Plasschaert V F P, Ketelaar M, Nijnuis M G, Enkelaar L, Gorter J W
Sophia Rehabilitation Center, Delft, The Netherlands.
Clin Rehabil. 2009 Feb;23(2):164-70. doi: 10.1177/0269215508098892. Epub 2009 Jan 7.
To assess the interobserver reliability of the Manual Ability Classification System (MACS) in young children (age 1-5 years) with cerebral palsy.
Interobserver reliability study.
A cross-sectional study of a hospital-based population of children with cerebral palsy.
Thirty children, 18 boys and 12 girls between 1 and 5 years of age (mean age 2.5 years +/- 14.2 SD, Gross Motor Function Classification System level I-IV).
the children were classified by means of the MACS by two independent observers. Interobserver reliability was analysed using Cohen's kappa.
Overall interobserver reliability of the MACS for children aged 1-5 years was moderate, with a linear weighted kappa (kappa) of 0.62 (95% confidence interval (CI) 0.49-0.76). According to the generally accepted categories of agreement, reliability was moderate for children under 2 years of age (kappa = 0.55), and good for children between 2 and 5 years of age (kappa = 0.67).
Classification of manual ability of young children with cerebral palsy is possible between 2 and 5 years of age. For children younger than 2 years old, it should be done with caution. Further development of the MACS for children under 5 years of age is recommended with an emphasis on age-appropriate descriptions of manual abilities.
评估手动能力分类系统（MACS）在1 - 5岁脑瘫幼儿中的观察者间信度。
观察者间信度研究。
一项基于医院的脑瘫患儿横断面研究。
30名儿童，年龄在1至5岁之间，18名男孩和12名女孩（平均年龄2.5岁±14.2标准差，粗大运动功能分类系统I - IV级）。
两名独立观察者使用MACS对儿童进行分类。采用Cohen's kappa分析观察者间信度。
1 - 5岁儿童MACS的总体观察者间信度为中等，线性加权kappa值为0.62（95%置信区间（CI）0.49 - 0.76）。根据普遍接受的一致性类别，2岁以下儿童的信度为中等（kappa = 0.55），2至5岁儿童的信度为良好（kappa = 0.67）。
2至5岁脑瘫幼儿的手动能力分类是可行的。对于2岁以下儿童，应谨慎进行。建议进一步开发适用于5岁以下儿童的MACS，重点是对手动能力进行适合年龄的描述。
