Functional motor performance and reliability of the Dubousset Functional Test in ambulatory children with spastic...

Area of Science:

• Pediatrics
• Rehabilitation Medicine
• Neurology

Background:

• Cerebral palsy (CP) leads to permanent motor impairments affecting posture and mobility.
• The Dubousset Functional Test (DFT) assesses daily activities, but its pediatric CP reliability and validity are unconfirmed.
• This study evaluates the DFT's psychometric properties in children with spastic CP (GMFCS Levels I-II).

Purpose of the Study:

• To assess the reliability, convergent validity, and discriminative validity of the DFT in children with spastic CP.
• To evaluate the clinical utility and feasibility of the DFT for routine rehabilitation.
• To determine the measurement precision and smallest detectable change (SDC) of the DFT.

Main Methods:

• A cross-sectional methodological study involving 33 children (aged 6-15) with spastic CP (GMFCS I-II).
• Administered the DFT (Rise-and-Walk, Step, Sit-to-Stand, Dual Task subtests) alongside TUG, Dual-task TUG, 3MBWT, FRT, and PBS.
• All assessments were repeated after seven days by the same physiotherapist to ensure reliability.

Main Results:

• The DFT showed excellent reliability (ICC(3,2) = 0.91-0.95) with minimal bias and precise measurements (SDC = 2.1-13.0 s).
• Strong correlations between DFT Dual Task and TUG/Dual-task TUG (r=0.95, p<0.001) confirmed convergent validity.
• ROC analysis demonstrated excellent discriminative accuracy for balance limitations (AUC=0.82).

Conclusions:

• The DFT is a reliable, valid, and clinically feasible tool for assessing balance and mobility in ambulatory children with spastic CP (GMFCS I-II).
• Findings support the DFT's routine use in pediatric CP rehabilitation.
• The DFT aids in monitoring functional status and guiding therapeutic interventions.