• Physical Therapy Korea
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• v.23 no.4
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• pp.63-70
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• 2016

Background: The Pediatric Balance Scale (PBS) and the Fullerton Advanced Balance (FAB) scale were used to assess balance function in patients with balance problem. These multidimensional clinical balance scales provide information about potential risk factors for falls. Objects: The purpose of this study was to investigate and compare the predictive properties of the PBS and FAB scales relative to fall risk in children with cerebral palsy (CP) using a receiver operating characteristic analysis. Methods: In total, 49 children with CP (boy=21, girl=28) who were diagnosed with level 1 or 2 according to the Gross Motor Function Classification System participated in this study. The PBS and FAB were performed, and verified cut-off score, sensitivity, specificity, and the area of under the curve (AUC). Results: In this study, the PBS scale was as a predictive measure of fall risk, but the FAB was not significant in children with CP. A cut-off score of 45.5 points provided optimal sensitivity of .90 and specificity of .69 on the PBS, and a cut-off score of 21.5 points provided optimal sensitivity of .90 and specificity of .62 on the FAB. Both scales showed moderately accurate of AUC with .79 and .76, respectively. Conclusion: The PBS is a useful screening tool for predicting fall risk in children with cerebral palsy, and those who score 45.5 or lower indicate a high risk for falls and are in need of balance intervention.

• Physical Therapy Korea
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• v.15 no.1
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• pp.86-95
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• 2008

The Pediatric Balance Scale (PBS) is a modified Berg's Balance Scale developed as a balance measure for school-aged children with mild to moderate motor impairments. The purpose of this study was to determine the inter-examiner reliability of the Korean version of PBS when applied to children with developmental delays. In this study, PBS was administrated to a total of 79 children with developmental delays (17 with global developmental delay, 31 with cerebral palsy, and 31 with mental retardation) in the Seoul Community Rehabilitation Center. Two pediatric trained physical therapists with longer than 13 year of clinical experience scored the children's performance blind, while replaying videotaped data. The inter-examiner reliability was statistically determined by intraclass correlation coefficients (ICCs). The results of this study revealed that the Korean version of PBS seems to have high inter-examiner reliability when applied to children with movement disorders such as global developmental delay (ICC=.96) and cerebral palsy (ICC=.97); however, it has relatively lower inter-examiner reliability (ICC=.78) for children with developmental delay secondary to mental retardation. therefore, the results support that the Korean version of the PBS could be a useful clinical measurement to assess the balance skills for children with developmental delay who have an adequate level of cognition to enable them to fol1ow the verbal instructions to complete the test.

• Journal of the Korean Society of Physical Medicine
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• v.5 no.2
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• pp.281-288
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• 2010

Purpose : The purpose of this study was to examine the correlation between Pediatric Balance Scale(PBS) and Gross Motor Function Measurement(GMFM) with cerebral palsy(CP) children. Methods : 31 ambulatory children with CP were recruited for this study. PBS is a modified version of the Berg’s Balance Scale to access the children with motor impairments. To access the motor functions that directly influence to the functional independence of the ambulatory CP children, total scores of standing category and walking/running/jumping category of GMFM were selectively compared with PBS score by Spearman correlation coefficient analysis. Results : The results revealed high correlation between PBS and GMFM scores both in standing and walking/running/jumping categories(r=.9). Conclusions : Therefore, this study indicates that PBS can be applied not only as a tool to access balance, but also as a measurement to predict and access the level of standing and ambulatory related functions of children with CP.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.1
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• pp.137-145
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• 2013

