Balance Reactions to Varied Sensory Inputs in Children with and without

Vestibular Dysfunction

Lin-Ya Hsu, PT, PhC

Advisor: Dr. Washington

Background- Postural Control

• Postural control

– Control COM over BOS

– Achieved by the interaction of 3 sensory systems:

• Visual system

• Vestibular system (inner ear)

• Somatosensory system

– Important for engagement and learning

Jeka et al., 2006 2

Background- Vestibular Assessments

• Vestibular cues

– Difficult to directly manipulate

– Activated by the effect of gravity and/or change in head speed on the vestibular end organs

• Research

– Activate the vestibular system by moving the standing surface

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Background- MuMBER • Sensory weighting

• Measurement of sensory weighting

– MuMBER System

• Previous findings: Compared to TD, children with FASD had difficulty weighting the vestibular information during postural control

• need to confirm with children with vestibular problems

Jeka , Oie, & Kimel, 2008; Bair et al., 2008

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Purpose

• To compare standing balance of children with typical development (TD) to children with vestibular dysfunction (VD) when moving the standing surface

• To compare balance skills of children with TD and children with VD by using clinical assessments

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Sample

• Sample of convenience

• 6 children (8-18 years)

– 5 children with TD (3 girls, 2 boys)

– 1 child with VD (1 boy)

• Exclusion criteria

– Children with other diagnoses

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• Lab assessment

– MuMBER

• Clinical assessments

– Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) short form

– Dynamic Gait Index (DGI)

– Pediatric-Clinical Test of Sensory Interaction for Balance (P-CTSIB)

Procedure

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Results- Clinical Assessments

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50

60

70

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BOT-2 P-CTSIB DGI

TD

VD

Sensory weighting- All three sensory input

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TD – VD –

Sensory weighting- No touching

11 TD – VD –

Sensory weighting- No touching+ eyes close

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TD – VD –

Summary

• MuMBER

– 3 sensory systems: TD and VD have similar patterns

– No vision, somatosensory: different

• Clinical assessments

– TD showed better balance skills

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Clinical Relevance

• Importance of postural control

– Engagement, and Learning

• Sensory integrated balance control

– Assessment

– Intervention

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Acknowledgements Walter C. and Anita C. Stolov Research Fund

NIH- NIAAA, R21AA019579

Sally Westcott McCoy, PhD, PT

Tracy Jirikowic, PhD, OTR/L

Deborah Kartin, PhD, PT

Robert Price, MSME

Marcia A. Ciol, PhD

Beth Gendler, MSW

Alyssa Mannikko, BS, and Madisen Clark, BS

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