EVALUATING THE CABA’S ABILITY TO IDENTIFY CHANGE IN BODY ALIGNMENT IN POSTURE MANAGEMENT PROGRAMS FOR CHILDREN WITH CEREBRAL PALSY

F.K. George¹, A. Benham²

Background: Posture management programs typically utilize positioning equipment to support body alignment in order to prevent musculoskeletal deformity and promote function. Despite the recognition that posture management involves assessment of total body alignment, there is paucity in evaluative studies which utilize clinical assessments that measure body alignment in posture management.

Purpose: This study examines the responsiveness of the Clinical Assessment of Body Alignment (CABA) in a group of children with cerebral palsy (CP).

Methods: One physiotherapist scored the CABA in 10 children with CP GMFCS IV (n=5) and V (n=5). Two frames of reference for determining responsiveness where used: 1) Immediate change in and out of posture management equipment and 2) positional criterion. Pearson correlation coefficient was also used to examine the correlation of scores with and without equipment. Summed scores are calculated for all measurements; positions and body segments. Paired sample t-test examined positional criteria. to compare with/without equipment for each category. Independent sample t-test compared between GMFCS IV and V.

Results: Strong significant correlations (r=0.769, p=0.002) were found between score with and without equipment at GMFCS levels. Paired and independent t-test indicated significant differences in measures with equipment between positional criteria and GMFCS level (t(9)=20.1, p<0.001).  Pearson correlation coefficient examined individual scores with and without equipment strongly correlated (r=0.769, p=0.002). The CABA items demonstrated statistically significant difference between measurements taken with equipment compared measurements without, t(9)=20.1, p<0.001, indicating that the CABA was responsive to detect change in alignment in posture management programs.
The CABA demonstrated statistically significance at GMFCS level IV (t(4)=20, p<0.001) and V (t(4)=44, p<0.001), indicating that the CABA was responsive at GMFCS IV and V.

Conclusion(s): The CABA has been shown to be responsive to immediate change in body alignment across sitting, lying and standing positions in children with CP GMFCS IV and V

Implications: The CABA sensitivity and responsive data supports its usefulness in measuring body alignment in children with CP. The CABA is a standardized clinical assessment demonstrating excellent responsiveness, sensitivity, validity and reliability. Support for clinical utilization through further examination of the CABA’s psychometric properties in larger scale studies would be beneficial in supporting its use as a clinical outcome measure, examining efficacy and effectiveness of interventions.  

Funding, acknowledgements: None

Keywords: Body alignment, measurement, cerebral palsy

Topic: Paediatrics: cerebral palsy

Did this work require ethics approval? Yes

Institution: York St John University

Committee: Faculty of Health & Life Sciences Research Ethics Committee

Ethics number: 069011429_George_22092017