How to Use the Pediatric Balance Scale

Elise is constantly falling during her school day.   She often has skinned knees and bruises.  Although she is 10,  she walks down stairs one step at a time.    As Elise’s physical therapist, what will you use to measure her functional balance skills?  How will you document her progress?  

Balance is defined as the ability to keep the center of mass over the base of support.

Postural control is the act of maintaining, achieving or restoring a state of balance during an activity.  

Link to Pediatric Balance Scale Score Sheet with minimal detectable change (MDC) & minimally clinically important difference (MCID)  values.

Pediatric physical therapists informally evaluate balance and postural control in every movement.   Multiple body systems contribute to balance, and this makes measurement of functional balance somewhat challenging.

Continue reading “How to Use the Pediatric Balance Scale”

How to Use the Gross Motor Function Measure (GMFM-66)

Freya is a 6-year-old girl with ataxic cerebral palsy.   She moved to California from Iowa last month and has been prescribed six months of physical therapy.   Freya’s parents are concerned; she has been having difficulty going down the front stairs of their new home.  As her physical therapist, do you have a standardized test that will measure her initial gross motor function?   In six months, how will you determine whether Freya has made progress?  

GMFM-66 Quick Facts:

  • 5mo-16 years
  • Cerebral palsy or Down Syndrome
  • Test re-test reliability GMAE-scoring method: 0.9932
  • Most sensitive to change in children 5 years and younger
  • Motor growth curves link

My Gross Motor Function Measure User’s Manual is tattered.  I could not work without the GMFM!    Like all things that are well designed, the creators have taken a complex concept and made it logical and simple.   The GMFM is an evaluative measure that assesses change in motor function over time.  I can test Freya in January,  provide PT 1x/week and then retest in July to determine if she has made significant progress.  In addition, I won’t overlook Freya’s inability to reach across midline while I am heavily focused on her stair skills; the test covers all domains from lying and rolling  up to running and jumping, with each skill being incrementally harder than the last (in the GMFM-66). Continue reading “How to Use the Gross Motor Function Measure (GMFM-66)”

Exploring the ICF-CY: What is Activity?

ACTIVITY WORDLE

The International Classification of Functioning, Disability & Health- Children & Youth (ICF-CY) is a framework for describing and organizing information on functioning and disability.

In this post we explore another category of the ICF-CY….activity!  This is the heart and soul of physical therapy, at least in the clinic or during a home visit.  The activity section of the ICF-CY describes what a person can do in a standard environment or their regular environment.  Activity is defined as the execution of a task or action.    The activity section includes the following:

  • developmental skills that babies learn in the first year of life,
  • gross motor skills at any age
  • fine motor skills at any age
  • activities of daily living/self-care
  • gait
  • communication

Continue reading “Exploring the ICF-CY: What is Activity?”