Comparison of different methods used in balance evaluation in children with diparetic cerebral palsy

Area of Science:

• Pediatric Rehabilitation
• Neurology
• Biomedical Engineering

Background:

• Cerebral Palsy (CP) significantly impacts motor function, particularly balance.
• Accurate balance assessment is crucial for effective intervention in children with CP.
• Existing balance tests require validation for specific pediatric CP populations.

Purpose of the Study:

• To investigate the validity and reliability of Single Leg Stance (SLS), Tandem Stance (TS), and Pediatric Reach Tests (PRT).
• To assess the utility of these tests in children diagnosed with diparetic Cerebral Palsy (CP).
• To determine the tests' ability to differentiate balance capacities across Gross Motor Function Classification System (GMFCS) levels.

Main Methods:

• Fifty-three children (3-15 years) with diparetic CP (GMFCS Level I-II) participated.
• Balance was evaluated using SLS (dominant/non-dominant leg, eyes open/closed), TS (eyes open/closed), and PRT (forward, right, left).
• Internal consistency (Cronbach's alpha), correlations with GMFCS, and discriminant ability (AUC) were analyzed.

Main Results:

• All tested balance assessments demonstrated excellent to acceptable internal consistency.
• SLS and TS showed strong correlations with GMFCS levels, while PRT showed moderate to low correlations.
• All tests, except PRT-Right and PRT-Left, effectively discriminated between GMFCS Level I and II (AUC > 0.800).

Conclusions:

• SLS, TS, and PRT are valid and reliable tools for balance assessment in children with diparetic CP.
• These tests are sensitive in distinguishing between GMFCS levels I and II.
• The findings suggest these balance tests offer clinical advantages for physiotherapists assessing children with CP.