Gross Motor Function Classification System - Expanded & Revised

Gross Motor Function Classification System - Expanded & Revised (GMFCS E&R) is a clinical tool designed to classify the gross motor function of children and young adults with cerebral palsy. The system provides a standardized way to describe the capabilities and limitations of individuals with cerebral palsy in terms of their movement abilities. The GMFCS E&R focuses on self-initiated movement, with particular emphasis on sitting, walking, and wheeled mobility. It is used worldwide by clinicians, researchers, and health professionals to assess and communicate about the motor functions of those with cerebral palsy.

Overview

The GMFCS E&R categorizes individuals into five levels based on their self-initiated movement abilities, with a focus on sitting, transfers, mobility, and use of assistive mobility devices. The levels range from I, indicating the highest level of mobility, to V, indicating very limited self-mobility even with the use of assistive technology. The system emphasizes the importance of functional mobility and environmental adaptation.

Levels of Classification

• Level I - Walks without limitations
• Level II - Walks with limitations
• Level III - Walks using a hand-held mobility device
• Level IV - Self-mobility with limitations; may use powered mobility
• Level V - Transported in a manual wheelchair

Applications

The GMFCS E&R is used in various settings, including clinical, research, and educational environments. It assists in decision-making for interventions, helps to predict future motor function, and serves as a tool in research studies to classify participants consistently. It also plays a crucial role in setting realistic goals for individuals with cerebral palsy and their families.

Revisions

The original GMFCS was expanded and revised to improve clarity and ensure that the classification system remains relevant with advances in medical care and therapeutic interventions. The revisions included clearer definitions of the levels, the addition of age bands to reflect changes in motor function with age, and the inclusion of examples to guide classification.

Importance

The GMFCS E&R is significant because it provides a common language for describing the abilities of individuals with cerebral palsy. This facilitates communication among healthcare providers, researchers, and families. It also aids in the planning and evaluation of treatment programs, and in the assessment of outcomes in clinical research.

Challenges and Considerations

While the GMFCS E&R is a valuable tool, it is important to recognize that it classifies gross motor function, not the abilities or potential of an individual. It should be used in conjunction with other assessments to get a comprehensive understanding of a person's capabilities.

Conclusion

The Gross Motor Function Classification System - Expanded & Revised is a critical tool in the field of cerebral palsy care and research. It provides a standardized way to classify the gross motor function of individuals with cerebral palsy, facilitating better communication, planning, and evaluation of interventions.