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Clinical tools that measure sitting posture, seated postural control or functional abilities in children with motor
Debra Field1, Roslyn Livingstone
11Sunny Hill Health Centre for Children, Canada.
Insights
This study reviewed measurement tools for children with motor impairments needing seating interventions. Limited evidence supports the reliability and validity of available tools for assessing sitting posture and function.
Area of Science:
- Rehabilitation Science
- Clinical Measurement
- Pediatric Physical Therapy
Background:
- Children with motor impairments often require specialized seating interventions.
- Accurate assessment of sitting posture and functional abilities is crucial for effective intervention.
Purpose of the Study:
- To identify and critically appraise clinical measurement tools for assessing sitting posture, seated postural control, and functional abilities in children with motor impairments.
- To evaluate the psychometric properties and clinical utility of these assessment tools for seating interventions.
Main Methods:
- Comprehensive literature search across 15 electronic databases and hand searching up to December 2011.
- Inclusion criteria and PRISMA statement followed; two independent reviewers screened titles, abstracts, and full-text articles.
- Data extraction focused on tool description and clinical utility; quality assessment used two rating scales for study conduct and tool psychometrics.
Main Results:
- 19 measurement tools were identified from 29 full-text articles, covering International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) components.
- Evidence for reliability and validity varied, often limited by small sample sizes; reliability evidence was more common than validity evidence.
- Only four tools reported responsiveness; limited information on clinical utility was available.
Conclusions:
- Existing measurement tools for seating interventions in children with motor impairments have limited supporting evidence for their measurement properties.
- Few tools adequately address participation, environmental factors, or the perspectives of the child and family.
- Further research is needed to develop and validate robust assessment tools for this population.
Objective:
To identify and critically appraise clinical measurement tools used to assess sitting posture, seated postural control or functional abilities for children with motor impairment who are candidates for seating interventions.
Data Sources:
Searches were run in 15 electronic databases along with hand searching. The search included articles published in English to December 2011.
Review Methods:
Key terms included: posture, sitting, sitting posture, seated posture, seated postural control, sitting position, seating, wheelchair(s), outcome and assess(ment). The PRISMA statement was followed with inclusion criteria set a priori. Two reviewers independently screened titles, reviewed abstracts and identified full-text articles that met criteria. Data extraction included tool description and clinical utility. Two quality-rating scales were used to evaluate conduct of the studies and psychometric properties of the tools.
Results:
Of the 497 titles found in the search, 29 full-text articles met the inclusion criteria and 19 tools were identified. Tools represented all components of the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY), with emphasis on body structure and function and activity components. Evidence supporting reliability and validity varied, with small sample sizes influencing quality ratings. Evidence of the tools' reliability was more prevalent than evidence of the tools' validity. Only four tools reported on responsiveness, an important consideration for evaluating change. Little information on clinical utility was provided.
Conclusion:
Although a number of tools are available, evidence supporting their use for seating interventions is limited, as is the evidence supporting the strength of their measurement properties. Few tools address participation, environmental factors or the child's and family's perspective.
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