Postural Sway in 6, 8, 13 and 16 Year Old Children: Validity, Absolute and Relative Reliability and Minimal Detectable Change

S Talley, Jamie Haines

Research output: Contribution to conferencePosterpeer-review


<b><u>INTRODUCTION/CLINICAL RELEVANCE</u></b>: The development of postural control is an important component in the maturation of balance in children. Postural control is moderated by visual, vestibular and somatosensory input. Dependence on visual input is hypothesized to decrease with increased age in typically developing children. Postural sway (PS) measures the center of pressure displacement (degrees/sec). Decreased velocity of PS is associated with better balance. There is a paucity of research on the development of PS in children. The purpose of this study was to describe characteristics of and changes in PS in typically developing children in two younger (6 and 8 year old) and two older (13 and 16 year old) age groups.<br> <br><b><u>METHODS</u></b>: This was a cross-sectional observational design. <b><i>Subjects</i>:</b> Seventy-six typically developing children (51.3% female) in four age groups (6 [N=20], 8 [N=20], 13 [N=18] and 16 [N=18] years old) were recruited from two public schools. <b><i>Methods/Procedures</i></b><i>:</i> Parental consent and assent from the participants were obtained. Children with known neurological or other conditions which would prevent participation were excluded from the study. Height and weight were measured and recorded. PS was measured using a portable Balance Master System. Two conditions were tested: bipedal stance with eyes open (EO) and eyes closed (EC). Center of pressure displacement (deg/sec) was measured during three 10-second trials in each condition. Each trial, the mean and a megascore (Trial 1 + Trial 2 + Trial 3) was recorded in degrees per second for each condition (EO, EC). A visual dependence score was calculated (megascore<sub>EC</sub> – megascore<sub>EO</sub>) to estimate the influence of visual input on postural sway. <b><i>Statistical Analysis:</i></b> Descriptive statistics were computed for demographic information. Tests of normality were computed for the postural sway variables. . Independent t-tests, Mann Whitney U, WIlcoxin Signed Ranks, ANOVA with <i>post hoc </i>Bonferroni corrections and Kruskal-Wallis were used to compare groups. Alpha was set at 0.05<br> <br><b><u>RESULTS</u></b>: PS (mean<u>+</u>SD, deg/sec) varied by age group and condition: 6 YO, EO =.470<u>+</u>.745, EC = .745<u>+</u>.313; 8 YO, EO = .435<u>+</u>.122, EC = .577<u>+</u>.166; 13 YO: EO = .257<u>+</u>.057, EC = .365<u>+</u>.083; 16 YO: EO = .361<u>+</u>.161, EC = .435<u>+</u>.408. Velocity of PS EC was significantly increased in all age groups compared to EO (<i>p</i><.05). There was no significant difference in PS between the 6 and 8 YO groups in either condition, nor in the 3 older age groups. The 16 YO group had a significantly decreased visual dependence score compared to the 6 YO group (<i>p</i><.05). Relative and absolute reliability as well as MDC are described.<br> <br><b><u>DISCUSSION/CONCLUSION</u></b>: The velocity of PS EO generally decreases significantly with increasing age, reflecting maturation of postural control. Significant decreases in PS EC were observed only comparing the 6 YO group to the 2 older groups. Visual dependence decreased significantly with age, indicating maturation of postural control. Variability in PS in both conditions decreased with age except between 13 and 16 YO groups. Clinicians should consider developmental changes of PS in children and utilize MDC scores to identify real change in PS.
Original languageEnglish
StatePublished - Feb 2016
EventAmerican Physical Therapy Association Combined Sections Meeting - Anaheim, CA
Duration: Feb 1 2016Feb 28 2016


ConferenceAmerican Physical Therapy Association Combined Sections Meeting


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