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Measuring postural stability in young children with cerebral palsy: a comparison of 2 instruments

Katharine Elizabeth Randall1, Doreen J Bartlett, Sarah Westcott McCoy

  • 1Health and Rehabilitation Sciences Program (Ms Randall), and School of Physical Therapy (Dr Bartlett), Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada; CanChild Centre for Childhood Disability Research (Dr Bartlett), McMaster University, Hamilton, Ontario, Canada; Department of Rehabilitation Medicine (Dr Westcott), Division of Physical Therapy, University of Washington, Seattle.

Pediatric Physical Therapy : the Official Publication of the Section on Pediatrics of the American Physical Therapy Association
|July 1, 2014
PubMed

Insights

The Early Clinical Assessment of Balance (ECAB) is a superior measure for assessing postural stability in children with cerebral palsy (CP), showing strong validity and reliability compared to the Pediatric Reach Test.

Area of Science:

  • Pediatric physical therapy
  • Neurological rehabilitation
  • Biomedical engineering

Background:

  • Children with cerebral palsy (CP) often experience impaired postural stability, impacting their motor function.
  • Accurate assessment of postural stability is crucial for effective intervention planning in pediatric CP.
  • Existing measures require rigorous evaluation for clinical utility in this population.

Purpose of the Study:

  • To compare the construct validity, interrater and test-retest reliability of the Pediatric Reach Test and the Early Clinical Assessment of Balance (ECAB).
  • To assess the relationship between these measures and the Gross Motor Function Measure, 66-item version, Basal and Ceiling approach (GMFM-66-B&C).
  • To determine the clinical utility of postural stability measures for children with CP.

Main Methods:

  • A cohort of 28 children with CP, aged 2-7 years, participated in two assessment sessions spaced two weeks apart.
  • Two independent assessors evaluated the participants during the initial assessment to evaluate interrater reliability.
  • Construct validity was assessed by comparing the measures with the GMFM-66-B&C.

Main Results:

  • Both the Pediatric Reach Test and ECAB demonstrated strong construct validity (rs of 0.88) and correlated highly with the GMFM-66-B&C (rs > 0.95).
  • The ECAB exhibited superior interrater and test-retest reliability (intraclass correlation coefficients > 0.98) compared to the Pediatric Reach Test (0.87-0.94).
  • The ECAB showed reduced measurement error and smaller minimal detectable change values.

Conclusions:

  • The Early Clinical Assessment of Balance (ECAB) is recommended as a more effective measure for assessing postural stability in children with cerebral palsy.
  • The ECAB's superior reliability and lower measurement error support its clinical utility in this population.
  • This study provides evidence-based guidance for selecting appropriate tools for evaluating postural control in pediatric CP.
Abstract

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