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Psychometric properties of functional balance assessment in children with cerebral palsy
Sue-Mae Gan1, Li-Chen Tung, Yue-Her Tang
1Department of Physical Therapy, Chung Shan Medical University Rehabilitation Hospital, Taichung, Taiwan.
Insights
Three functional balance tests are reliable and valid for assessing children with cerebral palsy. These measures, including the Berg Balance Scale and Timed Up and Go, are suitable for clinical use.
Area of Science:
- Pediatric physical therapy
- Motor control in children
- Rehabilitation sciences
Background:
- Children with cerebral palsy (CP) exhibit impaired balance.
- Accurate balance assessment is vital for functional activities in pediatric CP.
- Reliable and valid functional balance measures are needed for clinical settings.
Purpose of the Study:
- To evaluate the reliability and validity of three functional balance measures.
- To determine if the Functional Reach Test (FRT), Berg Balance Scale (BBS), and Timed Up and Go (TUG) are suitable for pediatric CP.
Main Methods:
- Thirty children with CP (Gross Motor Function Classification System levels I-IV) participated.
- Test-retest and interrater reliability were assessed for FRT, BBS, and TUG.
- Convergent and discriminant validity were examined using Gross Motor Function Measure (GMFM), walking speed, and 10-second sit-to-stand test.
Main Results:
- All three measures demonstrated excellent test-retest and interrater reliability (ICC > 0.95).
- BBS and TUG showed high correlation with GMFM, walking speed, and sit-to-stand test (convergent validity).
- FRT distinguished between different GMFCS levels, while BBS and TUG did not differentiate between GMFCS levels I and II (discriminant validity).
Conclusions:
- The FRT, BBS, and TUG are reliable and valid tools for assessing balance in children with CP.
- These simple measures are appropriate for use in clinical practice.
- FRT is particularly useful for differentiating functional levels in pediatric CP.
Background:
Children with cerebral palsy often suffer from a lack of balance compared with typically developing children. Because balance capacity is relevant to functional activities, reliable and valid functional balance measures are crucial for the pediatric clinical setting.
Objective:
This study examined the reliability and validity of 3 functional balance measures.
Methods:
Thirty children aged 60 to 142 months with Gross Motor Function Classification System (GMFCS) levels of I to IV were recruited. For test-retest reliability, the same physical therapist administered the Functional Reach Test (FRT), Berg Balance Scale (BBS), and Timed Up and Go (TUG) twice. For interrater reliability, the testing processes were video recorded and later scored by another therapist. For convergent validity, children with cerebral palsy received the Gross Motor Function
Measures:
(GMFM), walking speed, and 10-second sit-to-stand test within 1 week and the results evaluated.
Results:
The 3 functional balance measures had excellent test-retest reliability (intraclass correlation coefficient [ICC] >0.95) and interrater reliability (ICC = 0.98-1.00). With regard to convergent validity, the BBS and the TUG were highly correlated with GMFM total score, walking speed, and the 10-second sit-to-stand test. The discriminate validity indicates that the FRT can distinguish children with cerebral palsy with different GMFCS levels, whereas the BBS total score and TUG failed to distinguish between children with cerebral palsy with GMFCS levels of I and II.
Conclusion:
The 3 functional balance measures are simple, valid, and reliable for examining children with cerebral palsy and are thus suitable for clinical practice.
