Article

AIM: To review classification systems for the upper limb in children with
cerebral palsy (CP), and evaluate their validity, reliability, and clinical
utility to make recommendations for clinical practice and future research.
METHOD: We comprehensively searched electronic databases to identify upper limb
classification tools and associated evidence of psychometric testing. Two
independent reviewers assessed the quality of the psychometric studies, and rated
the clinical utility of each system using previously published tools. RESULTS:
Eighteen classification systems were eligible for inclusion, with two primary
functions: classification of function or deformity. Published evidence of
psychometric testing was available for fewer than half of the identified systems.
Reliability studies were frequently limited by sample size, rater blinding,
representativeness, and the number of observers. The Manual Ability
Classification System (MACS) demonstrated content validity and interrater
reliability. The original and modified House functional, House thumb, swan-neck,
and Zancolli systems had evidence of reliability; the modified House functional
system also demonstrated criterion-related validity. INTERPRETATION: This review
supports the use of the MACS and modified House functional system to classify
upper limb function in children with CP. Similarly, the House thumb and Zancolli
systems are recommended to classify thumb, and hand and wrist deformity
respectively.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2011 Mac Keith
Press.

Langue : ANGLAIS