyd, R. and Ziviani, J. and Chatfield, M. and Ware, R. and Sakzewski, L. 2019. Stability of the Manual Ability Classification System in young children with cerebral palsy. Developmental Medicine and Child Neurology. 61 (7): pp. 798-804.
    Source Title
    Developmental Medicine and Child Neurology
    DOI
    10.1111/dmcn.14143
    ISSN
    0012-1622
    School
    School of Occ Therapy, Social Work and Speech Path
    URI
    http://hdl.handle.net/20.500.11937/74433
    Collection
    • Curtin Research Publications
    Abstract

    Aim: To examine the stability over time of the Manual Ability Classification System (MACS) levels in children with cerebral palsy (CP) aged 18 to 60 months. Method: This was a prospective longitudinal population-based study of 252 Australian children (160 males [63%] 92 females [37%]; mean age [SD] 41.7mo [14], range 17.2mo–69.2mo) with CP. Children were classified at 18 months (n=70), 24 months (n=131), 30 months (n=173), 36 months (n=209), 48 months (n=226), and 60 months (n=221) of age. Stability of the MACS was examined using the proportion of specific positive agreement and transition proportions, which are measures of agreement. Results: There were 1030 unique observations, with each of the 252 participants seen between two and six occasions (median=4). Average specific positive agreement over the study period was 76% for MACS level I, 67% for level II, 50% for level III, 51% for level IV, and 83% for level V. MACS levels I and V have the highest degree of stability, while levels III and IV have the lowest. We show how this may be explained by the proportion of children in each MACS level. Interpretation: Using measures of agreement rather than measures of reliability provides accurate information when measuring stability over time of an ordinal classification system. The relative stability of MACS levels can be explained by the proportion of children in each level.

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