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Bimanual Fine Motor Function (BFMF)
Availability
Please visit this website for more information about the instrument: Bimanual Fine Motor Function.
Classification
Exploratory: Cerebral Palsy (CP)
Short Description of Instrument
The Bimanual Fine Motor Function (BFMF) is a scale that classifies the fine motor function in children with CP. The level of fine motor function is determined by assessing the child’s ability to grasp, manipulate, and hold objects for each hand (Beckung & Hagberg, 2002; Elvrum et al., 2016a). The five classification levels of BMFM include (Beckung & Hagberg, 2002):
Level I: One hand manipulates without restrictions. The other hand manipulates without restrictions or has limitations in more advanced fine motor skills.
Level II: (a) One hand manipulates without restrictions. The other hand has only ability to grasp or hold. (b) Both hands have limitations in more advanced fine motor skills.
Level III: (a) One hand manipulates without restrictions. The other hand has no functional ability. (b) One hand has limitations in more advanced fine motor skills. The other hand has only ability to grasp or worse.
Level IV: (a) Both hands have only ability to grasp. (b) One hand has only ability to grasp. The other hand has only ability to hold or worse.
Level V: Both hands have only ability to hold or worse.
Comments/Special Instructions
Not clear as to whether the BFMF best measures the child’s capacity (what the child can do in an environment promoting the child’s best ability) (Beckung & Hagberg, 2002), or the child’s performance (what the child does do in daily life) (Elvrum et al., 2016a).
Scoring
Similar to the Gross Motor Function Classification System, the BFMF is scored I to V with lower levels indicating higher ability:
Level I = No problem
Level II = Mild problem
 Level III = Moderate problem
Level IV = Severe problem
Level V = Complete problem
Rationale/Justification
Strengths/Weaknesses: The BFMF has high inter-rater reliability and allows for the description of bimanual functional limitations (Elvrum et al., 2016a). Intra- and interrater reliability for a revised BFMF is ongoing (Elvrum et al., 2016b).
References
Beckung E, Hagberg G. Neuroimpairments, activity limitations, and participation restrictions in children with cerebral palsy. Dev Med Child Neurol. 2002;44(5):309– 316.
Elvrum AK, Andersen GL, Himmelmann K, Beckung E, Ohrvall AM, Lydersen S, Vik T. Bimanual Fine Motor Function (BFMF) Classification in Children with Cerebral Palsy: Aspects of Construct and Content Validity. Phys Occup Ther Pediatr. 2016a;36(1):1– 16.
Elvrum AG, Beckung E, Sæther R, Lydersen S, Vik T, Himmelmann K. Bimanual Capacity of Children With Cerebral Palsy: Intra- and Interrater Reliability of a Revised Edition of the Bimanual Fine Motor Function Classification. Phys Occup Ther Pediatr. 2016b;26:1–12.
 
Randall M, Harvey A, Imms C, Reid S, Lee KJ, Reddihough D. Reliable classification of functional profiles and movement disorders of children with cerebral palsy. Phys Occup Ther Pediatr. 2013;33(3):342–352.
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