IJCRR - 3(11), November, 2011
Pages: 206-213
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CONCURRENT VALIDITY OF PEDIATRIC BALANCE SCALE WITH COMPUTERIZED POSTUROGRAPHY
Author: Snehal Lende, Vijaymuniraj, John Solomon. M
Category: Healthcare
Abstract:Purpose: To establish the concurrent validity of Pediatric Balance Scale (PBS) with the measures of Computerized Posturography Methods: Typically developing children between the age group of 3 to 8 years and children with balance impairment were tested Results: The total numbers of subjects included in study were 47, mean score on PBS was 50.21+ 4.07. Out of
seven items performed on Computerized Posturography six items correlated significantly and
only reaching forward with outstretched hand did not correlate significantly. Also Velocity
Moment of Computerized Posturography correlated significantly with Centre of Sway in
Anterior-Posterior and in Medial-Lateral direction. Maximum correlation was present for
standing with feet together (0.902) in A-P direction and for standing unsupported (0.936) in ML
direction. Conclusion: Concurrent validity sub items of Pediatric Balance Scale (PBS) with
measures of Computerized Posturography is fair to good
Keywords: pediatric balance scale (PBS), berg balance scale (BBS), computerized posturography, balance, children
Full Text:
INTRODUCTION
Balance is an essential part of movement and skill. It is the ability to maintain the centre of body mass over the base of support with minimal sway or maximum steadiness.1 Static balance is defined as the ability to maintain the centre of gravity within the base of support in a quiet upright position during sitting or standing. Dynamic balance involves maintaining an upright position while the centre of gravity and base of support is moving or the centre of gravity is moving outside the base of support. Both static and dynamic balance is thought to be important and necessary for maintaining posture and for doing activities.2 Maintenance of balance requires active efferent information from the proprioceptive, visual and vestibular systems, as well as from the cognitive system, which is integrated and evaluated to generate motor responses that keep the body inside its limits of stability.3 This integration of system occurs by responding quickly and accurately to all internal and external environmental changes. During functional activities, these changes may occur independently or in any combination.4 Development of balance occurs in sequential order. Studies have shown that the greatest development of balance occurs between the age group of 4 to 6 years. And CONCURRENT VALIDITY OF PEDIATRIC BALANCE SCALE WITH COMPUTERIZED POSTUROGRAPHY Snehal Lende1 , Vijaymuniraj2 , John Solomon. M2 1 Sigma Institute of Physiotherapy, Vadodara, Gujarat 2Department of Physiotherapy, MCOHAS, Manipal University, Manipal E-mail of Corresponding Author: snehalrathi2003@gmail.com 207 International Journal of Current Research and Review www.ijcrr.com Vol. 03 issue 11 November 2011 becoming similar to that exhibited by adult when the child is 7 to 10 years of age.5 Balance skills are an integral part of gross motor abilities and poor balance causes difficulties with functional tasks involved in activities of daily living. Balance deficits in a functional context become an important issue in rehabilitation, and are often the focus of intervention. Therefore, an outcome measure addressing the construct of functional balance is required. A reliable, valid and simple tool to measure balance in children should be valuable to clinicians that are involved in the rehabilitation of the children with balance impairment.2 Traditional balance assessments include timed measures of static sitting and standing balance including single limb stance. Standardized examination tools currently utilized by pediatric physical therapists for children with mild to moderate motor impairment include the Bruininks-Oseretsky Test of Motor Proficiency, Peabody Developmental Motor Scale and Gross Motor Function Measure. These scales provide clinicians with valuable information, but may not fully meet their needs to assess a child's functional balance abilities.5 Computerized posturography provides the gold standard of measurement of balance, and in literature it is the most widely used reported method to quantify balance measurement.6 It offers a technology for objective assessment and comprehensive documentation of postural control.7 The general census is that computerized measures have a greater precision and potential to detect sub clinical balance impairments.6 But clinical functional tests have a more direct functional relevance and are usually less costly and easier to administer.7 One of the clinical functional tests used in Pediatric clinic is Pediatric Balance Scale (PBS) which is a modified version of Berg Balance Scale. It is a 14 item scale and is used to assess the functional balance of children with mild to moderate motor impairments. It identifies need for physical therapy intervention and to monitor progress within a therapeutic program.8 By nine years of age a child is able to score fully on PBS.9 And it has a good test-retest reliability (0.99), also clinical observation supports the content validity of PBS.8 PBS is being correlated with BOTMP (0.73).10 But PBS is not yet correlated with the standardized Computerized Posturography. Thus attainment of balance in children occurs sequentially. And various clinical tests have being incorporated to assess the balance. The standardized balance assessment is done by Computerized posturography which gives quantitative balance measures. Pediatric Balance Scale (PBS) involves fourteen items tested for balance in children and requires less time to complete test. And by nine years of age child is able to score fully on PBS. PBS has been validated with BOTMP. But PBS concurrent validation is not yet established with Computerized posturography measures. Thus the main objective of the study was to establish the concurrent validity of sub items of PBS with the measures of gold standard assessment of balance that is Computerized posturography.
METHODOLOGY
Typically developing children in the age group of 3 to 8 years and children with balance impairment admitted at Kasturba Hospital, Manipal (India) were taken. The balance testing of children was done in Balance and Vestibular Rehabilitation unit, Physiotherapy department, Manipal, India.
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