Responsiveness and reliability of a pediatric strategy score for balance

Various motor patterns or 'strategies' can be used to maintain balance. The purpose of this study was to determine the responsiveness of a pediatric strategy score (PED-SS) compared to a standard strategy score (SS) as a measure of age-related changes in the force patterns used to maintain stance. Eighty-one healthy children between 3-6 years of age were tested during stance on a force platform while facing a visual surround. The platform, visual surround (or both) moved simultaneously with the child's body sway. Four sensory conditions that altered visual and somatosensory (support surface) inputs were presented. The PED-SS was found to be more responsive to age-related changes in balance behavior compared to the SS. The oldest children (aged 5 and 6 years) showed the greatest ability to utilize horizontal A/P shear force to maintain stance and this finding was reflected only in the PED-SS. The implications of evaluating force strategy as one component of balance in healthy children is discussed with respect to the early developmental assessment of vestibular and developmental coordination disorders.