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Checks and balances : a meta-analysis on the known-groups validity of functional postural control tests in children

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Abstract
INTRODUCTION: Pediatric physical therapists commonly treat children with postural control deficits. Ideally, pediatric functional postural control tests should therefore be able to identify postural control deficits in children with various disorders. Despite a plethora of available tests, evidence for their validity - especially known-groups - remains scarce. This review aims to determine the known-group validity of available functional postural control tests to differentiate various pediatric pathological groups of different ages from their typically developing (TD) peers. EVIDENCE ACQUISITION: PubMed, Web of Science and Scopus were systematically searched (last update: February 2023; PROSPERO: CRD42023408982). Forty case-control studies with a pathological pediatric sample (N.=1331) and TD peers (N.=1889) were included and selected for data-extraction and -analysis. Risk of bias was assessed using the SIGN checklist and level of evidence was scored using GRADE. Random-effect meta-analyses were performed to estimate pooled standardized mean differences (SMD) for the various test types and subclassified based on pathology and/or age. EVIDENCE SYNTHESIS: When compared with TD peers, children with underlying pathologies performed significantly worse on pediatric functional postural control test batteries (SMD=-2.21), the Timed Up and Go Test and variants (SMD=2.30), the One Leg Stance test and variants (SMD=-2.14), while the Reach tests showed a smaller difference (SMD=-1.19). Subclassification within the meta-analyses showed that pathology was an influencing factor for the test batteries and the one leg stance test and variants. Age was an influencing factor for the reach tests. None of the included functional postural control tests exceeded a low level of evidence. CONCLUSIONS: Pediatric functional postural control tests that assess multiple aspects of postural control (such as test batteries) seem to offer higher known-groups validity than single-task tests (e.g. reach tests). The underlying pathology has a larger impact on the validity of these tests than age. There remains an overall low level of evidence for the known-groups validity of pediatric functional postural control tests indicating the need for research with more homogenous groups and norm reference data.
Keywords
Children, Postural balance, Reproducibility of results, LATERAL REACH TESTS, NORMAL VALUES, BRAIN-INJURY, GO TEST, PERFORMANCE, HEARING, ADOLESCENTS, RELIABILITY, DISABILITY, MATURATION

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MLA
Ockerman, Jorn, et al. “Checks and Balances : A Meta-Analysis on the Known-Groups Validity of Functional Postural Control Tests in Children.” EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE, vol. 60, no. 4, 2024, pp. 656–70, doi:10.23736/s1973-9087.24.08187-5.
APA
Ockerman, J., Velghe, S., Van Bladel, A., Auvinet, E., Saldien, J., Klingels, K., … Verbecque, E. (2024). Checks and balances : a meta-analysis on the known-groups validity of functional postural control tests in children. EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE, 60(4), 656–670. https://doi.org/10.23736/s1973-9087.24.08187-5
Chicago author-date
Ockerman, Jorn, Silke Velghe, Anke Van Bladel, Edouard Auvinet, Jelle Saldien, Katrijn Klingels, Lynn Bar-On, and Evi Verbecque. 2024. “Checks and Balances : A Meta-Analysis on the Known-Groups Validity of Functional Postural Control Tests in Children.” EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE 60 (4): 656–70. https://doi.org/10.23736/s1973-9087.24.08187-5.
Chicago author-date (all authors)
Ockerman, Jorn, Silke Velghe, Anke Van Bladel, Edouard Auvinet, Jelle Saldien, Katrijn Klingels, Lynn Bar-On, and Evi Verbecque. 2024. “Checks and Balances : A Meta-Analysis on the Known-Groups Validity of Functional Postural Control Tests in Children.” EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE 60 (4): 656–670. doi:10.23736/s1973-9087.24.08187-5.
Vancouver
1.
Ockerman J, Velghe S, Van Bladel A, Auvinet E, Saldien J, Klingels K, et al. Checks and balances : a meta-analysis on the known-groups validity of functional postural control tests in children. EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE. 2024;60(4):656–70.
IEEE
[1]
J. Ockerman et al., “Checks and balances : a meta-analysis on the known-groups validity of functional postural control tests in children,” EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE, vol. 60, no. 4, pp. 656–670, 2024.
@article{01J01943GS06DXBKGYGVWSY2VG,
  abstract     = {{INTRODUCTION: Pediatric physical therapists commonly treat children with postural control deficits. Ideally, pediatric functional postural control tests should therefore be able to identify postural control deficits in children with various disorders. Despite a plethora of available tests, evidence for their validity - especially known-groups - remains scarce. This review aims to determine the known-group validity of available functional postural control tests to differentiate various pediatric pathological groups of different ages from their typically developing (TD) peers.
EVIDENCE ACQUISITION: PubMed, Web of Science and Scopus were systematically searched (last update: February 2023; PROSPERO: CRD42023408982). Forty case-control studies with a pathological pediatric sample (N.=1331) and TD peers (N.=1889) were included and selected for data-extraction and -analysis. Risk of bias was assessed using the SIGN checklist and level of evidence was scored using GRADE. Random-effect meta-analyses were performed to estimate pooled standardized mean differences (SMD) for the various test types and subclassified based on pathology and/or age.
EVIDENCE SYNTHESIS: When compared with TD peers, children with underlying pathologies performed significantly worse on pediatric functional postural control test batteries (SMD=-2.21), the Timed Up and Go Test and variants (SMD=2.30), the One Leg Stance test and variants (SMD=-2.14), while the Reach tests showed a smaller difference (SMD=-1.19). Subclassification within the meta-analyses showed that pathology was an influencing factor for the test batteries and the one leg stance test and variants. Age was an influencing factor for the reach tests. None of the included functional postural control tests exceeded a low level of evidence.
CONCLUSIONS: Pediatric functional postural control tests that assess multiple aspects of postural control (such as test batteries) seem to offer higher known-groups validity than single-task tests (e.g. reach tests). The underlying pathology has a larger impact on the validity of these tests than age. There remains an overall low level of evidence for the known-groups validity of pediatric functional postural control tests indicating the need for research with more homogenous groups and norm reference data.}},
  author       = {{Ockerman, Jorn and Velghe, Silke and Van Bladel, Anke and Auvinet, Edouard and Saldien, Jelle and Klingels, Katrijn and Bar-On, Lynn and Verbecque, Evi}},
  issn         = {{1973-9087}},
  journal      = {{EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE}},
  keywords     = {{Children,Postural balance,Reproducibility of results,LATERAL REACH TESTS,NORMAL VALUES,BRAIN-INJURY,GO TEST,PERFORMANCE,HEARING,ADOLESCENTS,RELIABILITY,DISABILITY,MATURATION}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{656--670}},
  title        = {{Checks and balances : a meta-analysis on the known-groups validity of functional postural control tests in children}},
  url          = {{http://doi.org/10.23736/s1973-9087.24.08187-5}},
  volume       = {{60}},
  year         = {{2024}},
}

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