Relationship Between Postural Asymmetry, Balance, and Pain in Children With Spastic Cerebral Palsy.

BACKGROUND: Primary symptoms of cerebral palsy (CP), such as spasm and weakness, can lead to secondary musculoskeletal problems. Exploring the interplay and impact of secondary symptoms is essential in CP management. METHODS: A total of 56 children (32 males and 24 females) aged eight to 12 years in level I to III of Gross Motor Function Classification System (GMFCS) completed The Pediatric Balance Scale and Wong-Baker Faces Scale and the Posture and Postural Ability Scale. Relationships between the three groups were examined using the Kruskal-Wallis test, Tukey test, gamma coefficient, De Somers D, phi coefficient, Cramér V, and one-way analysis of variance. RESULTS: There was a significant correlation between balance and postural asymmetry (P < 0.001), and no significant difference in balance was there between the severe and moderate asymmetry groups (P = 0.759) and between the mild asymmetry and no asymmetry groups (P = 0.374). Furthermore, there was a significant relationship between postural asymmetry and each of the variables of pain (P < 0.001) and gross motor function (P = 0.002). Although a meaningful correlation was identified between balance and gross motor function (P < 0.001), the relationship between postural asymmetry and balance in GMFCS levels was not found (P = 0.052, P = 0.052, P = 0.233). Conversely, no significant relationship was detected between pain and gross motor function (P = 0.072). SIGNIFICANCE: Postural asymmetry negatively impacts balance and correlates with pain intensity. Addressing postural problems can contribute to pain management and improved balance.

Psychometric Evaluation of the Persian Version of the Functional Mobility Scale: Assessing Validity and Reliability.

AIM: This study aimed to assess the content, concurrent validity, test-retest, and intra-rater reliability of the Persian version of the Functional Mobility Scale (FMS) for evaluating functional mobility in children and adolescents with cerebral palsy (CP). METHODS: Following international standards for measurement translation, we developed a Persian version of the FMS. A total of 160 participants took part in this study. Concurrent validity was assessed using Spearman's coefficient to correlate with the Gross Motor Function Classification System (GMFCS). Test-retest (n = 30) and intra-rater (n = 30) reliability of the FMS were also examined by Cohen's weighted kappa coefficient. RESULTS: Concurrent validity ranged from -0.912 to -0.941 for children and -0.912 to -0.936 for adolescents. Test-retest ranged from 0.902 to 1. Intra-rater ranged from 0.933 to 0.987. CONCLUSION: The Persian version of the FMS demonstrates very strong validity and almost perfect reliability for assessing and classifying functional mobility in children and adolescents with CP. These findings suggest that this tool could be a useful addition to clinical practice and research for the Persian-speaking population.