Affiliations: Associação Mineira de Reabilitação,
Belo Horizonte, MG, Brazil | Graduate Program in Rehabilitation Sciences, School of
Physical Education, Physical Therapy and Occupational Therapy, Universidade
Federal de Minas Gerais, Belo Horizonte, MG, Brazil | Universidade FUMEC, Belo Horizonte, MG, Brazil | Banco do Desenvolvimento de Minas Gerais, Belo
Horizonte, MG, Brazi
Note: [] Corresponding author: Marisa Cotta Mancini, Graduate Program in
Rehabilitation Sciences, School of Physical Education, Physical Therapy and
Occupational Therapy, Universidade Federal de Minas Gerais, Av. Antônio
Carlos, 6627, Campus Pampulha, CEP: 31270-901, Belo Horizonte, MG, Brazil.
Tel.: +55 31 3409 4781; E-mail: mcmancini@ufmg.br; marisamancini@gmail.com
Abstract: Purpose: To analyze the agreement between gross motor and hand
function levels and clusters of functional performance in children with
cerebral palsy (CP). Method}: The sample consisted of 129 children with
CP aged 4 to 13~years. Children's gross motor and hand function were classified
with the Gross Motor Classification System (GMFCS) and Manual Ability
Classification System (MACS). Their daily functioning on self-care and mobility
was assessed with the Pediatric Evaluation of Disability Inventory (PEDI).
Cluster analyses grouped children with similar repertoires on self-care and
mobility skills using the agglomerative hierarchical technique. The
associations across self-care and mobility clusters with daily living skills
were tested with Chi-Square tests. The level of agreement was quantified with
the Kappa coefficient. Results: Four groupings of children's functional
skills in self-care (R^{2}= 0.92) and mobility (R^{2}= 0.95) were
identified. These groupings were associated with hand function (χ ^{2}=
145.43; p< 0.001) and mobility levels (χ ^{2}= 198.13; p<
0.001), respectively. The agreement between MACS and self-care skills was
61.7% (Kappa=0.47; p< 0.001) and between GMFCS and mobility skills
was 64.4% (Kappa=0.54; p< 0.001). Conclusion: The findings
support the adequacy of functional classifications and functioning
repertoires. The magnitude of agreement reinforces the importance of the
concomitant use of functional classification and assessments.
Keywords: Cerebral palsy, clinical evaluation, activities of daily living, mobility, cross-sectional study
