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Psychometric properties of functional postural control tests in children: A systematic review. Ann Phys Rehabil Med 2023; 66:101729. [PMID: 36669385 DOI: 10.1016/j.rehab.2022.101729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/10/2022] [Accepted: 11/04/2022] [Indexed: 01/20/2023]
Abstract
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.
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Aldirmaz E, Uğur F, Yilmaz Ö, Karaduman A, Alemdaroğlu-Gürbüz İ. A New Instrument to Assess Dynamic Balance in Children with Duchenne Muscular Dystrophy: Four Square Step Test and Its Validity, Reliability and Feasibility. Dev Neurorehabil 2023; 26:27-36. [PMID: 36367327 DOI: 10.1080/17518423.2022.2143924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM The aim of this study was to investigate validity, reliability and feasibility of the Four Square Step Test (FSST) in children with Duchenne Muscular Dystrophy (DMD). METHODS The study included 44 children with DMD aged 5-12 years. The functional level of the children was determined by using the Brooke Lower Extremity Functional Classification (BLEFC). The concurrent validity of the FSST, a dynamic balance assessment, was investigated by analyzing the association between FSST and Timed Up and Go Test (TUG), North Star Ambulatory Assessment (NSAA) and Six-Minute Walk Test (6MWT) distance. The intra- and inter-rater reliability of the FSST was determined by using the Intra Class Correlation Coefficient (ICC) while the feasibility of the test was determined by calculating the percentage of children who successfully completed the test in accordance with the test instructions. RESULTS The FSST score of the children (mean age 9.25 ± 2.14 years) was 11.91 ± 3.43 and the BLEFC level ranged from Level 1 (65.9%) to Level 3 (9.1%). FSST had positive, moderate relation with BLEFC (r = 0.447; p = .002); positive, strong relation with TUG (rs = 0.623), and negative, moderate correlations with NSAA (rs = -0.529) and 6MWT distance (rs = -0.592) (p < .001). Intra-rater (ICC: 0.965) and inter-rater (ICC: 0.991) reliability was "excellent," and the test was feasible with successful performance of 88% children. DISCUSSION The FSST is a valid, reliable and feasible instrument to assess dynamic balance as well as having the ability to reflect falling risk and different functional levels of children with DMD.
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Affiliation(s)
- Esra Aldirmaz
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Altındağ, Turkey
| | - Fatma Uğur
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Altındağ, Turkey
| | - Öznur Yilmaz
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Altındağ, Turkey
| | - Ayşe Karaduman
- Faculty of Health Sciences, Physiotherapy and Rehabilitation Department, Lokman Hekim University, Çankaya, Turkey
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Reliability of the Modified Star Excursion Balance Test in individuals with Down Syndrome. J Bodyw Mov Ther 2022; 32:171-175. [DOI: 10.1016/j.jbmt.2022.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/08/2022] [Accepted: 05/15/2022] [Indexed: 11/23/2022]
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Raghupathy MK, Divya M, Karthikbabu S. Effects of Traditional Indian Dance on Motor Skills and Balance in Children with Down syndrome. J Mot Behav 2021; 54:212-221. [PMID: 34233594 DOI: 10.1080/00222895.2021.1941736] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The objective of the study was to examine the effects of traditional Indian dances like Bharatanatyam, Kuchipudi and Kathak on motor skills and balance in children with Down syndrome compared to neuromuscular training. In this randomised double-arm design, 36 children with Down syndrome aged 6-10 years and with a score of <5 in Beighton's hypermobility test participated in either Indian classical dance (n = 18) or neuromuscular training (n = 18). Both the groups practised an hour-long session a day, three days a week for six weeks in six special-schools. Test of Gross Motor Development-2 (TGMD-2), Four Square Step Test (FSST) and paediatric balance scale were the outcome measures. After six weeks of training, there is a significant group difference of change score in the Gross Motor Quotient standard score of TGMD-2 [experimental: 30.47 vs. control: 11.1], locomotor subset of TGMD-2 [experimental: 11.1 vs. control: 4.35] and FSST [experimental: 4.29 vs. control: 2.41], but not in the paediatric balance scale [experimental: 3.59 vs. control: 3.76]. The traditional Indian dance substantially improved the locomotor skills of children with Down syndrome than that of neuromuscular exercises. Both the dance and neuromuscular training equally impacted the balance capacity.
