Urdu Version of Pediatric Balance Scale
Condition: Cerebral Palsy
MeSH terms: Cerebral Palsy
Study type: Observational

Summary: 
      Children with cerebral palsy often suffer from a lack of balance compared with typically
      developing children. Because balance capacity is relevant to functional activities, reliable
      and valid functional balance measures are crucial for the pediatric clinical setting in local
      native languages, so the aim of this study is to translate the Pediatric Balance Scale (PBS)
      into Urdu and to find the reliability and validity of the translated version Pediatric
      Balance Scale (PBS) in cerebral palsy.
    

Detailed description: 
      Cross cultural researches are scientific methods which focus on making systematic comparisons
      from culture to culture responding to questions about the reasons of occurrence,
      dissemination and sources of variety in different cultures about compound issues referring to
      a similar problem across the globe arising from a wide spread field e.g. language which is an
      integral part of culture . Children with cerebral palsy often suffer from a lack of balance
      compared with typically developing children. Because balance capacity is relevant to
      functional activities, reliable and valid functional balance measures are crucial for the
      pediatric clinical setting.

      Cerebral palsy is the most commonly affecting physical dysfunction of childhood. In United
      States alone 9200 - 9500 children including both infants and preschools are labelled with
      Cerebral palsy on yearly basis. It has a variety of appearances from isolated to global
      mental and mental impairments causing disturbance in a multiplicity of motor and cognitive
      functions such as gait disturbance and cognitive issues.

      There are a lot of tools available which are used in physical therapy to assess balance in
      adults as well as children living with cerebral palsy and out of these tools one commonly
      used tool for pediatric population is Pediatric Balance Scale (PBS). According to the ICF
      domain it lies in the "Activity" category. The primary purpose of this scale is to evaluate
      and discriminate the capacity to maintain and achieve balance both in sitting and standing
      positions. It is a 14- item questionnaire, takes less than 15 minutes to administer and is
      used for cerebral palsy population aged between 5-15 years. In clinical settings standardized
      tools are thought useful in attaining scholarly objectives. But these standardized tools
      don't seem to serve their purpose to the fullest specifically in situations when they become
      indifferent to the culture and language of the population they are addressed to. This
      ultimately makes the assessment of persons from a varied culture groups difficult and hence
      makes the need of translations significant.

      According to the reviewed literature Pediatric Balance Scale has already been translated into
      many other languages like Brazilian, Persian and Turkish. Validity and reliability of the
      tool has also been established in the fore mentioned languages. Despite being the need, till
      date Pediatric Balance Scale has not been translated into Urdu language. This study targets
      at the cross cultural adaptation of the tool's contents and the evaluation of the face
      validity, content validity, discriminate validity, construct validity, internal consistency
      and reliability of the translated version of pediatric balance scale will also be done for
      children diagnosed with Cerebral Palsy falling in the inclusion criteria.

      In 2012 Lilian G K Ries conducted a research along with the research mates at University of
      Estado de Santa Catarina, Brazil under the title of "Cultural-adaptation and Reliability
      analysis of Brazilian version of pediatric balance scale (PBS)" and the results of this study
      concluded that PBS is adequately reliable for children diagnosed with Cerebral Palsy and
      having GMFCS level I and II. In 2019, Elnaz ALIMIl et al conducted a study with the aim to
      evaluate the Test-retest and inter-rater reliability of Persian version of Pediatric Balance
      Scale in children with spastic Cerebral Palsy. They concluded the study with the notion that
      the PBS shows high inter-rater reliability & the test-retest reliability appropriate for
      measuring functional balance in children with spastic cerebral palsy with mild to moderate
      motor impairment. Arzu Erden conducted a study in 2020 to evaluate the Reliability and
      validity of Turkish version of PBS and showed that the Turkish version of the scale is a
      valid and reliable tool to evaluate children with balance impairments.

      Another study conducted by Gi-won kim et al in 2010 evaluated reliability of PBS based on
      raters clinical experience and test experience showed high inter rater and intra rater
      reliability. In 2012 Jin Gang Her's study on Reliability of Pediatric Balance Scale in
      assessment of the children with cerebral palsy showed high inter rater and intra rater
      reliability of Pediatric Balance Scale in Children with Cerebral Palsy.In 2017 Sivatejaa
      Panibatla's study on Relationship of trunk control and balance in children with cerebral
      palsy suggested a strong correlation between trunk control and balance when evaluated using
      PBS.

      In 2013 Mary rose et al showed in her study about the pediatric balance scale: a modified
      version of the berg scale for children with mild to moderate motor impairment that PBS
      demonstrate good test-retest and interrater reliability when used with school-age children
      with mild to moderate motor impairments.In 2000 Palisano et al conducted a study on
      validation of a model of GMFC in children with CP suggests that distinction between GMFC
      levels are meaningful. In 2013 Beatriz O et al suggested about Portuguese version of
      pediatric berg balance scale that this is a reliable tool to be used in balance assessment of
      Portuguese Children. A study conducted by Sue-mae gan et al in 2008 on psychometric
      properties of functional balance assessment in children with cerebral palsy and concluded
      that the 3 functional balance measures are simple, valid, and reliable for examining children
      with cerebral palsy and are thus suitable for clinical practice
    

Intervention name(s): Tool Translation
Intervention type(s): Other
Intervention description(s): Data Collection procedure will be done in two phases. The first phase will revolve around the translation of the instrument. Firstly the tool will be translated into Urdu with help of two professional translators and then it will be back translated into English to cross check the clarity of text. The translation will focus more on the context and understanding of the text rather literal word-to-word meanings. The translation will be done according to the WHO guidelines
Observational model: Other
Time perspective: Other
Sampling method: Non-Probability Sample
Study population: 
        • To translate the Pediatric Balance Scale (PBS) into Urdu, and to find the reliability and
        validity of the translated version Pediatric Balance Scale (PBS) in cerebral palsy
      
Keywords: Pediatric Balance scale; Cerebral palsy; Urdu version