Gross Motor Function Classification System (GMFCS) | Cerebral Palsy Alliance Research Foundation

The mobility and gross motor skills of people with cerebral palsy are categorized into five different levels using a tool called the Gross Motor Function Classification System (GMFCS).

GMFCS looks at movements like sitting and walking, and it provides adults with cerebral palsy, families, and clinicians with:

a clear description of someone’s current motor function, and
an idea of what equipment or mobility aids a child or adult may need in the future, like crutches, a walker, or a wheelchair.

Generally, a child over the age of five won’t improve their GMFCS level. For example, if a child is classified at a Level IV when they’re six, then it’s likely that they’ll need to use a mobility device throughout their lifetime.

GMFCS Levels

GMFCS Level I

Can walk indoors and outdoors and climb stairs without using their hands for support.
Can run and jump.
Has decreased speed, balance, and coordination.

GMFCS Level II

Can walk indoors and outdoors and climb stairs using a railing.
Experiences difficulty with uneven surfaces, inclines, or while in crowds.
Can minimally run or jump.

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; may require assistance for long distances or uneven surfaces.

GMFCS Level IV

Walking ability is severely limited, even with assistive devices.
Uses a wheelchair most of the time and may propel their own power wheelchair.
May participate in standing transfers.

GMFCS Level V

Has physical impairments that restrict voluntary movement control and the ability to maintain head and neck position against gravity.
Experiences impairment in all areas of motor function.
Can’t sit or stand independently, even with adaptive equipment.
Can’t independently walk, though may be able to use powered mobility devices.