Tests & Measures: A Resource for Pediatric Physical Therapy Practitioners

Early Clinical Assessment of Balance

Article: Measuring Postural Stability in Young Children with Cerebral Palsy: A Comparison of 2 Instruments.

Category: Evaluative

Background: The Early Clinical Assessment of Balance is an evaluative measure used by clinicians to assess balance in the cerebral palsy population.  The test typically takes 15-30 minutes and does not require any materials outside of a bench and mat. Scoring is on a 0-100 scale where higher scores equate to better balance. The ECAB can identify children at higher risk of falling and measure balance changes.

Purpose: To compare the inter-rater reliability, test-retest reliability, and validity of the Early Clinical Assessment of Balance (ECAB) and Pediatric Reach Test (PRT); and look at the relationship between these tests and the GMFM-66

Population: 28 children with CP, with no other significant co-morbidities, such as autism, between the ages of 2-7.

Methods: Testing was performed in two sessions separated by two weeks to limit learning of the test by the participants. During the first session, two administrators both the ECAB and the PRT to determine the inter-rater reliability. The GMFM was also administered during the first session. The second session, the ECAB and PRT were randomly assigned to the clinicians for administration to determine inter-test reliability.

Outcome Measures: ECAB, PRT, and the GMFM-66

Intervention: None because the study looked at validity.

Results: The ECRB showed good intra-rater and test-retest reliability and better validity than the PRT. Both the ECRB and the PRT showed good validity with the GMFM-66.

Strengths: The large age range allows the test to be applied to many children. It also allows the test to track changes and improvement in the child’s balance over 5 years. The study takes into account learning of the test and set the testing sessions weeks apart to avoid learning.

Limitations: One limitation is the small population, the study only used 28 children. While the test is designed to track changes in balance over time; the study did not show how reliability the ECAB was able to track those changes.

Conclusions: Overall, both the PRT and ECAB are valid and reliable tests but the ECAB shows that it is more valid and can be precise. The ECAB can be used to assess and track balance in children with a primary diagnosis of CP. According to come clinicians, the ECAB can be easier to learn and administer.

 

Reference Article:

Randall, K E, et al. “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., U.S. National Library of Medicine, 2014, www.ncbi.nlm.nih.gov/pubmed/24979089.