COSMIN database

Clinical tools to assess balance in children and adults with cerebral palsy: a systematic review

Saether, R., Helbostad, J. L., Riphagen, II, and Vik, T.
We aimed to review tools used to assess balance in clinical practice in children and adults with cerebral palsy (CP), to describe their content and measurement properties and to evaluate the quality of the studies that have examined these properties. CINAHL, Embase, and PubMed/MEDLINE were searched. The COnsensus-based Standards for selection of health Measurement INstruments (COSMIN) was used to assess the 'quality of studies' and the Terwee criteria were used to assess the 'result of studies'. Twenty-two clinical balance tools were identified from 35 papers. The content and focus of the tools varied significantly. There was moderate or limited levels of evidence for most of the measurement properties of the tools; the strongest level of evidence was found for the Trunk Control Measurement Scale and the Level of Sitting Scale, in the category 'maintain balance', the Timed Up and Go and the Segmental Assessment of Trunk Control in the categories 'achieve balance' and 'restore balance' respectively. Information on responsiveness was scarce. Further studies providing better evidence for reliability and responsiveness for clinical balance tools are needed. In the meantime, results of studies evaluating effects of treatment of balance in individuals with CP should be interpreted with caution.
Dev Med Child Neurol
1469-8749 (Electronic)
Publication year:
Biological and physiological variables:
Biological and physiological variables
Functional status:
Physical functioning
Adults (18-65)
Children (0-18)
Seniors (65+)
Certain conditions originating in the perinatal period and related symptoms
Diseases of and symptoms related to the nervous system
PRO / non-PRO:
Non-patient Reported Outcome
Type of measurement instrument:
4 - Performance-based tests
6 - Clinical rating scales
7 - Observations
BBS - Berg Balance Scale   
FRT - Functional Reach Test   
FWT - Functional Walking Test
HTS - Heel-to-Toe Stand
LSA - Level of Sitting Ability
LSS - Level of Sitting Scale
MPAS - Modified Posture Assessment Scale
PAS - Posture Assessment Scale
PBS - Pediatric Balance Scale
P-CTSIB - Pediatric Clinical Test of Sensory Interaction for Balance
PPAS - Posture and Posture Ability Scale
PRT - Pediatric Reach Test
SACND - Sitting Assessment of Children with Neuromotor Dysfunction
SAROMM - Spinal alignment and range of motion measure
SAS - Sitting Assessment Scale
SATCo - Segmental Assessment of Trunk Control
SPCM - Seated Postural Control Measure
TCMS - Trunk Control Measurement Scale
TIS - Trunk Impairment Scale (two different scales; one scale developed by Verheyden et al 2004; one scale developed by Fujiwara et al. 2004 )   
TOLS - Timed One-Leg Stance
TUDS - Timed Up-and-Down Stairs
TUG - Timed Up and Go test