Normative reference values for functional, lateral, and oblique direction reach tests in Saudi children aged six to 15 years old and psychometric properties of the oblique direction reach test

Effect of Foot Posture on Limits of Stability in Children With Spastic Diplegic Cerebral Palsy

Cerebral palsy (CP) is a neurological condition that affects musculoskeletal system causing altered balance control, which is governed by constant adjustments by muscular activity and joint positioning. Since the foot is the platform upon which we stand and balance, it is important to study and characterize foot posture abnormalities in CP to better understand their possible effect on multidirectional limits of stability (MDLS) in standing. Our aim was to find relation between foot posture and MDLS in diplegic children. Thirty diplegics (13 pes-planus and 17 pes-cavus) between the age of 6 to 14, gross motor function classification system (GMFCS) levels I and II, whose parents consented were included in this study. Diplegics unable to stand unsupported for < 2 minutes, undergone lower-limb surgeries in 6 months, having visual impairments were excluded. Foot posture was assessed with arch index, MDLS were measured by GEAMASTER stabilometer. There was significant positive correlation between foot posture and limits of stability. Diplegic children having pes-planus have better MDLS as compared with pes-cavus.

Balance performance among horseback-rider compared to non-horseback-rider women in Saudi Arabia: A cross-sectional study

Horseback riding requires adapting to constant changes in balance conditions, maintaining equilibrium on the horse, and preventing falls. However, differences in balance performance among horseback riders and non-rider-healthy young women in Saudi Arabia have not been explored. This study investigates whether horseback-rider women would perform better on static and dynamic balance tests than non-rider women. Also, the study examined the effect of years of horseback riding on balance performance in the rider group. Twenty healthy young females participated in the study using a convenience sampling method. Ten were riders, and ten were non-riders. Static and dynamic balance tests, including the Berg balance scale (BBS), timed up and go (TUG), and unipedal stance test (UPST), was obtained from all subjects. Descriptive and inferential statistics were used to compare balance performance between the horseback riders and non-riders groups. The horseback-rider group had statistically significantly higher scores on both the static and dynamic tests than non-riders: BBS test (Z = -2.537, P = .011), TUG (t = -3.889, P = .001), and unipedal stance test with the eyes open and closed (t = 14.048, t = 13.639, P = .000). Our rider sample did not show a statistically significant correlation between years of riding and balance scores. The horseback riders have greater static and dynamic balance abilities than non-riders. Further study is needed to compare the balance performance between experienced riders versus beginners among healthy adults in Saudi Arabia.

Oblique, forward, and lateral directions reach test distances in young adults, and concurrent validity of these tests with the center of pressure excursion in assessing the limits of stability

Limits of stability is required to perform functional activities and other advanced tasks of life without losing balance, and assessment of limits of stability is essential in clinical practice. Forward, Lateral, and Oblique direction reach tests are clinical balance tests that assess limits of stability, and these reach distances in various directions may be symmetrical or asymmetrical. The aim was to establish the symmetry between various reach distances on three reach tests and to establish the concurrent validity of oblique, forward, and lateral direction reach test distances with limits of stability measured by the Iso Free machine of TecnoBody company.

METHODS

The measurements of oblique, forward, and lateral reach tests and limits of stability excursions of center of pressure were taken in eight directions on Iso Free machine of Techno Body in fifty typical college-going young adults who were recruited through convenience sampling. Pearson correlation test was used to find the relationship between forward, lateral, and oblique direction reaches and limits of stability in forward, lateral, and oblique directions. Regression analysis was used to find the factors influencing the forward, lateral, and oblique reach tests.

RESULTS

The reach distances were symmetrical, and out of the three tests, the lateral and oblique direction reach tests have a moderate positive correlation with limits of stability test in lateral and oblique directions with an r-value of 0.569 (p < 0.001) and 0.50 (p < 0.001) respectively. A Significant standardized beta value of 0.49 (p < 0.05) for the oblique direction reach test with total stability limits.

