Objective

Evaluate the validity of the Kids-Balance Evaluation Systems Test (Kids-BESTest) clinical criteria for the Functional Reach Test (FRT) forward and lateral with laboratory measures of postural control in children with cerebral palsy (CP).

Design

Psychometric study of face, concurrent, and content validity.

Setting

Clinical laboratory.

Participants

Children (N=58) aged 7-18 years (ambulant CP n=17, typically developing [TD] n=41).

Intervention

Not applicable.

Main Outcome Measures

Stability limits in standing were assessed using the Kids-BESTest items for FRT forwards (FRT_FORWARD), FRT lateral preferred (FRT_LATERAL(P)), and FRT lateral nonpreferred (FRT_LATERAL(NP)). Force platforms and kinematic markers were used to collect information on center of pressure (CoP) and joint movement during reach. Analyses included face validity (Kids-BESTest scores compared between CP and TD groups), concurrent validity (agreement between Kids-BESTest scores and digitally derived scores), and content validity (relations between Kids-BESTest scores with kinematic and CoP data).

Results

Face validity of Kids-BESTest criteria was demonstrated with lower scores for CP compared to TD groups for FRT_FORWARD (P<.001) and FRT_LATERAL(NP) (P=.03) and equal scores for FRT_LATERAL(P) (P=.12). For concurrent validity, agreement between Kids-BESTest scores and digitally derived scores was good to excellent for FRT_{LATERAL(both P/NP)} (88%-100%) and good for FRT_FORWARD (86%-88%) for both groups. For content validity, the CP group Kids-BESTest scores were correlated with CoP-Range_FORWARD during FRT_FORWARD (ρ=0.68) and CoP-Range_LATERAL during FRT_LATERAL(NP) (ρ=0.57). For kinematic data, correlations were moderate-high between Kids-BESTest scores and range of hip flexion (ρ=0.51) and ankle plantar flexion (ρ=0.75) during FRT_FORWARD, and trunk lateral flexion (ρ=0.66) during FRT_LATERAL(NP).

Conclusion

The FRT_FORWARD demonstrated face, concurrent, and content validity. The FRT_{LATERAL(P/NP)} demonstrated concurrent validity, but partial face and content validity. To improve validity of Kids-BESTest FRT criteria, additional descriptors have been added under the scoring criteria to enable clinicians to quantify observed reach strategies.

中文翻译：

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功能范围测试的姿势控制性能：儿童平衡评估系统测试 (Kids-BESTest) 标准的有效性

客观的

评估儿童平衡评估系统测试 (Kids-BESTest) 临床标准的有效性，用于脑瘫 (CP) 儿童姿势控制的实验室测量前后功能测试 (FRT)。

设计

面子效度、并发效度和内容效度的心理测量研究。

环境

临床实验室。

参与者

7-18 岁的儿童 (N=58)（行走的 CP n=17，通常发育 [TD] n=41）。

干涉

不适用。

主要观察指标

站立时的稳定性限制使用儿童最佳项目进行评估，用于 FRT 前倾 (FRT _FORWARD )、FRT 横向首选 (FRT _LATERAL(P) ) 和 FRT 横向非首选(FRT _LATERAL(NP) )。力平台和运动学标记用于收集有关压力中心 (CoP) 和伸展过程中关节运动的信息。分析包括表面效度（CP 和 TD 组之间比较的 Kids-BESTest 分数）、并发效度（Kids-BESTest 分数和数字派生分数之间的一致性）和内容效度（Kids-BESTest 分数与运动学和 CoP 数据之间的关系）。

结果

与 TD 组相比，FRT _FORWARD ( P <.001) 和 FRT _LATERAL(NP) ( P = .03) 和 FRT _LATERAL(P) ( P =.12）。对于并发有效性，Kids-BESTest 分数和数字派生分数之间的一致性对于 FRT _{LATERAL（均为 P/NP）}（88%-100%）和 FRT _FORWARD（86%-88%）均良好至极好（86%-88%）。对于内容有效性，CP组儿童-BESTEST得分与COP-范围相关_FORWARD FRT期间_FORWARD（ρ= 0.68）和COP-范围_LATERAL FRT期间_横向(NP) (ρ=0.57)。对于运动学数据，Kids-BESTest 分数与 FRT _FORWARD期间的髋关节屈曲范围 (ρ=0.51) 和踝关节跖屈 (ρ=0.75)以及 FRT _LATERAL期间躯干侧屈 (ρ=0.66)之间的相关性为中高_NP）。

结论

FRT _FORWARD展示了表面效度、并发效度和内容效度。FRT _{LATERAL(P/NP)}表现出同时效度，但部分表面效度和内容效度。为了提高 Kids-BESTest FRT 标准的有效性，在评分标准下添加了额外的描述符，以使临床医生能够量化观察到的到达策略。