Measurements and clinical examination Name: Classification of function: GMFCS (Gross Motor Function Classification System FMS (Functional Mobility Scale) 5, 50 and 500 meters MACS (Manual Ability Classification System) Use of assistive device: Wheelchair Frame + seat Buggies Standing device Walking Toilet and bath Age: Body weight: Name of product: Date: . Measurements 1. Wheelchair, seating, toilet & bath, Scallop and buggies 8 5 7 1 2 4 3 No. Type 1 Back height 2 Arm height 3 Lower leg length 4 Seat depth 5 Chest width 6 Seat width 7 Height from seat to top of head 8 Shoulder width Measurement 6 2. Standing & walking 14 13 9 10 11 18 19 15 12 20 21 17 16 22 23 No. Type 9 Total height 10 Shoulder height 11 Chest height / Armpit height 12 Buttock height 13 Chest width 14 Shoulder width 15 Top of pelvic height 16 Hip / pelvis width 17 Below knee 18 Chest circumference 19 Pelvic circumference 20 Knee circumference 21 Knee width 22 Foot length 23 Foot width Measurement
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