CONCLUSIONS

The oblique and lateral direction reach tests are correlated with their respective center of pressure excursion. However, the oblique direction reach test moderately correlated with the total limits of stability scores. Forward reach distances were more in number followed by oblique and lateral reach distances among young Saudi adults.

Normative values and factors affecting Pediatric Reach Tests in Saudi children aged 6-11 years in the eastern province: cross-sectional study

Background

The Pediatric Reach Tests (PRTs) assess balance while standing-the Functional Reach Test (FRT) and Lateral Reach Test (LRT)-and in a sitting position-the Modified Functional Reach Test (MFRT) and Modified Lateral Reach Test (MLRT). Normative values have not been fully evaluated in Saudi children. The objectives are; to estimate the normative values for PRTs; investigate the correlation between the PRTs and demographic/anthropometric characteristics; and develop predictive equations for the PRTs.

Methods

In this cross-sectional study, 251 children aged 6-11 were recruited. The PRTs were measured and correlated with demographic/anthropometric variables. A stepwise regression was conducted to develop the predictive equations for the PRT scores.

Results

The mean and standard deviations (in cm) of the PRT scores were as follows: FRT = 20.02 ± 4.31; LRT = 13.42 ± 3.38; MFRT = 21.49 ± 4.70, and MLRT = 14.64 ± 3.66. Several significant correlations were found. Moderate correlations existed between the PRT scores and age, height, upper extremity length, lower extremity length, and foot length; there was a weak correlation with body mass index. Weight was moderately correlated with FRT and MFRT and weakly correlated with LRT and MLRT. The correlation between the base of support and LRT was moderate and was weak with FRT, MFRT, and MLRT. A weak correlation was found between sex and LRT. Age and height were the most predictive of PRT scores.

Conclusion

This study provided PRT normative values that can be used as a clinical reference for evaluating balance in typically developing children.

Oblique direction reach test: evaluating psychometric properties in stroke population

Background

Post-stroke individuals are observed to have reduced limits of stability (LOS) in all directions. Functional activities are rarely performed in pure cardinal planes; instead, they are most likely to be performed in an oblique direction. Existing tools are either expensive or sophisticated to assess the LOS in an oblique direction. Therefore, this study's primary objective is to evaluate the intra-rater, inter-rater reliability, and validity of the oblique direction reach test (ODRT) among stroke subjects.

Materials & Methods

A total of 96 first-time stroke patients with age, gender, height, and weight-matched healthy controls aged 18-80 years were recruited for the study. Oblique, forward, and lateral reach distances were assessed using the standard procedure of ODRT, Functional Reach Test (FRT), and Lateral Reach Test (LRT), respectively. Validity was tested by correlating the ODRT distance with the Berg Balance Scale (BBS) Score using Spearman's rank correlation coefficient. Intraclass correlation coefficients (ICCs) and Bland Altman analysis were used to establish inter-rater reliability. ICCs were used to find intra-rater reliability. The Mann-Whitney U test was used to establish the mean difference of the FRT, LRT, and ODRT. Spearman's rank correlation coefficient and linear regression were used to correlate the distance of FRT and LRT with ODRT.

Results

A high concurrent validity was found between BBS and ODRT with an r-value of 0.905 (p < 0.001). Inter-rater reliability was high with an ICC of 0.997 (95% CI [0.996-0.998]), and intra-rater reliability was highly significant with an ICC of 0.996 (95% CI [0.994-0.998]). The stroke subjects reached a significantly shorter distance than healthy individuals in FRT, ODRT, and LRT. ODRT was highly correlated with FRT (r = 0.985) and LRT (r = 0.978) (p < 0.001) and had an R2 = 0.987.

Conclusion

ODRT is a highly valid and reliable tool that can be used to evaluate balance in stroke patients. Individuals who reached less in the forward and lateral directions showed reduced reach distance in the oblique direction.