Clinical assessments designed to measure body alignment posture in children with cerebral palsy: A systematised review

Purpose: To critically review the clinical assessments used by therapists to assess and measure body alignment posture in children with CP. To determine if assessments have psychometric properties specifically measured for this population, and to identify the assessments main characteristics.
Methods: A systematic literature search was performed in 5 electronic databases along with hand searching. The search included articles published in English to March 2019 Key terms included: Cerebral palsy, posture, body alignment, assessment(s) measure(s), outcome(s), child(ren). One reviewer screened titles, reviewed abstracts and identified full-text articles that met the inclusion criteria. Data extraction included study design, tool description and psychometric properties.
Results: Of the 696 titles found in the search, 10 full-text articles met the inclusion criteria and 7 clinical assessments were identified. 6 assessments were observational measurements; 4 observed body alignment, whilst 2 observed gross functional movement and body alignment combined, and 1 assessment was a checklist. Evidence supporting reliability and validity varied, with small sample size influencing quality rating. Only 2 assessments demonstrated adequate evidence to support validity and reliability. Little information clinical utility and responsiveness was provided.
Conclusion(s): Although this critical review identified a number of assessments are available, evidence supporting their use for entire body alignment measurement is limited, as is the evidence supporting the strength of their measurement properties.
Implications: In children with CP, many of the clinical assessments used to measure body alignment have limited psychometric properties. An assessment of body alignment needs to be selective, accurate and discriminative to body alignment changes in children with CP.