Development of the Greek manual ability classification system for children with cerebral palsy

Abstract

OBJECTIVE Cross-cultural adaptation and testing of the reliability of the Greek version of the Manual Ability Classification System (MACS) in children with cerebral palsy (CP). METHOD In the first step, the Greek translation was produced according to international guidelines. The second step included the test-retest and inter-rater reliability between therapists and parents, using the intraclass correlation coefficient (ICC). The association was then investigated, using Spearman’s rank correlation coefficient (rs), of the Greek MACS with the Gross Motor Function Classification System (GMFCS) for a pediatric population with CP in Greece. Specifically, 66 children with CP, aged 4–18 years, were recruited for the study. RESULTS The translation process was performed with no difficulty. The Greek version of the MACS was shown to have excellent test-retest reliability for both therapists (ICC=0.99, p<0.0001) and parents (ICC=0.97, p<0.0001). The inter-rater reliability between therapists and parents was also excellent (ICC=0.92, p<0.0001). The Greek version of the MACS showed strong correlation with the GMFCS (rs=0.65–0.66, p<0.0001). CONCLUSIONS The Greek version of the MACS is highly reliable, and can now be used with confidence in everyday clinical practice by therapists and with parents, to classify and evaluate children with CP in the Greek population. © Athens Medical Society.