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Arm Muscle Strength in Children with Bilateral Spastic CP. AIMS: To assess arm-muscle strength related to motor function in children with bilateral spastic cerebral palsy, 5-15 years old. METHODS: Muscle strength was measured for shoulder abductors, elbow extensors and flexors, wrist extensors, and grip strength. The children were grouped according to the Manual Ability Classification Scale (MACS). RESULTS: Forty-two children were included. The majority of the children at MACS levels I-II were within the normal range; shoulder abductors were weakest (mean 60-80% of predicted value), and variation was greatest for wrist extensors.Children at MACS level II showed lower values than children at level I, with significant differences for shoulder abductors (p=.028) and wrist extensors (p<.001). Differences between the dominant and non-dominant side was greater in children at MACS level II and statistically significant for wrist extensors (p=.024).Of 15 children tested for grip strength, nine were within the 2 SD range. The three children at MACS level II, all walking with a walker, had a higher mean value than those at MACS level I. CONCLUSIONS: Muscle strength was lower and differences were greater between sides in children at MACS level II. Wrist extensors showed a decreasing trend with age as compared with normal development.