Diparetik Serebral Palsili Çocuklarda Fullerton Gelişmiş Denge Ölçeği ve Fonksiyonel Yürüme Değerlendirmesi’nin Güvenilirlik ve Geçerliliğinin Araştırılması

Abstract

The study was conducted to examine the validity and reliability of the Fullerton Advenced Balance scale (FABs) and Functional Gait Assessment (FGA) in children with diparetic cerebral palsy (CP). A total of 51 children with diparetic CP, 23 girls and 28 boys, aged 7-18 (mean±standard deviation=11.31±3.55) and 32 children with normaltypical development were included in the study. The reliability of the FABs and FGA were examined with test-retest reliability, observer reliability and internal consistency analyses. Test-retest reliability was made 7 days after the first evaluation by evaluating only FABs and FGA. Observer reliability analysis was carried out by 2 two physiotherapists watching FABs and FGA, which were video-recorded during the initial evaluation of 30 of 51 individuals, 14 days later. The construct validity (factor analysis and hypothesis testing) and criterion validity (concurrent validity) of the scales were investigated within the scope of the validity of FABs and FGA. This research of both scales was performed by examining the correlation with Pediatric Balance Scale (PBS), Gross Motor Function Measurement-66 (GMFM-66) Part D and E items, Time Up and Go Test (TUG), Five Times Sit and Stand Test (FTSST), 1-minute walking test (1-MWT) Gillette Functional Assessment Questionnaire (FAQ) and Gross Motor Function Classification System (GMFCS). At the end of the study, it was found that the FABs and FGA had excellent test-retest reliability (Intraclass Correlation Coefficient values: 0.971 and 0.927, respectively). Internal consistency was found to be excellent for FABs and FGA (Cronbach's alpha values: 0.910 and 0.922, respectively). The intra-observer (ICC=0.996, p<0.001) and inter-observer (ICC=0.939, p<0.001) reliability was excellent for FABs, and the intra-observer (ICC=0.987, p<0.001) reliability for FGA was excellent and inter-observer (ICC=0.866, p<0.001) reliability was found to be good. An excellent correlation between FABs and PBS and an excellent correlation between FGA and GMFM-66 Part D and E items showed concurrent validity of both scales (r values: 0.942 (p<0.001); 0.859-0,913 (p<0.001), respectively ). As a result of Explanatory Factor Analysis, it was seen that FABs and FGA consisted of a single factor. FABs association with TUG (r=-0.855, p<0,001), FTSTT (r=-0.557, p<0.001), GMFCS (r=-0.794, p<0.001) and GMFS-66 subdivisions Part-D (r= 0.853, p<0.001) and Part-E (r=0.941, p<0.001) proved the convergent validity of this test. The relationship between FGA and TUG (r=-0.860, p<0.001), 1-MWT (r=0.867, p<0.001), Gillette FAQ (r=0.898, p<0.001) and GMFCS (r=-0.791, p<0.001) showed that this test had convergent validity. As a result, it was determined that FABs and FGA are valid and reliable measurement tools in the evaluation of balance and walking balance in children with diparetic CP.