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Affiliation(s)
- Manasa Kolibylu Raghupathy
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal Hospital, Bangalore, India
| | - Mohan Divya
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal Hospital, Bangalore, India
| | - Suruliraj Karthikbabu
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal Hospital, Bangalore, India
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Nocera VG, Wood AP, Wozencroft AJ, Coe DP. The Test-Retest Reliability of the Bruininks-Oseretsky Test of Motor Proficiency-Short Form in Youth with Down Syndrome-A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105367. [PMID: 34069921 PMCID: PMC8157598 DOI: 10.3390/ijerph18105367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/06/2021] [Accepted: 05/15/2021] [Indexed: 11/26/2022]
Abstract
Background: It is unclear whether assessments of motor proficiency are reliable for individuals with Down syndrome. The purpose of the study was to evaluate the test–retest reliability of the Bruininks–Oseretsky Test of Motor Proficiency-Short Form (BOT-2 SF) in youth with Down syndrome. Methods: Ten youth (ages 13.1–20.7 years) with Down syndrome completed the BOT-2 SF (14 items) plus a standing long jump on two separate occasions. Intraclass correlation coefficients (ICC), 95% confidence intervals (CIs), and standard error of measurement (SEM) were calculated to determine the test–retest reliability of the BOT-2 SF and the standing long jump. Results: The test–retest reliability of the BOT-2 SF overall scores and percentile rankings were considered excellent. The test–retest reliability of each of the subtests varied with classifications of poor (n = 5), fair to good (n = 6), and excellent (n = 4). Conclusion: Current evidence suggests that children with Down syndrome have reduced motor skills. However, there appears to be a lack of assessment tools that reliably evaluate the motor skills of this population. The results from this investigation suggest that the BOT-2-SF provides “excellent reliability” (≥0.75) to assess the motor skills in youth with Down syndrome.
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Affiliation(s)
- Vincenzo G. Nocera
- Department Health and Human Performance, Plymouth State University, Plymouth, NH 03264, USA
- Correspondence: ; Tel.: +603-535-3108
| | - Aaron P. Wood
- Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, TN 37996, USA; (A.P.W.); (A.J.W.); (D.P.C.)
| | - Angela J. Wozencroft
- Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, TN 37996, USA; (A.P.W.); (A.J.W.); (D.P.C.)
| | - Dawn P. Coe
- Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, TN 37996, USA; (A.P.W.); (A.J.W.); (D.P.C.)
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Promsorn S, Taweetanalarp S. The multi-directional reach test in children with Down syndrome. Hong Kong Physiother J 2021; 41:65-74. [PMID: 34054258 PMCID: PMC8158406 DOI: 10.1142/s1013702521500062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 12/31/2020] [Indexed: 11/18/2022] Open
Abstract
Objective: This study investigated the limits of stability (LOS) and the movement patterns during reaching by applying the Multi-Directional Reach Test (MDRT) in children with Down syndrome (DS) aged 7–12 years old. Methods: Thirty children with DS and 30 age and gender typical development (TD) matched children, aged 7–12 years old were recruited. Each child was asked to reach as far as possible during standing in four directions using a self-selected movement pattern. The movement patterns were classified by two experienced pediatric physical therapists. Results: The reach distance in children with DS aged 7–9 years old was significantly shorter than TD children aged 7–9 years old for the forward and backward directions. Also, the reach distance in DS children aged 7–9 years old was significantly smaller than that of TD children aged 10–12 years old for all directions. For children with DS aged 10–12 years old, the reach distance was significantly less than that of TD children only in the backward direction. All children with DS in this study adopt a hip and mixed strategy during forward and backward reaching. In contrast, TD children adopt an adult-like movement pattern. Conclusion: The boundary of stability in an anteroposterior (AP) direction of children with DS aged 7–12 years old was lesser than the matched TD children, especially for the backward direction. These findings may assist therapists in detecting postural control and balance problems in children with DS.
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Affiliation(s)
- Sawika Promsorn
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, 154 Rama I road, Wangmai, Pathumwan, Bangkok 10330, Thailand
| | - Soontharee Taweetanalarp
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, 154 Rama I road, Wangmai, Pathumwan, Bangkok 10330, Thailand
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Downs SJ, Boddy LM, McGrane B, Rudd JR, Melville CA, Foweather L. Motor competence assessments for children with intellectual disabilities and/or autism: a systematic review. BMJ Open Sport Exerc Med 2020; 6:e000902. [PMID: 33324486 PMCID: PMC7722274 DOI: 10.1136/bmjsem-2020-000902] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/29/2020] [Accepted: 11/02/2020] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE Gross motor competence is essential for daily life functioning and participation in physical activities. Prevalence of gross motor competence in children with intellectual disabilities (ID) and/or autism is unclear. This systematic review aimed to identify appropriate assessments for children with ID and/or autism. DESIGN & DATA SOURCES An electronic literature search was conducted using the EBSCOhost platform searching MEDLINE, Education Research Complete, ERIC, CINAHL Plus and SPORTDiscus databases. ELIGIBILITY CRITERIA Included studies sampled children with ID and/or autism aged between 1 and 18 yrs, used field-based gross motor competence assessments, reported measurement properties, and were published in English. The utility of assessments were appraised for validity, reliability, responsiveness and feasibility. RESULTS The initial search produced 3182 results, with 291 full text articles screened. 13 articles including 10 assessments of motor competence were included in this systematic review. There was limited reporting across measurement properties, mostly for responsiveness and some aspects of validity. The Bruininks-Oseretsky Test of Motor Proficiency-2 followed by The Test of Gross Motor Development-2 demonstrated the greatest levels of evidence for validity and reliability. Feasibility results were varied, most instruments required little additional equipment (n=8) and were suitable for a school setting, but, additional training (n=7) was needed to score and interpret the results. CONCLUSION This review found the BOT-2 followed by the TGMD-2 to be the most psychometrically appropriate motor competency assessments for children with ID and/or autism in field-based settings. Motor competence assessment research is limited for these cohorts and more research is needed. PROSPERO REGISTRATION NUMBER CRD42019129464.
