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Evaluation of postural stability in children: current theories and assessment tools
S L Westcott1, L P Lowes, P K Richardson
1Allegheny University of the Health Sciences, Philadelphia, PA 19102, USA. westcotts@allegheny.edu
Insights
Pediatric therapists assess postural stability in children with motor dysfunction. Current assessment tools show limited reliability and validity, highlighting a need for better measurement development in pediatric physical therapy.
Area of Science:
- Pediatric physical therapy
- Motor control research
- Rehabilitation science
Background:
- Children with motor dysfunction often exhibit impaired postural stability.
- Postural stability is crucial for executing all movements.
- Therapists routinely evaluate and treat postural stability deficits in pediatric populations.
Purpose of the Study:
- To review current pediatric assessment tools for postural stability.
- To identify challenges in testing postural stability in children.
- To classify existing measurements based on the National Center for Medical Rehabilitation Research (NCMRR) disablement framework.
Main Methods:
- Systematic review of pediatric postural stability assessment tools.
- Classification of tests by purpose and NCMRR framework (impairment and functional limitation dimensions).
- Description of tests from a systems perspective (sensory, motor, biomechanical).
Main Results:
- Limited availability of pediatric postural stability measures with documented reliability and validity.
- Existing tools are categorized by their focus on impairment or functional limitations.
- Discussion of sensory, motor, and biomechanical system contributions to postural stability.
Conclusions:
- There is a significant gap in validated and reliable postural stability assessment tools for children.
- Further research is needed for the development and validation of pediatric measurement instruments.
- Improved assessment tools are essential for effective pediatric physical therapy interventions.
Abstract:
Children with many types of motor dysfunction have problems maintaining postural stability. Because maintenance of postural stability is an integral part of all movements, therapists evaluate and treat to improve postural stability in these children. This article reviews current pediatric assessment tools for postural stability and issues affecting testing this construct in children. The tests and measurements are classified according to their testing purpose and the National Center for Medical Rehabilitation Research disablement framework, focusing on the impairment and functional limitation dimensions. Postural stability is defined from a systems perspective with tests related to the sensory, motor, and biomechanical systems described. Reliability and validity information on the measurements is discussed. Relatively few measurements of postural stability in children are available that have acceptable reliability and validity documentation. Suggestions for research on test development in this area are discussed.