PURPOSE: The purpose of this study is to examine assessment of test-retest reliability for 13 items of pediatric balance scales, then the intrarater reliability among the raters. METHODS: Study participants included 6 children with spastic cerebral palsy who could walk. Raters were consist of seventy-four, 2nd year physical therapy major students. The children's ability to achieve physical balance was wideotaped for PBS items. The raters watched the tapes and evlauated each child twice. Test-retest reliability was analyzed using the Spearman correlation, and interrater reliability was analyzed using the Kendall's coefficient of concordance for ranks. RESULTS: The total PBS scores averaged 49.22 and 50.06 for first and second tests. Test-retest reliability of PBS individual items were between low and high. The low itmes were 3 items, and high were 4 itmes. Interrater reliability were low agreement. CONCLUSION: Based on the study, the pediatric balance scale is an effective evaluating tool for measuring functional balance of school age child. However, the agreement of students or beginner's interpretation is necessary in conjunction to this study results. On top of that, it is important to provide detailed explanation and repetitive training, which improves the analysis reliability. Also, each category subscores level for the pediatric balance scale must be examined carefully in conjunction to performing test, only after improving match quality via preceding practice.

• The Journal of Korean Physical Therapy
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• v.22 no.4
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• pp.43-48
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• 2010

Purpose: This study was designed to determine the test-retest, inter-rater, and intra-rater reliability of the Pediatric Balance Scale (PBS) when applied to children with cerebral palsy (CP). Methods: Subjects were out-patient children with cerebral palsy at four CP clinics in Gyeonggyi-do and Chungcheong nam-do. For test-retest and inter-rater reliability studies, the PBS was used twice on 7 separate days by twenty-four children with CP. To assess intra-rater reliability, 10 CP subjects were selected by random sampling. Four pediatric-trained physical therapists with 2-13 years of clinical experience scored the children’s performance blindly, while replaying videotaped data. Results: There was no significant difference in total scores (ICC 3,1=0.89, 0.93, 0.90, and 0.91) measured by each of the four therapists on two occasions. The Inter-rater reliability assessed the 1st and 2nd time was high (1stICC 3,1=0.91, 2nd ICC 3,1=0.93). The intra-rater reliability measured by each of the four therapists using the 2nd scores was also high (ICC 3,1=0.98, 0.99, 0.97, and 0.98). Conclusion: The PBS is reliable. We believe that it can be used in characterizing children with CP.

• Physical Therapy Korea
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• v.24 no.1
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• pp.41-50
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• 2017

Background: The Pediatric Balance Scale (PBS) was developed to assess of balance ability in children with balance problem. The PBS was translated into Korean and its reliability had been studied. However, it had need to be verified using psychometric characteristics including item fit and rating scale. Objects: The purpose of this study was to investigate the item fit, item difficulty, and rating scale of the Korean version of PBS using Rasch analysis. Methods: In total, 40 children with cerebral palsy (CP) (boy=17, girl=23) who were diagnosed with level 1 or 2 according to the Gross Motor Function Classification System participated in this study. The PBS was performed, and was verified regarding the item fit, item difficulty, rating scale, and separation index and reliability using Rasch analysis. Results: In this study, the 'transfer', and 'turning to look behind left and right shoulders while standing still' item showed misfit statistics. in total 40 children with CP. Also, 'transfer', 'standing unsupported with feet together' and 'standing with one foot in front' items showed misfit statistics in diplegia CP group. Regardless of the classification of CP, the most difficult item was 'standing on one foot', whereas the easiest item was 'sitting with back unsupported and feet supported on the floor'. The 4 rating scale categories of PBS were acceptable with all criteria. Both item and person separation indices and reliability showed acceptable values. Conclusion: The PBS has been proven reliable, valid and is an appropriate tool, but it needs to modify the items of PBS according to CP classification.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.10 no.4
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• pp.251-257
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• 2016

The Pediatric Balance Scale (PBS) was balance measurement equipment for school-age children with mild to moderate motor impairments. The aims of this study are to examine the correlation between PBS and spatiotemporal gait parameter and to identify the walking function with cerebral palsy through balance scale. The PBS consists of 14 items such as sitting of standing, standing to sitting, transfers, standing unsupported, standing on one foot, turning 360 degrees, turing to look behind, etc., and the spatiotemporal parameters include walking speed, stride length, step length, step width, cadence, double-limb support. All subjects were independently ambulatory children with spastic diplegic cerebral palsy, and they were assessed on PBS and spatiotemporal gait parameters by an experienced pediatric physical therapist. Pearson's correlation coefficient was used to assess the correlation between PBS and spatiotemporal gait parameters, and the level of significance was set at ${\alpha}$ = 0.05. Total score of PBS(r=.49~.58), standing to sitting(r=.48~.60), turning to look behind(r=.47~.53), and pick up object(r=.52~.69) were positively correlated with walking speed, stride length, step length, and cadence. Most items of the PBS were negatively correlated with double-limb support(r=-.48~-.92). These findings suggest that the pediatric balance scale can be applied to estimate gait function level for children with spastic diplegic cerebral palsy.

