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Using the berg balance scale to distinguish balance abilities in children with cerebral palsy
Gayatri Kembhavi1, Johanna Darrah, Joyce Magill-Evans
1Departments of Physical Therapy (G.K., J.D.) and Occupational Therapy (J.M-E.), and Faculty of Rehabilitation Medicine (J.L.), University of Alberta, Edmonton, AB, Canada.
Insights
The Berg Balance Scale (BBS) effectively assesses balance in children with cerebral palsy. Functional classification, like the Gross Motor Function Classification System (GMFCS), groups children more effectively than diagnosis alone.
Area of Science:
- Pediatric Rehabilitation
- Neurology
- Biomedical Engineering
Background:
- Cerebral palsy (CP) significantly impacts motor function, particularly balance.
- Accurate assessment tools are crucial for effective intervention in children with CP.
- The Berg Balance Scale (BBS) is a common tool, but its utility in pediatric CP requires further validation.
Purpose of the Study:
- To evaluate the efficacy of the Berg Balance Scale (BBS) in assessing balance in children with cerebral palsy (CP).
- To compare the BBS with the Gross Motor Function Measure (GMFM) for balance assessment in pediatric CP.
- To determine if functional classification (GMFCS) or diagnostic classification better differentiates balance abilities.
Main Methods:
- Thirty-six ambulatory children with CP and 14 typically developing children (8-12 years) were assessed.
- Participants were grouped by CP diagnosis (hemiplegia, diplegia with/without aids) and a control group.
- The BBS and GMFM were administered, with subsequent analysis using Gross Motor Function Classification System (GMFCS) levels.
Main Results:
- Both BBS and GMFM scores showed significant differences between groups when classified by GMFCS levels.
- The GMFM demonstrated slightly better discrimination among diagnostic groups compared to the BBS.
- Functional classification via GMFCS provided more homogeneous groupings than traditional diagnostic categories.
Conclusions:
- The Berg Balance Scale (BBS) is a viable clinical tool for measuring balance in children with cerebral palsy.
- Functional classification systems, such as the GMFCS, offer a more refined approach to grouping children with CP for assessment.
- These findings support the use of BBS and GMFCS in pediatric rehabilitation for children with CP.
Purpose:
This study was designed to evaluate the use of the Berg Balance Scale (BBS) to assess the balance abilities of children with cerebral palsy.
Methods:
Thirty-six ambulatory children with cerebral palsy and 14 children with no motor impairment (ages eight to 12 years) were assessed on the BBS and the Gross Motor Function Measure (GMFM). Participants with cerebral palsy comprised three groups based on diagnosis (spastic hemiplegia, spastic diplegia who ambulated without aids, and spastic diplegia who ambulated with aids). A fourth group consisted of control subjects with no motor impairment. It was hypothesized that these four groups demonstrated a hierarchy of balance abilities. A one-way ANOVA was used to detect significant differences in test scores among the four groups. The analysis was repeated categorizing children on the Gross Motor Function Classification System (GMFCS) instead of diagnosis.
Results:
The ability to use scores on the GMFM was slightly better than using BBS scores to distinguish among the groups when children were classified using diagnosis. Significant pair-wise differences among the groups were present on both the BBS and the GMFM when the children were grouped on the GMFCS.
Conclusions:
The results suggest that the BBS can be considered as a clinical measure of balance for children with cerebral palsy, and a functional classification system can be used to group children more homogeneously than traditional classification by diagnosis.
