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Validity of pediatric balance scales in children with spastic cerebral palsy
Sook-Hee Yi1, Ji Hye Hwang, Sang Jun Kim
1Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Insights
The Pediatric Balance Scale (PBS) is a valid tool for assessing functional balance in children with spastic cerebral palsy (CP). It effectively distinguishes functional levels and predicts motor capacity.
Area of Science:
- Pediatrics
- Rehabilitation Medicine
- Neuroscience
Background:
- Spastic cerebral palsy (CP) significantly impacts motor function, particularly balance, in children.
- Accurate assessment of balance is crucial for effective intervention and tracking progress in pediatric CP.
- Existing balance scales may require adaptation for specific pediatric populations like those with spastic CP.
Purpose of the Study:
- To evaluate the convergent and discriminant validity of the Pediatric Balance Scale (PBS) in children with spastic cerebral palsy (CP).
- To determine if the PBS can accurately measure functional balance capacity in this population.
- To compare the predictive ability of the PBS with other established measures.
Main Methods:
- The study included 38 children aged 4-10 years with spastic CP who could ambulate.
- Participants underwent assessment using the Pediatric Balance Scale (PBS), Sensory Organization Test (SOT) equilibrium scores, Gross Motor Function Measure (GMFM), and Pediatric Evaluation of Disability Inventory (PEDI) mobility skills.
- Convergent and discriminant validity of the PBS were analyzed using correlation and comparison across Gross Motor Function Classification Scale (GMFCS) levels.
Main Results:
- The PBS total score showed moderate correlations with SOT equilibrium scores (eyes open and closed) and PEDI mobility performance.
- High correlations were observed between PBS total score and GMFM scores (dimensions D, E, GMFM-88, GMFM-66) and PEDI mobility capability.
- The PBS demonstrated discriminant validity, distinguishing between different GMFCS levels in children with spastic CP.
Conclusions:
- The Pediatric Balance Scale (PBS) is a simple and valid instrument for assessing functional balance in children with spastic CP.
- The PBS demonstrates good convergent and discriminant validity in this population.
- The PBS may be a superior predictor of motor capacity and capability compared to SOT equilibrium scores and PEDI motor performance.
Abstract:
This study was performed to examine the convergent and discriminant validity of the Pediatric Balance Scale (PBS), a modified version of the Berg Balance Scale (BBS), in children with spastic cerebral palsy (CP). A total of 38 children (age, 4 to 10 years) with spastic CP who could ambulate participated in this study. PBS, equilibrium scores of Sensory Organization Test derived from computerized dynamic posturography, Gross Motor Function Measure (GMFM), and Pediatric Evaluation of Disability Inventory (PEDI) mobility skills were evaluated. With regard to convergent validity, PBS total score was moderately correlated with equilibrium score under the condition with eyes open, fixed foot support and condition with eyes closed, fixed foot support (rs = 0.579, eye open; rs = 0.448, eye closed; p < 0.05). PBS total score was highly correlated with GMFM scores (dimensions D and E; total GMFM-88; and GMFM-66) and capability, of the PEDI mobility domain, and moderately correlated with performance of the PEDI mobility domain. Discriminant validity indicated that PBS total score can distinguish between different Gross Motor Function Classification Scale levels in children with CP. PBS can be considered a simple, valid scale for examining functional balance capacity in children with spastic CP. Furthermore, it can better predict motor capacity and capability than equilibrium score and motor performance.