The Gross Motor Function Classification System or GMFCS is a 5 level clinical classification system that describes the gross motor function of people with cerebral palsy on the basis of self-initiated movement abilities. Particular emphasis in creating and maintaining the GMFCS scale rests on evaluating sitting, walking, and wheeled mobility. Distinctions between levels are based on functional abilities; the need for walkers, crutches, wheelchairs, or canes / walking sticks; and to a much lesser extent, the actual quality of movement.
GMFCS Level I
• Can walk indoors and outdoors and climb stairs without using hands for support • Can perform usual activities such as running and jumping • Has decreased speed, balance and coordination ==GMFCS Level II==
GMFCS Level II
• Can climb stairs with a railing • Has difficulty with uneven surfaces, inclines or in crowds • Has only minimal ability to run or jump ==GMFCS Level III==
GMFCS Level III
• Walks with assistive mobility devices indoors and outdoors on level surfaces • May be able to climb stairs using a railing • May propel a manual wheelchair and need assistance for long distances or uneven surfaces ==GMFCS Level IV==
GMFCS Level IV
• Walking ability severely limited even with assistive devices • Uses wheelchairs most of the time and may propel own power wheelchair • Standing transfers, with or without assistance ==GMFCS Level V==
GMFCS Level V
• Has physical impairments that restrict voluntary control of movement • Ability to maintain head and neck position against gravity restricted • Impaired in all areas of motor function • Cannot sit or stand independently, even with adaptive equipment • Cannot independently walk but may be able to use powered mobility ==Use==
Use
The GMFCS has been used to describe study samples in terms of the number of children in each band. Hence, the GMFCS is much more of a categorization tool or an independent variable rather than an outcome measure. For example, cerebral palsy children with higher GMFCS levels i.e. (III, IV, V) have a greater risk of developing hip subluxation/dislocation than those with lower GMFCS levels i.e. (I, II). A limitation of the original GMFCS was that parents and therapists would rate a child on their best performance rather than their average performance. There seems to be more uncertainty between classifying children at level I or II than in other levels. The GMFCS has been used to classify people with conditions other than cerebral palsy. This use is not recommended by the authors of the GMFCS. ==Alternatives==