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Affiliation(s)
- Samantha J Downs
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Lynne M Boddy
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Bronagh McGrane
- School of Arts Education and Movement, Dublin City University, Dublin, Ireland
| | - James R Rudd
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Craig A Melville
- Institute of Health and Well-being, University of Glasgow, Glasgow, UK
| | - Lawrence Foweather
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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Feasibility and Reliability of Functional Mobility Measures in Children With Cri du Chat (5P-) Syndrome. Pediatr Phys Ther 2020; 32:161-167. [PMID: 32218082 DOI: 10.1097/pep.0000000000000681] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate feasibility and reliability of functional mobility measures in children with Cri du Chat syndrome (CdCS). METHODS Nine children with CdCS and 9 children with typical development (TD) completed the Timed Up and Go, 5 times sit-to-stand test, Timed Floor to Stand, and 4 Square Step Test. Feasibility was determined using testing time and need for modifications. Intraclass correlation coefficients were calculated for intrarater and interrater reliability. RESULTS Children with CdCS required modifications to complete all tests. One child with CdCS completed the 4 Square Step Test. Good reliability was found for both groups. CONCLUSIONS The Timed Up and Go, 5 times sit-to-stand test, and Timed Floor to Stand are feasible and reliable tools for children with TD between ages of 5 and 15 years; however, may require modifications to the protocols to be feasible in children with CdCS. The 4 Square Step Test is not a feasible tool for children with CdCS.
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Ayán Pérez C, Martínez-Lemos I, Lago-Ballesteros J, Cancela Carral JM, Loira-Camiña N. Reliability and Validity of Physical Fitness Field-Based Tests in Down Syndrome: A Systematic Review. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2016. [DOI: 10.1111/jppi.12155] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Carlos Ayán Pérez
- Faculty of Education and Sports Science; University of Vigo; Vigo Spain
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Bandong ANJ, Madriaga GO, Gorgon EJR. Reliability and validity of the Four Square Step Test in children with cerebral palsy and Down syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 47:39-47. [PMID: 26318393 DOI: 10.1016/j.ridd.2015.08.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 07/23/2015] [Accepted: 08/17/2015] [Indexed: 06/04/2023]
Abstract
Little is known about the measurement properties of clinical tests of stepping in different directions for children with cerebral palsy (CP) and Down syndrome (DS). The ability to step in various directions is an important balance skill for daily life. Standardized testing of this skill can yield important information for therapy planning. This observational methodological study was aimed at defining the relative and absolute reliability, minimal detectable difference, and concurrent validity with the Timed Up-&-Go (TUG) of the Four Square Step Test (FSST) for children with CP and DS. Thirty children, 16 with CP and 14 with DS, underwent repeat testing 2 weeks apart on the FSST by 3 raters. TUG was administered on the second test occasion. Intraclass correlation coefficients (ICC [1,1] and [3,1]) with 95% confidence intervals, standard error of measurement (SEM), minimal detectable difference (MDD) and the Spearman rank correlation coefficient were computed. The FSST demonstrated excellent interrater reliability (ICC=.79; 95% CI: .66, .89) and high positive correlation with the TUG (r=.74). Test-retest reliability estimates varied from moderate to excellent among the 3 raters (.54, .78 and .89 for raters 1, 2 and 3, respectively). SEM and MDD were calculated at 1.91s and 5.29s, respectively. Scores on the FSST of children with CP and DS between 5 and 12 years of age are reliable and valid.
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Affiliation(s)
- Aila Nica J Bandong
- Department of Physical Therapy, College of Allied Medical Professions, University of the Philippines Manila, Pedro Gil Street, Malate, 1004 Manila, Philippines
| | - Gilbert O Madriaga
- Department of Epidemiology and Biostatistics, College of Public Health, University of the Philippines Manila, Pedro Gil Street, Malate, 1004 Manila, Philippines
| | - Edward James R Gorgon
- Department of Physical Therapy, College of Allied Medical Professions, University of the Philippines Manila, Pedro Gil Street, Malate, 1004 Manila, Philippines.
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Richter RR, Werner CM. Understanding Validity in Evidence-Based Medicine. J Physician Assist Educ 2015; 26:149-154. [PMID: 26309208 DOI: 10.1097/jpa.0000000000000036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Randy R Richter
- Christine M. Werner, PhD, PA-C, RD, is a professor at Saint Louis University, St Louis, Missouri. Randy R. Richter, PhD, PT, is a professor in the Program in Physical Therapy at Saint Louis University, St Louis, Missouri
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