Document Type: Original Articles

Authors

1 University of Social Welfare and Rehabilitation Sciences, Tehran, Iran

2 Department of Physiotherapy Faculty of Rehabilitation Sciences Tehran University of Medical Sciences and Health Services, Tehran , Iran

3 University of social welfare and rehabilitation sciences, Tehran, Iran

4 university of social welfare and rehabilitation sciences, Tehran, Iran

Abstract

Background: Centre of pressure displacement is an indicator of postural control. Children with cerebral palsy have poor postural control. One common intervention to enhance their balance is vestibular stimulation. The aim of this research was to investigate the effect of vestibular stimulation on COP parameters in children with cerebral palsy (3-10 years old).Methods: This study was a randomized double-blind controlled clinical trial. Twenty children with cerebral palsy received vestibular stimulation, two sessions per week with a course of twelve sessions, based on vestibular stimulation protocol including antero­posterior, lateral, ascending – descending movements and spinning. One cerebral palsy group experienced current and conventional occupational therapy while the other received a period of vestibular stimulation during treatment. Force plate outcome measures were center of pressure displacement parameters as well as velocity, area, displacement in X and Y axes.Results: According to Mann-Whitney U test, means in post-tests in two groups with both conditions of eyes open and closed were significant in velocity parameter (eyes open P= 0.036; eyes closed P = 0.021) while Area parameter, COP displacement in X axis (Rang fore after), COP displacement in Y axis (Rang side way) were not significant (P>0.05). Wilcoxon Test showed significant difference in the velocity parameter; eyes open (P=0.012) and eyes closed (P =0.018).Conclusion: Children who received vestibular stimulation are able to change and control COP displacement faster (according to changes in velocity parameters). So we suggest rehabilitation team members especially occupational therapist to apply vestibular stimulation during their treatment.

Keywords

  1. - Hosseini S. A. Vestibular Stimulation on cerebral palsy designing a vestibulator [PhD dissertation].India: School of biosciences and bioengineering IITB; 2007, 1-300
  2. - Shepar TN, Telian SA. Practical management of the balance disorder patient. Singular publication Group INC: 1996, 8-16, 17-25, 40-50, 53-63, 85-95 , 109-119,169-179
  3. - Pompeiano. Neural mechanisms of postural control. In Taguchi K, Igarshi M, (eds).Vestibular and neural front: proceeding of the 12th International symposium on posture and gait; .Amsterdam:Elsevier1994; 423-436
  4. - Mori M. S., Takakusaki k. Integration of posture and locomotion .In Amblard B Berthoz A Clarac F Posture and gait: Development, adaptation and modulation1988; 341-354.
  5. - Allum JH.Organization of stabilizing reflex responses in tibialis and muscle following ankle flexion perturbation of standing man, Brain Res1983; 264,297,301
  6. - Hobeika, C.P., 1999. Equilibrium and balance in the elderly. Ear, nose & throat journal, 78(8): 558-566.
  7. - Alan Desmond.Vestibular function evaluation and treatment. Thieme: 2004, 21-44, 89-120,220-223
  8. - Herdman S. Vestibular Rehabilitation.2 Ed. Philadelphia: F.A. Davis Company: 1994, 3-24, 27-48, 55-60,358-359,360-376,549-557.
  9. - Horak FB Nashner LM, Diener HC .Postural strategies associated with somatosensory and vestibular lost .Exp Brain Res1990;( 82):167-177
  10. -Horak F B, Nashner LM .Central programming of postural movements: Adaptation to altered support surface configuration .J Neurophysiology 1986; (55): 1369-1381
  11. - Nashner, Greem. Prevalence of Nonorganic Sway Patterns in Normal Subjects, Patients, and Suspected Malingerers Otolaryngology Head and Neck Surgery, August, 1995, 113: 61
  12. -Palmer F .Evaluation of developmental therapies in cerebral palsy, mental retardation and developmental disabilities research reviews; 1997;3(2):145-152
  13. - Fisher AG. The validity of the Clinical diagnosis of vestibular dysfunction. Occupational therapy J 1986; (6):30
  14. - Leila Dehghan, Inter rater reliability of Persian version of gross motor function classification system expanded and revised in patients with cerebral palsy. Daneshvar medical journal 18(91), 37-44
  15. - Raymakers. H.J.J. Verhaar M.M. Samson, Gait & Posture 2005 Volume 21, Issue 1, January 2005, Pages 48–58
  16. - Sellick KJ.Over. Effects of vestibular stimulation on motor development of cerebral-palsied children. Develop. Med Child Neurol. 1980; 22,476-483
  17. - Chee F. Kreutzberg J. Clark D. Semicircular canal stimulation in cerebral palsied children Phys Ther1978; (58):1071-1075
  18. - Hosseini SA, Ray GG.Vestibular therapy in cerebral palsy. Proceeding of the 34th Conference of Indian Association of Physical Medicine and Rehabilitation: IAPMRCON; 2006 20-22 Jan; Mumbai, India. All India of Physical Medicine and Rehabilitation ;2006 .169
  19. - Schler P. The vestibular apparatus in neurosis and psychosis. J Nerv Ment Dis1933; (78):1-23
  20. - Kreutzberg J. Effects of Vestibular Stimulation on the Reflex and Motor Development in Normal Infants. Dissertation. Columbus, OH, the Ohio State University1976
  21. - Ayres A., Sensory Integration and Learning Disorders. Los Angeles, CA, Western Psychological Services, 1972; 129--113
  22. - Dequiros JB, Schrager OL. Neuropsychological Fundamentals in learning disabilities .San Rafael ,CA,Academic therapy publications ,1978The labyrinth, the brain, and posture Am Sci. Wilson1975; 331-325.
  23. - Walsh R, Cummins RA. Neural responses to therapeutic environments. In Walsh R, Greenough W (eds): Environment as Therapy for Brain Dysfunction. New York, NY, Plenum Publishing Corp, 1976; 171-20
  24. - Hosseini SA. Ray GG. Effect of vestibular therapy on gross motor function of children with spastic cerebral palsy. Saudi Journal of Disability and Rehabilitation under correspondence.
  25. - Hosseini SA, Ray GG. Design of a vestibulator for cerebral palsy children .Proceeding of the International Conference on Humanizing Work and Work Environment HWWE ;2005 10th -12th.Dec;Guwahati, India. Indian Institute of Technology; 2005.149-154