Measuring Balance Confidence in Youth with Cerebral Palsy: Measure Development, Sensibility, Content Validity, and Initial Psychometric Evaluation
Bibliographic record
Abstract
Background: Youth with cerebral palsy (CP) generally participate in less physical activity than typically developing youth. In adults with physical disabilities, balance confidence is a strong predictor of participation. However, balance confidence has not been studied in youth with CP. Research objectives: (1) To explore whether concerns about balance influence physical activity participation of ambulatory youth with CP; (2) to determine how youth with CP feel when they lose their balance; (3) to build a balance confidence measure for this population; (4) to examine the sensibility and content validity of the measure; and (5) to evaluate test-retest reliability and construct validity of the measure. Participants: Eighty-one participants were involved in one or more stages of this measurement study (25 youth with CP, eight parents of youth with CP, 17 typically developing youth, and 31 health care professionals). Methods: Qualitative descriptive methodology with 16 interviews was used to explore balance confidence with ambulatory youth with CP and parents. A multi-step process was used to create the Feelings About Balance–Cerebral Palsy (FAB-CP) youth-report questionnaire and evaluate sensibility, content validity, test-retest reliability, and convergent and discriminant validity. Results: Qualitative analysis demonstrated that ambulatory youth with CP, especially those who do not use gait aids for ambulation, are often concerned about losing their balance during physical activities, which may lead to avoiding physical activities. The FAB-CP, an 11-item computer-based measure was created to investigate balance confidence of this population. Test-retest reliability was excellent (n=21; one-to-four week interval; ICC 0.97 [95% CI 0.93, 0.99]). Convergent validity was good when evaluated against measures of balance capacity (rho=0.74), advanced motor skills (rho=0.83), physical activity enjoyment (rho=-0.61) and participation (rho=0.77). The FAB-CP discriminated among participants of different levels of gross motor function (maximum p
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.019 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".