Components of Standing Postural Control Evaluated In Pediatric Balance Measures: A Scoping Review

Publication date: Available online 22 April 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Kathryn M. Sibley, Marla K. Beauchamp, Karen Van Ooteghem, Marie Paterson, Kristy DM. Wittmeier
ObjectiveTo identify measures of standing balance validated in pediatric populations and determine the components of postural control captured in each tool.Data SourcesElectronic searches of Medline, Embase, and CINAHL databases using key word combinations of postural balance/ equilibrium, psychometrics/ reproducibility of results/ predictive value of tests, child/ pediatrics; grey literature; and hand searches.Study SelectionInclusion criteria were measures with a stated objective to assess balance, pediatric (<=18 years) populations, at least one psychometric evaluation, one standing task, standardized protocol and evaluation criteria, and published in English. Two reviewers independently identified studies for inclusion. 21 measures were included.Data extractionTwo reviewers extracted descriptive characteristics and two investigators independently coded components of balance in each measure using a systems perspective for postural control, an established framework for balance in pediatric populations.Data synthesisComponents of balance evaluated in measures were underlying motor systems (100% of measures), anticipatory postural control (72%), static stability (62%), sensory integration (52%), dynamic stability (48%), functional stability limits (24%), cognitive influences (24%), verticality (9%), and reactive postural control (0%).LimitationsThe review did not consider difficulty of items or non-standing postural tasks.ConclusionsAssessing children's balance with valid and comprehensive measures is important for ensuring development of safe mobility and independence with functional tasks. Balance measures validated in pediatric populations to date do not comprehensively assess standing postural control and omit some key components for safe mobility and independence. Existing balance measures, which have been validated in adult populations and address some of the existing gaps in pediatric measures, warrant consideration for validation in children.



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