Functional motor performance and reliability of the Dubousset Functional Test in ambulatory children with spastic cerebral palsy

Cerebral palsy (CP) causes permanent motor impairments, limiting postural control and mobility. The Dubousset Functional Test (DFT) was developed to assess daily activity performance, but its reliability and validity in pediatric CP are unclear. This study aimed to evaluate its reliability, convergent and discriminative validity, and clinical utility in children with spastic CP at GMFCS Levels I – II. Thirty-three children aged 6–15 years with spastic CP (GMFCS I – II) participated in this cross-sectional methodological study. The DFT (Rise-and-Walk, Step, Sit-to-Stand, and Dual Task subtests) was administered along with the Timed Up and Go (TUG), Dual-task TUG, 3-Meter Backward Walk Test (3MBWT), Functional Reach Test (FRT), and Pediatric Balance Scale (PBS). All assessments were conducted twice, seven days apart, by a single experienced physiotherapist. The DFT demonstrated excellent reliability, with ICC(3,2) values ranging from 0.91 to 0.95 and minimal measurement bias (−0.61 to 0.36 s). The smallest detectable change (SDC) ranged from 2.1 to 13.0 s, confirming high measurement precision. Strong correlations were observed between the DFT Dual Task and both TUG (r = 0.95, p < .001) and Dual-task TUG (r = 0.95, p < .001), supporting convergent validity. ROC analysis indicated excellent discriminative accuracy for identifying children with balance limitations (PBS < 45) (AUC = 0.82, sensitivity = 0.81, specificity = 0.78). The DFT is a reliable, valid, and clinically feasible tool for assessing balance and mobility in ambulatory children with spastic CP at GMFCS I – II, supporting routine rehabilitation use. ClinicalTrials.gov (NCT06831591). • The Dubousset Functional Test (DFT) demonstrates strong reliability and convergent and discriminative validity in ambulatory children with spastic cerebral palsy (GMFCS Levels I – II), supporting its use as a standardized measure of functional mobility. • DFT offers a time-efficient and clinically feasible method for assessing dynamic balance and postural control, making it suitable for routine use in pediatric neurorehabilitation settings. • The test provides sensitive performance-based metrics that can assist clinicians in monitoring response to therapy, identifying subtle functional changes, and guiding individualized rehabilitation planning. • Integrating the DFT into regular assessment batteries may enhance the accuracy of functional profiling in children with mild to moderate motor impairments and support data-driven clinical decision-making.