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Test-retest reliability of balance tests in children with cerebral palsy
1School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Republic of China. hfliao@ha.mc.ntu.edu.tw
Insights
Balance tests show good reliability for children without disabilities and moderate to good reliability for children with cerebral palsy. These findings support using specific tests to monitor balance control in children.
Area of Science:
- Pediatric physical therapy
- Motor control research
- Biomechanical assessment
Background:
- Assessing balance is crucial for children's motor development and identifying functional limitations.
- Reliability of balance assessments needs to be established for both typically developing children and those with disabilities like cerebral palsy.
- Standardized tests are essential for accurate and consistent evaluation of balance control.
Purpose of the Study:
- To evaluate the intrasession and intersession reliability of various balance tests.
- To compare the reliability of these tests in children without disabilities (ND) and children with cerebral palsy (CP).
- To identify reliable balance assessment tools for monitoring children's motor function.
Main Methods:
- Tested 50 children without disabilities and 36 children with cerebral palsy (ages 5-12).
- Assessed intrasession reliability using the Smart Balance Master System and one-leg standing tests.
- Evaluated intersession reliability using the Smart Balance Master System and the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) balance subtest.
Main Results:
- Smart Balance Master System showed moderate to good intersession reliability (ICC 0.72-0.84) in ND children across four conditions.
- Intrasession reliability was high (ICC 1) for the Smart Balance Master System's center target condition in children with CP.
- One-leg standing tests demonstrated moderate to good intersession reliability (ICC 0.56-0.99) in both groups.
Conclusions:
- Postural stability tests (CT, SV, EOSS, SVSS), lateral rhythmic shifting, one-leg standing, and walking on a line are reliable for monitoring balance in ND children.
- The center target condition of postural stability and the one-leg standing test are reliable for children with CP.
- Further research is needed to develop more reliable balance tests specifically for children with cerebral palsy.
Abstract:
To investigate intrasession and intersession reliability of balance tests in children with or without disabilities, 50 children without disabilities (ND) and 36 children with cerebral palsy (CP) aged from 5 to 12 years were tested. Intrasession reliability of postural stability of the Smart Balance Master System and one-leg standing test were assessed in both groups and intersession reliability of the Smart Balance Master System and balance subtest of the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) were assessed in ND children. Intersession reliability of the postural stability test in ND children, obtained using the Smart Balance Master System, was of moderate to good reliability in centre target (CT), sway vision (SV), eyes open and sway surface (EOSS), and sway vision and sway surface (SVSS; ICC 0.72 to 0.84). In children with CP, intrasession reliability was high in CT (ICC 1). One-leg standing tests in both groups also had moderate to good intersession reliability (ICC 0.56 to 0.99). Agreement of failure score of lateral rhythmic shifting (LRS) at 1 second and 2 seconds pace was 85% and 93% respectively in ND children. Within the balance subtest of BOTMP, only two items had 100% agreement. Results suggest that postural stability tests in four conditions (CT, SV, EOSS, and SVSS), LRS, one-leg standing, and walking on a line are reliable and can be used to monitor balance control in ND children. Postural stability in CT condition and one-leg standing test are reliable in children with CP. Further study is needed to establish more reliable balance tests for children with CP.