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.

Cross-cultural adaptation and reliability analysis of the Brazilian version of Pediatric Balance Scale (PBS) / Adaptação cultural e análise da confiabilidade da versão brasileira da Escala de Equilíbrio Pediátrica (EEP)

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.

CONTEXTUALIZAÇÃO: A Pediatric Balance Scale (PBS) foi desenvolvida a partir de uma modificação da Escala de Equilíbrio de Berg (EEB), visando obter uma escala de equilíbrio mais apropriada para a população infantil. OBJETIVOS: Adaptar para o português-Brasil e avaliar a confiabilidade intra-avaliador e interavaliadores/observadores da versão brasileira da PBS. MÉTODOS: Para a adaptação cultural da versão americana da PBS, foram envolvidos quatro tradutores que realizaram duas traduções e respectivas retrotraduções, uma revisão por um comitê multidisciplinar e uma avaliação subsequente da equivalência de significado entre as retrotraduções e o original (respectivamente três e 30 profissionais da área de saúde). A confiabilidade intra-avaliador da escala final em Português - Escala de Equilíbrio Pediátrica (EEP) - foi avaliada comparando-se duas avaliações repetidas pelo mesmo avaliador com o intervalo de uma semana. A confiabilidade interavaliadores foi testada comparando-se as avaliações de dois avaliadores diferentes que realizaram o teste no mesmo dia. A confiabilidade interobservadores, a partir do vídeo do desempenho dos voluntários, foi avaliada por meio da comparação da pontuação dada independentemente por cinco observadores. A confiabilidade foi avaliada por meio do Coeficiente de Correlação Intraclasse (CCI). Foram avaliados 15 voluntários (11±2,7 anos) com diagnóstico de Paralisia Cerebral (PC), classificados nos níveis I e II do Sistema de Classificação da Função Motora Grossa (GMFCS). RESULTADOS: A confiabilidade para o escore total da EEP foi excelente tanto para o teste intra-avaliador (CCI=0,85) como para o interavaliadores (CCI=0.91). A confiabilidade interobservadores (a partir do vídeo) para o escore total foi excelente (CCI=0,98). CONCLUSÃO: Os resultados mostraram confiabilidade adequada para a EEP para a população pediátrica com diagnóstico de PC classificada nos níveis I e II do GMFCS.