Purpose: Evaluate validity of the Clinical Test of Sensory Integration of Balance (CTSIB) when scored using Kids-Balance Evaluation Systems Test (Kids-BESTest) criteria compared to laboratory measures of postural control.
Method: Participants were 58 children, 7-18 years, 17 with ambulant CP (Diplegia=4, Hemiplegia=13; 11 males) and 41 typically developing (TD). Postural control in standing was assessed using CTSIB items for firm and foam surfaces, with eyes open (EO) then closed (EC). Face validity was evaluated by comparing clinical Kids-BESTest scores between groups, from 0='unable' to 3='stable for 30s'. Concurrent and content validity were assessed by evaluating force plate centre-of-pressure (CoP) data (excursion, velocity, area) and correlating this with clinical scores.Results: Face validity: TD children scored 2-3 points for all CTSIB conditions, whereas children with CP scored lower (0-3 points). Concurrent validity: agreement between clinical and CoP derived scores ranged from poor to excellent (Firm-EO=76%, Firm-EC=76%, Foam-EO=59%, Foam-EC=94%). Clinical scores of '2-unstable' and '3stable' were not distinguished reliably by force plate measures. Content validity for children with CP: significant correlations were found between clinical scores and CoP data for the two intermediate conditions (Firm-EC: rs -0.40 to -0.72; Foam-EO: rs -0.12 to -0.50), but not the easier (Firm-EO: rs -0.41 to -0.36) or harder conditions (Foam-EC: rs -0.25 to -0.27).
Conclusion: Face validity of Kids-BESTest CTSIB criteria was supported. Content and concurrent validity were partially supported. To improve Kids-BESTest scoring, new terms were recommended to better describe postural characteristics of '2-unstable'. 3 Abbreviations Antero-posterior (AP) BOS (Base-of-support) Cerebral Palsy (CP) CoM (Centre-of-Mass) CoP (Centre-of-pressure) CTSIB (Clinical Test of Sensory Integration of Balance) EO (Eyes open) EC (Eyes closed) Kids-Balance Evaluation Systems Test (Kids-BESTest) Medio-lateral (ML) Typically Developing (TD)