Manual Ability Classification System (MACS): reliability between therapists and parents in Brazil

Abstract

BACKGROUND:The Manual Ability Classification System (MACS) has been widely used to describe the manual ability of children with cerebral palsy (CP); however its reliability has not been verified in Brazil. OBJECTIVE:To establish the inter- and intra-rater reliability of the Portuguese-Brazil version of the MACS by comparing the classifications given by therapists and parents of children with CP. METHOD:Data were obtained from 90 children with CP between the ages of 4 and 18 years, who were treated at the neurology and rehabilitation clinics of a Brazilian hospital. Therapists (an occupational therapist and a student) classified manual ability (MACS) through direct observation and information provided by parents. Therapists and parents used the Portuguese-Brazil version of the MACS. Intra- and inter-rater reliability was obtained using unweighted Kappa coefficient (k) and intra-class correlation coefficient (ICC). The Chi-square test was used to identify the predominance of disagreements in the classification of parents and therapists. RESULTS:An almost perfect agreement resulted among therapists [K=0.90 (95% CI 0.83-0.97); ICC=0.97 (95%CI 0.96-0.98)], as well as with intra-rater (therapists), with Kappa ranging between 0.83 and 0.95 and ICC between 0.96 and 0.99 for the evaluator with more and less experience in rehabilitation, respectively. The agreement between therapists and parents was fair [K=0.36 (95% CI 0.22-0.50); ICC=0.79 (95% CI 0.70-0.86)]. CONCLUSIONS:The Portuguese version of the MACS is a reliable instrument to be used jointly by parents and therapists.

An investigation of the quality of pretend play ability in children with cerebral palsy

“…To determine the physical ability of the children, the Gross Motor Function Classification System -Extended and Revised (GMFCS E & R) (Silva, Pfeifer & Funayama, 2013) and Manual Ability Classification System (MACS) (Silva, Funayama & Pfeifer, 2015) were used. They both are characterised as a five-level ordinal scale that shows, in descending order, the level of independence and functionality of children with CP.…”

Sementes... Refletindo Sobre Os Frutos De Uma Trajetória Profissional

“…Dra. Carolina Rodrigues Funayama e do Prof. Dr. João Pereira Leite, fui credenciada como orientadora plena do Programa de Pós-Graduação em Neurologia (mestrado e doutorado), assumindo, imediatamente, a orientação da doutoranda Daniela Baleroni Rodrigues FUNAYAMA, 2010aFUNAYAMA, , 2010bFUNAYAMA, , 2013FUNAYAMA, , 2015.…”

Brazilian Version of the Shriners Hospital Upper Extremity Evaluation (Shuee): Translation, Cultural Adaptation, and Evaluation of Psychometric Properties

“…In Brazil, the evaluation of the UL in hemiplegic CP is still limited, considering that no instruments to assess the capacity and performance of UL activity have been translated and validated for the Portuguese language. The only instruments validated for Brazilian Portuguese are the Pediatric Evaluation of Disability Inventory (PEDI), 3,4 the Manual Ability Classification System (MACS), 5,6 and more recently, the ABILHAND-Kids. 7 SHUEE is an instrument that evaluates the UL in children and adolescents aged three to 18 years with hemiplegic CP.…”