Clinical Bottom Line
“How could I apply this information?”
In recent years, several tests of balance for use with children have emerged. A notable shortcoming of all these tests is the lack of control of characteristics known or suspected to effect balance: gender, height, weight, and body mass index. The authors have made tremendous progress in evaluating how these characteristics affect outcome scores on the Pediatric Balance Scale. More than 600 preschool- and school-aged children developing typically were tested. Analysis of their data supported the idea that (1) age is a factor, particularly for children younger than 5 years; (2) gender affected static, but not anticipatory balance scores; (3) body mass index had only a weak correlation with scores; and (4) height and weight affected scores. Maximum score was attained by most children older than 6 years (ceiling effect) limiting its usefulness to testing children less than this age. Means and standard deviations by age and gender are provided.
The following is the bottom line. Therapists must exercise caution when interpreting scores of balance tests that have not been normed or standardized for age and gender. Neither this test nor any of the tools currently available (eg, timed up and go, Functional Reach Test, pediatric Berg Balance Scale) have been normed or standardized. Therefore, these tests cannot be used to determine whether a delay or deficit in balance exists. As noted by the authors, the very small number of subjects in the youngest group, where most change was evident, and the unequal distribution of gender within age groups did not enable normative interpretation of the scores provided here.
“What should I be mindful about in applying this information?”
The Pediatric Balance Scale does provide a reliable measure of balance for children younger than 6 years. The test is sensitive in detecting change and can thus be used to monitor changes in balance ability in any particular child. However, the lack of normative standardized data does not enable therapists to interpret whether changes are clinically meaningful or simply due to maturation, or to compare groups of children.
Rose Marie Rine, PT, PhD Specialty Therapy Source, LLC, Jacksonville, Florida
James G. Moore, PT, PhD, PCS Children's Therapies, Inc, Jupiter, Florida