Reliability of pediatric reach test in children with hearing impairment

The reliability and validity of the balance tests in hearing-impaired athletes

BACKGROUND

It is known that balance is affected in hearing-impaired athletes and its effects on performance. However, studies on the reliability and validity of scales evaluating balance are insufficient.

AIM

To analyze and demonstrate the effectiveness of various clinical tests using assessment balance for hearing-impaired athletes.

METHOD

The study included 60 elite athletes (aged between 18 and 25) with (n = 30) and without (n = 30) hearing impairment. The static balance was evaluated with the Flamingo Test (FT) and the dynamic balance with the Functional Reach Test (FRT), Four-Step Square Test (FSST), Star Excursion Balance Test (SEBT), and Y Balance Test (YBT). All balance tests were repeated at 1-week intervals. Test-retest reliability, known-group validity, and predictive validity of the scales were investigated.

RESULT

All balancing tests demonstrated strong test-retest reliability. FT and FSST had known-group and predictive validity. While FRT and the components of both YBT and SEBT involving anterior reaching were not valid tests for hearing-impaired individuals, YBT and SEBT had validity considering the composite score and other components.

CONCLUSION

It was revealed that the balance of hearing-impaired athletes was comparable to the balance of healthy athletes in test conditions in which visual information could be used effectively. For this reason, it is important to consider the visual information factor when evaluating the balance of hearing-impaired athletes. Additionally, taking into account time and tiredness, FT for static balance and FSST for dynamic balance may be helpful to evaluate hearing-impaired athletes.

Psychometric properties of functional postural control tests in children: A systematic review

BACKGROUND

Postural control deficits are one of the most common impairments treated in pediatric physiotherapeutic practice. Adequate evaluation of these deficits is imperative to identify postural control deficits, plan treatment and assess efficacy. Currently, there is no gold standard evaluation for postural control deficits. However, the number of studies investigating the psychometric properties of functional pediatric postural control tests has increased significantly.

OBJECTIVE

To facilitate the selection of an appropriate pediatric functional postural control test in research and clinical practice.

METHODS

Systematic review following the PRISMA guidelines. PubMed, Web of Science and Scopus were systematically searched (last update: June 2022; PROSPERO: CRD42021246995). Studies were selected using the PICOs-method (pediatric populations (P), functional assessment tools for postural control (I) and psychometric properties (O). The risk of bias was rated with the COSMIN checklist and the level of evidence was determined with GRADE. For each test, the postural control systems were mapped, and the psychometric properties were extracted.

RESULTS

Seventy studies investigating 26 different postural control tests were included. Most children were healthy or had cerebral palsy. Overall, the evidence for all measurement properties was low to very low. Most tests (95%) showed good reliability (ICC>0.70), but inconsistent validity results. Structural validity, internal consistency and responsiveness were only available for 3 tests. Only the Kids-BESTest and FAB covered all postural control systems.

CONCLUSION

Currently, 2 functional tests encompass the entire construct of postural control. Although reliability is overall good, validity results depend on task, age and pathology. Future research should focus on test batteries and should particularly explore structural validity and responsiveness in different populations with methodologically strong study designs.

Psychometric properties of functional balance tests in children: a literature review

AIM

Identifying balance problems are the first step towards monitoring and rehabilitation. Therefore, this paper aims to make an overview of the psychometric properties of the functional balance tests available for children.

METHOD

A literature search was performed in PubMED and Web of Science on 8 February 2014 and updated on 6 July 2014. A conceptual framework for functional balance tests was defined, taking balance control components and task constraints into account. The tests were selected for inclusion by consensus of 2-3 reviewers using the conceptual framework.

RESULTS

Fourteen tests were investigated in 25 articles and analysed within the conceptual framework. The Timed Up and Go test, Pediatric Balance Scale, and Pediatric Reach Test are well investigated and all show good reliability. Validity remains unclear because of lack of a criterion standard to measure balance control.

INTERPRETATION

Because of the lack of good methodological studies, strong evidence for the use of one or more functional balance tests in children cannot be provided. Moreover, it is necessary that a criterion standard to measure balance is established.

A preliminary randomized controlled study on the effectiveness of vestibular-specific neuromuscular training in children with hearing impairment

Objective:

To determine the effectiveness of vestibular-specific neuromuscular training on motor skills, balance and health-related quality of life in children with hearing impairment.

Design:

Controlled, randomized, preliminary study.

Setting:

Rehabilitation school for children with hearing impairment.

Subjects and intervention:

Twenty-three children with mean age of 7.5–8.1 years with hearing impairment were randomized to either the intervention or the control group. Children in the experimental group ( n = 11) participated in vestibular-specific neuromuscular training for six weeks and the children in the control group continued their regular activities followed at school.

Outcome measures:

Measurement of motor skills (Test of Gross Motor Development-2), postural control (Pediatric Reach Test, One Leg Standing Balance Test and postural sway meter) and health-related quality of life (PedsQL Generic Core Scale).

Results:

Following intervention, the scores of motor skills (Test of Gross Motor Development P = 0.02; throw for distance P = 0.042; kick for distance P = 0.08; jump for distance P = 0.001; 15-yard dash P = 0.001), postural control measures (Pediatric Reach Test P = 0.001; One Leg Standing Test P = 0.03; and anteroposterior sway (eyes open P = 0.007, eyes closed P = 0.03); mediolateral sway (eyes open P = 0.014, eyes closed P = 0.017) and health-related quality of life ( P = 0.01) improved significantly in the experimental group and not in the control group.

Conclusion:

The findings of the study suggest that vestibular-specific neuromuscular training programme may improve the motor skills, balance and health-related quality of life in children with hearing impairment.