Early Clinical Assessment of Balance
Review of Article: Measuring Postural Stability in Young Children With Cerebral Palsy: A Comparison of 2 Instruments
Citation: Randall, K. E., Bartlett, D. J., & McCoy, S. W. (2014). Measuring postural stability in young children with cerebral palsy: a comparison of 2 instruments. Pediatric Physical Therapy: The Official Publication of the Section on Pediatrics of the American Physical Therapy Association,26(3), 332–337. http://doi.org/10.1097/PEP.0000000000000062
This article was looking to review the validity and reliability between two measures, the ‘ Early Clinical Assessment Balance (ECAB)’ and the ‘Pediatric Reach Test (PRT)’. This article is important because the main proven valid and reliable measure to determine postural stability in children with cerebral palsy besides the Gross Motor Function Classification System, which was mostly limited to laboratories. Therefore the aim of this study was to help determine the validity and reliability of both the ECAB and the PRT. There were a total of 28 children with cerebral palsy that participated in the study with a mean age of 56 months and varying GMFCS levels from I to V. The results of the study showed that the ECAB was both more reliable and valid than the PRT test; ECAB showed less variability of results between both reliability and validity measures. More specifically the ECAB showed significant results in higher test-rest reliability and lower measurement error. This study measured a MDC of 46.5 for the PRT and a 10.0 for the ECAB measure. Since the PRT is measured on a 200 point scale, this would mean you would need ~25% change to meet any difference. However, the ECAB is on a 100 point scale, therefore you would only need a 10% change to be able to detect any changes. In addition to this information, the clinicians reported the ECAB being simpler to administer and easier to learn. The final consensus of the article was that the ECAB proved to be the better measure in both reliability, validity, and administration.
3 responses to “Early Clinical Assessment of Balance”
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I was surprised to learn that a balance outcome measure similar to the the Berg exists for children. The Early Clinical Assessment of Balance seems like an easy test to administer that is also valid and reliable. I have never heard of or used this test but would be interested in using it to monitor progression in younger children with balance deficits. I like that it uses minimal props and only takes a short period of time to test. Similar to the berg, it can be used to assess fall risk but primarily targets children with cerebral palsy. However, I don’t like that it only targets children ages 1-5. Is there another outcome measure appropriate for children older than 5?
This is very good information to know. I feel like there are so many different test out there, and deciding which one is best to use for specific patient populations can sometimes be very difficult. Not only is the ECAB valid and reliable, but it is easy and quick to administer and those are especially important qualities when working with a pediatric population. I had not heard of either the ECAB or the PRT but I have used the GMFCS, but will look to be more specific with my choice of measures in the future.
The MDC numbers is what caught me off guard. Correct me if i’m wrong, but once you break an MDC raw number into percentages, shouldn’t those percentages be relatively close? A 10% change compared to a 25% change is glaringly different. 25% change to detect difference seems like a reach, and not focused enough when tracking patient progress over time.