Psychometric properties of functional postural control tests in children: A systematic review

Charlotte Johnson; Ann Hallemans; Mieke Goetschalckx; Pieter Meyns; Eugene Rameckers; Katrijn Klingels; Evi Verbecque

doi:10.1016/j.rehab.2022.101729

Psychometric properties of functional postural control tests in children: A systematic review

Ann Phys Rehabil Med. 2023 May;66(4):101729. doi: 10.1016/j.rehab.2022.101729. Epub 2023 Jan 18.

Authors

Charlotte Johnson¹, Ann Hallemans², Mieke Goetschalckx³, Pieter Meyns³, Eugene Rameckers⁴, Katrijn Klingels³, Evi Verbecque³

Affiliations

¹ Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2610 Wilrijk, Belgium; Rehabilitation Research Centre (REVAL), Faculty of Rehabilitation Sciences and Physiotherapy, Hasselt University, 3590 Diepenbeek, Belgium. Electronic address: charlotte.johnson@uantwerpen.be.
² Research Group MOVANT, Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, 2610 Wilrijk, Belgium.
³ Rehabilitation Research Centre (REVAL), Faculty of Rehabilitation Sciences and Physiotherapy, Hasselt University, 3590 Diepenbeek, Belgium.
⁴ Rehabilitation Research Centre (REVAL), Faculty of Rehabilitation Sciences and Physiotherapy, Hasselt University, 3590 Diepenbeek, Belgium; Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, 6229 Maastricht, the Netherlands; Center of expertise Adelante rehabilitation, 6301 KA Valkenburg, the Netherlands.

PMID: 36669385
DOI: 10.1016/j.rehab.2022.101729

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.

Publication types

Systematic Review
Review

MeSH terms

Cerebral Palsy*
Child
Humans
Postural Balance*
Psychometrics / methods
Reproducibility of Results
Research Design