Cross-cultural Translation and Validity of the Pediatric Balance Scale (PBS) Into Urdu.

Cross cultural researches are scientific methods which focus on making systematic comparisons from culture to culture responding to questions about the reasons of occurrence, dissemination and sources of variety in different cultures about compound issues referring to a similar problem across the globe arising from a wide spread field e.g. language which is an integral part of culture . Children with cerebral palsy often suffer from a lack of balance compared with typically developing children. Because balance capacity is relevant to functional activities, reliable and valid functional balance measures are crucial for the pediatric clinical setting.

Cerebral palsy is the most commonly affecting physical dysfunction of childhood. In United States alone 9200 - 9500 children including both infants and preschools are labelled with Cerebral palsy on yearly basis. It has a variety of appearances from isolated to global mental and mental impairments causing disturbance in a multiplicity of motor and cognitive functions such as gait disturbance and cognitive issues.

There are a lot of tools available which are used in physical therapy to assess balance in adults as well as children living with cerebral palsy and out of these tools one commonly used tool for pediatric population is Pediatric Balance Scale (PBS). According to the ICF domain it lies in the "Activity" category. The primary purpose of this scale is to evaluate and discriminate the capacity to maintain and achieve balance both in sitting and standing positions. It is a 14- item questionnaire, takes less than 15 minutes to administer and is used for cerebral palsy population aged between 5-15 years. In clinical settings standardized tools are thought useful in attaining scholarly objectives. But these standardized tools don't seem to serve their purpose to the fullest specifically in situations when they become indifferent to the culture and language of the population they are addressed to. This ultimately makes the assessment of persons from a varied culture groups difficult and hence makes the need of translations significant.

According to the reviewed literature Pediatric Balance Scale has already been translated into many other languages like Brazilian, Persian and Turkish. Validity and reliability of the tool has also been established in the fore mentioned languages. Despite being the need, till date Pediatric Balance Scale has not been translated into Urdu language. This study targets at the cross cultural adaptation of the tool's contents and the evaluation of the face validity, content validity, discriminate validity, construct validity, internal consistency and reliability of the translated version of pediatric balance scale will also be done for children diagnosed with Cerebral Palsy falling in the inclusion criteria.

In 2012 Lilian G K Ries conducted a research along with the research mates at University of Estado de Santa Catarina, Brazil under the title of "Cultural-adaptation and Reliability analysis of Brazilian version of pediatric balance scale (PBS)" and the results of this study concluded that PBS is adequately reliable for children diagnosed with Cerebral Palsy and having GMFCS level I and II. In 2019, Elnaz ALIMIl et al conducted a study with the aim to evaluate the Test-retest and inter-rater reliability of Persian version of Pediatric Balance Scale in children with spastic Cerebral Palsy. They concluded the study with the notion that the PBS shows high inter-rater reliability & the test-retest reliability appropriate for measuring functional balance in children with spastic cerebral palsy with mild to moderate motor impairment. Arzu Erden conducted a study in 2020 to evaluate the Reliability and validity of Turkish version of PBS and showed that the Turkish version of the scale is a valid and reliable tool to evaluate children with balance impairments.