Gross Motor Function Classification System (GMFCS)

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:

  1. a clear description of someone’s current motor function, and
  2. 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


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


  • 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.


  • 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.


  • 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.


  • 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.

GMFCS descriptors sourced from © Palisano et al. (1997) Dev Med Child Neurol 39:214-23 CanChild:

Illustrations © Kerr Graham, Bill Reid and Adrienne Harvey,
The Royal Children’s Hospital, Melbourne