Vanessa Costa Monteiro

Cross-cultural adaptation and reliability analysis of the Brazilian version of Pediatric Balance Scale (PBS)

BACKGROUND The Pediatric Balance Scale (PBS) was developed from a modified version of the Berg Balance Scale aiming to obtain a balance scale more appropriate for the child population. OBJECTIVES To adapt the PBS into Brazilian-Portuguese and to evaluate the intra and inter-rater reliability of the Brazilian-Portuguese version of PBS. METHODS To perform the cross-cultural adaptation of the American version of PBS four translators were involved, who have performed two translations and their respective back-translations. Then, a review by a multidisciplinary committee and a subsequent an assessment of the equivalence of meaning between the back-translations and the original English scale were performed by 3 and 30 healthcare professionals respectively. The intra-rater reliability of the final version of the Brazilian-Portuguese PBS was evaluated using a test-retest design with one-week interval. The Brazilian-Portuguese version of the PBS was tested twice on the same day by two different raters to test the inter-rater reliability. The inter-rater reliability, which was measured from a video of the volunteers performance, was evaluated by comparing the score given by five raters independently. Reliability was evaluated by Intraclass Correlation Coefficient (ICC). Fifteen volunteers (11±2.7 years) diagnosed with Cerebral Palsy (CP) classified at level I and II on the Gross Motor Function Classification System (GMFCS) were assessed. RESULTS The reliability of the PBS total score for both intra-rater (ICC=0.85) and inter-rater (ICC=0.91) was excellent. The inter-rater reliability (measured from the video) for the total score was also classified as excellent (ICC=0.98). CONCLUSION The results showed adequate reliability for the PBS for pediatric population with CP diagnostic classified at level I and II on the GMFCS.

Eletroestimulação e mobilização articular em crianças com paralisia cerebral e pés equinos

Introduction. Cerebral palsy (CP) leads to motor changes and postural adjustments that cause deformations in the children, among them the equinus deformity. One of the most used therapeutic procedures in CP children is the transcutaneous electric nerve stimulation whose benefits are well known. Another technique, also very used in clinical practice and with proven orthopedical effects is the joint mobilization. Objective. To verify the therapeutic effects of the association between electrical stimulation on dorsiflexor muscle and joint mobilization of the ankle in children with spastic diparetic cerebral palsy with equinus deformity. Method. The participants of this study were three CP children, (with ages) between 3 and 9 years of age that have the equinus deformity. They were evalued in terms of gross motor function, gait, energy expenditure, joint movement and spasticity. The protocol of treat ment was 16 sessions of 30 minutes each, twice a week. Results. All children showed improvements in gross motor function, gait and joint movement after the treatment. Conclusion. Association of those two therapeutic techniques was beneficial to improve gross motor function, gait and joint movement for this limited group of patients.