The Myelomeningocele Functional Classification (MMFC)

Group	Functional hallmark	FMS classification	Assistive devices
MMFC1	Might retain iliopsoas function or not Lack quadriceps function	Maximum 2,2,1	Walker Hip spanning orthoses (RGO or HKAFO) Wheelchair for long distances
MMFC2	Retain quadriceps and medial hamstrings function Lack gluteus medius function	Maximum 3, 3, 3	Walker or crutches HKAFOs or AFOs
MMFC3	Retain quadriceps and gluteus medius function Lack gastrocnemius-soleus function	Maximum 5, 5, 5	No external support AFOs only
MMFC4	Retain quadriceps and gluteus medius function Retain gastrocnemius-soleus function	Maximum 6, 6, 6	No external support SMOs, insoles, or nothing

FMS: Functional Mobility Scale; RGO: reciprocating gait orthosis; HKAFO: hip-knee-ankle-foot orthosis; AFO: ankle-foot orthosis; SMO: supramalleolar orthosis.

Republished with permission of the British Editorial Society of Bone & Joint Surgery, from Dias LS, Swaroop VT, de Angeli LRA, et al. Myelomeningocele: A new functional classification. J Child Orthop 2021; 15:1; permission conveyed through Copyright Clearance Center, Inc. Copyright © 2021.

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The Myelomeningocele Functional Classification (MMFC)