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Measuring Postural Stability in Young Children With Cerebral Palsy: A Comparison of 2 Instruments

Elizabeth Randall, Katharine PT, MScPT, MSc; Bartlett, Doreen J. PT, PhD; McCoy, Sarah Westcott PT, PhD, FAPTA

doi: 10.1097/PEP.0000000000000062
Research Article

Purpose: To compare construct validity, interrater and test-retest reliabilities of the Pediatric Reach Test and the Early Clinical Assessment of Balance (ECAB), and their relationships with the Gross Motor Function Measure, 66-item version, Basal and Ceiling approach (GMFM-66-B&C) to appraise clinical utility of postural stability measures for children with cerebral palsy (CP).

Methods: A total of 28 children with CP, 2 to 7 years old, across all functional ability levels participated in 2 assessments over 2 weeks. Two assessors scored the measures during the first assessment.

Results: Both measures demonstrated construct validity, rs of 0.88 (P < .001). Both measures correlated with GMFM-66-B&C, rs > 0.95. Interrater and test-retest reliabilities were stronger for the ECAB than for the Pediatric Reach Test (intraclass correlation coefficients > 0.98 vs 0.87-0.94). The ECAB demonstrated lower measurement error and proportionately smaller minimal detectable change values.

Conclusion: The ECAB is considered the better measure of postural stability among children with CP.

The authors consider the Early Clinical Assessment of Balance a better clinical measure of postural stability than the Pediatric Reach Test.

Health and Rehabilitation Sciences Program (Ms Randall), and School of Physical Therapy (Dr Bartlett), Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada; CanChild Centre for Childhood Disability Research (Dr Bartlett), McMaster University, Hamilton, Ontario, Canada; Department of Rehabilitation Medicine (Dr Westcott), Division of Physical Therapy, University of Washington, Seattle.

Correspondence: Katharine Elizabeth Randall, PT, MScPT, MSc, Health and Rehabilitation Sciences Program, Faculty of Health Sciences, The University of Western Ontario, 1151 Richmond St, London, ON N6A 3K7, Canada (

Grant Support: This project was funded by the Physiotherapy Foundation of Canada Community Rehab Grant.

The authors declare no conflicts of interests.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins and the Section on Pediatrics of the American Physical Therapy Association.