• The Journal of Korean Physical Therapy
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• v.22 no.6
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• pp.35-42
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• 2010

Purpose: To investigate the rater reliability of a Pediatric Balance Scale (PBS) for children with cerebral palsy, and to investigate possible differences among raters according to their clinical work experience and testing experience. Methods: Study participants included 18 children with spastic cerebral palsy who could walk. They were instructed by pediatric physical therapists, two of whom had ten years of clinical work experience and two who had less than one year of experience. The children's ability to achieve physical balance was videotaped for PBS items. The raters watched the tapes and evaluated each child twice. Rater reliability was analyzed using the intraclass correlation coefficient (ICC). Differences between experienced and novice raters were analyzed using a paired t-test. The statistical significance level was set to 0.05. Results: The total PBS scores averaged 45.78~48.00 and 45.72~47.67 for first and second tests. Intra-rater reliability was very high (ICC=0.89~0.99), and the repeated measurement coincidence was high (p>0.05). Inter-rater reliability was high (ICC=0.83~0.84), but there was a bit of a difference in the coincidence (p<0.05). The experienced raters' reliability and coincidence were higher than those of the novices, and there were differences in reliance and coincidence between experienced and novice raters (p<0.05). Conclusion: Inter-rater and intra-rater reliability is very high. However, rater reliability showed defferences depending on clinical work experience and testing experience. When testing pediatric patients with the PBS, the rater's clinical experience and test experience may affect the test results.

• The Journal of Korean Physical Therapy
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• v.28 no.1
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• pp.22-26
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• 2016

Purpose: The purpose of this study was to evaluate the relation between PBS scores and GMFCS levels and to examine whether pediatric balance scale (PBS) scores were useful for predicting gross motor functional classification system (GMFCS) levels in children with cerebral palsy. Methods: This cross-sectional study was performed conducted for to evaluatione of PBS and GMFCS using in 26 children with cerebral palsy (16 males and 10 females with GMFCS level I to III). PBS total and item scores at different levels of GMFCS were measured. Results: The hHigh PBS item average scores obtained from standing and postural change dimensions except sitting dimension were observed at the low levels of GMFCS and these results were statistically significant (p<0.05). The relation between PBS (standing and postural change dimensions) and GMFCS levels were was significantly different, except the relation between PBS sitting dimension and GMFCS levels showing a ceiling effect. Conclusion: GMFCS is designed to for classificationy of gross motor functions emphasizing on walking movement and PBS is was developed to for evaluatione of functional balance. Based on the results of this study showing high relation between GMFCS levels and PBS scores, PBS scores can be used for predicting GMFCS levels.

• Physical Therapy Korea
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• v.22 no.2
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• pp.52-58
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• 2015

Balance control deficits have been indicated to be a primary problem among cerebral palsy (CP) patients. Fabric ankle foot orthosis (AFO) can allow more efficient balance control by facilitating proprioception. The purpose of this study was to investigate the immediate effect of fabric AFO on balance, compared to a barefoot condition in children with unilateral CP. Twelve children with unilateral CP participated in this study. Their balance ability was evaluated using pediatric balance scale and bubble test. Both pediatric balance scale and bubble test showed significant improvement with the use of the fabirc AFO (p<.05). The fabric AFO could improve functional balance ability, and promote better balance among children with unilateral CP. We demonstrated that fabric AFO contributed to improving balance among children with unilateral CP, classified as Gross Motor Function Classification System level I and II. Consequently, fabric AFO might be an assistive device leading to the improvement of balance instead of the typical AFOs.