Peer-reviewed article

Translation, reliability and validity of the Greek Early Clinical Assessment of Balance for children with cerebral palsy.

Athanasia Kanellopoulou, Efthalia Zogka, Aristi Tsokani, Vasiliki Stefanouli, Eleni-Argyroula Tsounia et al. · 22 Aug 2026

Abstract

PURPOSE: This study aimed to systematically translate and culturally adapt the Early Clinical Assessment of Balance (ECAB) for the Greek-speaking population and to evaluate its psychometric properties, specifically its reliability and validity, in children with cerebral palsy (CP). METHODS: The ECAB was translated into Greek and its test-retest and inter-rater reliability, as well as convergent construct validity and known-groups validity, were assessed in children with CP. Sixty-eight children (mean age 7.96 ± 3.42 years) were recruited. Physiotherapists administered the ECAB by giving oral instruction to children and scoring the scale afterwards. The Pediatric Balance Scale (PBS) was additionally used for testing convergent construct validity. RESULTS: The translation of the ECAB was found to be easy to understand and administer. The Greek ECAB showed excellent test-retest reliability with an Intraclass Correlation Coefficient (ICC) of 0.959 and a 95% confidence interval (CI) of 0.88-0.96 and excellent inter-rater reliability with an ICC of 0.929 and a 95% CI of 0.86-0.95. Convergent construct validity with the Pediatric Balance Scale was very high with Spearman's rho = 0.956 and p < 0.001. A one-way ANOVA indicated that ECAB scores differed significantly across the represented GMFCS Levels I, II, IV, and V (p < 0.001). Post-hoc Bonferroni-corrected comparisons confirmed significant differences among all represented levels (all p < 0.001). No participant was classified at GMFCS Level III; therefore, discrimination involving Level III was not evaluated. The scale also demonstrated excellent internal consistency (Cronbach's α = 0.92). CONCLUSIONS: The Greek version of the ECAB is a reliable and valid balance assessment tool for children with CP within the GMFCS levels represented in this sample, suitable for use by Greek physiotherapists. Further research should include children at GMFCS Level III.