Validity, responsiveness, minimal detectable change, and minimal clinically important change of Pediatric Balance Scale in children with cerebral palsy.
Use PBS change scores ≥ 1.6 points (total scale) to claim real balance improvement and ≥ 3.7–5.8 points to claim clinically important change in kids with CP.
01Research in Context
What this study did
The team tested the Pediatric Balance Scale (PBS) in children with cerebral palsy. They wanted to know if the scale truly measures balance and how big a change counts as real progress.
Kids were tested twice to see how scores move when nothing special is done. This gave the numbers you need to judge later therapy gains.
What they found
The PBS showed fair-to-excellent validity and moderate responsiveness. A child must gain at least 1.6 points before you can say the balance really improved.
To claim the change matters in daily life, aim for a jump of 3.7 to 5.8 points on the 56-point scale.
How this fits with other research
Dijkhuizen et al. (2017) tried the modified Berg Balance Scale in adults with both intellectual and visual disabilities. They found poor validity and no link to future falls. The PBS works better in kids with CP than the mBBS works in that adult group.
Oppewal et al. (2013) showed the regular Berg is feasible in older adults with ID, but average scores sit 20 years below age norms. Together these papers warn: Berg-family tools can be useful, yet you must pick the version built for your client's age and diagnosis.
Arnkelsson et al. (2016) gave strong support numbers for the Supports Intensity Scale in adults with motor disability. Their high validity marks match the PBS results, giving you two solid choices: PBS for balance change in kids, SIS for support needs in adults.
Why it matters
You now have cut-offs to turn PBS numbers into plain talk for parents and payers. If a child gains less than 1.6 points, call it stable and keep training. Hit 3.7 or more and celebrate real-world progress. Share these thresholds in your next progress report.
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02At a glance
03Original abstract
This study examined criterion-related validity and clinimetric properties of the pediatric balance scale (PBS) in children with cerebral palsy (CP). Forty-five children with CP (age range: 19-77 months) and their parents participated in this study. At baseline and at follow up, Pearson correlation coefficients were used to determine criterion-related validity by analyzing the correlation between the PBS, including PBS-static, PBS-dynamic, and PBS-total, and criterion measures, including the Gross Motor Function Measure-66 items (GMFM-66) and Functional Independence Measures for Children (WeeFIM). Responsiveness was examined by paired t test and by standardized response mean (SRM). The minimal detectable change (MDC) was analyzed at the 90% confidence level, and the minimal clinically important differences (MCID) was estimated by anchor-based and distribution-based approaches. The PBS with GMFM-66 and WeeFIM showed fair-to-excellent concurrent validity at pretreatment and follow up and predictive validity. The SRM values of all PBS scales were 0.75. For the PBS-static, PBS-dynamic, and PBS-total, the MDC(90) values were 0.79, 0.96, and 1.59, and the MCID ranges were 1.47-2.92, 2.23-2.92, and 3.66-5.83, respectively. Improvement of at least MDC values on the PBS can be considered a true change, not measurement error. A mean change must exceed the MCID range on PBS to be considered clinically important change. Therefore, all PBS scales were moderately responsive to change. Clinicians and researchers can use these clinimetric data for PBS to determine if a change score represents a true or clinically meaningful effect at posttreatment and follow up.
Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2012.11.006