Abstract
Objective
Evaluate the validity of the Kids-Balance Evaluation Systems Test (Kids-BESTest) clinical
criteria for the Functional Reach Test (FRT) forward and lateral with laboratory measures
of postural control in children with cerebral palsy (CP).
Design
Psychometric study of face, concurrent, and content validity.
Setting
Clinical laboratory.
Participants
Children (N=58) aged 7-18 years (ambulant CP n=17, typically developing [TD] n=41).
Intervention
Not applicable.
Main Outcome Measures
Stability limits in standing were assessed using the Kids-BESTest items for FRT forwards
(FRTFORWARD), FRT lateral preferred (FRTLATERAL(P)), and FRT lateral nonpreferred (FRTLATERAL(NP)). Force platforms and kinematic markers were used to collect information on center
of pressure (CoP) and joint movement during reach. Analyses included face validity
(Kids-BESTest scores compared between CP and TD groups), concurrent validity (agreement
between Kids-BESTest scores and digitally derived scores), and content validity (relations
between Kids-BESTest scores with kinematic and CoP data).
Results
Face validity of Kids-BESTest criteria was demonstrated with lower scores for CP compared
to TD groups for FRTFORWARD (P<.001) and FRTLATERAL(NP) (P=.03) and equal scores for FRTLATERAL(P) (P=.12). For concurrent validity, agreement between Kids-BESTest scores and digitally
derived scores was good to excellent for FRTLATERAL(both P/NP) (88%-100%) and good for FRTFORWARD (86%-88%) for both groups. For content validity, the CP group Kids-BESTest scores
were correlated with CoP-RangeFORWARD during FRTFORWARD (ρ=0.68) and CoP-RangeLATERAL during FRTLATERAL(NP) (ρ=0.57). For kinematic data, correlations were moderate-high between Kids-BESTest
scores and range of hip flexion (ρ=0.51) and ankle plantar flexion (ρ=0.75) during
FRTFORWARD, and trunk lateral flexion (ρ=0.66) during FRTLATERAL(NP).
Conclusion
The FRTFORWARD demonstrated face, concurrent, and content validity. The FRTLATERAL(P/NP) demonstrated concurrent validity, but partial face and content validity. To improve
validity of Kids-BESTest FRT criteria, additional descriptors have been added under
the scoring criteria to enable clinicians to quantify observed reach strategies.
Keywords
List of abbreviations:
BoS (base of support), CoM (center of mass), CoP (center of pressure), CP (cerebral palsy), FRT (Functional Reach Test), Kids-BESTest (Kids-Balance Evaluation Systems Test), NP (nonpreferred), P (Preferred), TD (typically developing)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: January 25, 2021
Footnotes
Supported by the Research Foundation of Cerebral Palsy Alliance, New South Wales, Australia (grant no. PG4114) through the Children’s Motor Control Research Collaboration.
Disclosures: none.
Identification
Copyright
© 2021 by the American Congress of Rehabilitation Medicine