The Gross Motor Function Classification System
The gross motor skills (e.g. sitting and walking) of children, young people and adults with cerebral palsy can be categorised into 5 different levels using a tool called the Gross Motor Classification System (GMFCS) developed by CanChild in Canada.
Level 1 – Children walk at home, school, outdoors and in the community. They can climb stairs without the use of a railing. Children perform gross motor skills such as running and jumping, but speed, balance and co-ordination are limited.
Level 2 – Children walk in most settings and climb stairs holding onto a railing. They may experience difficulty walking long distances and balancing on uneven terrain, inclines in crowded areas or confined spaces. Children may walk with physical assistance, a hand-held mobility device or use wheeled mobility over long distances. Children have only minimal ability to perform gross motor skills such as running or jumping.
Level 3 – Children walk using a hand-held mobility device in most indoor settings. They may climb stairs holding onto a railing with supervision or assistance. Children use wheeled mobility when travelling long distances and may self-propel for shorter distances.
Level4 – Children use methods of mobility that require physical assistance or powered mobility in most settings. They may walk for short distances at home with physical assistance or use powered mobility or a body support walker when positioned. At school, outdoors, and in the community children are transported in a manual wheelchair or use powered mobility.
Level 5 – Children are transported in a manual wheelchair in all settings. Children are limited in their ability to maintain antigravity head and trunk postures and control leg and arm movement.
Most children with CP will walk
60% will walk without the use of an aid
10% will walk with an aid
30% will use a wheelchair