Children with hearing impairment have balance and motor deficits primarily due to concomitant damage to the vestibular structures. Psycho-intellectual and social developmental disorders, as well as elimination of social activities and participation may diminish health-related quality of life in these children. Despite the documentation, assessment of balance, motor deficits, and health-related quality of life of these children are not included in the educational program, unless obvious neurological or orthopedic disorders are diagnosed. The objective of this review was to systematically analyze the available information in the literatures regarding the postural control, motor skills, and health-related quality of life in children with hearing impairment. Searches of data sources PubMed, MEDLINE, CINHAL, EMBASE, SCOPUS, ISI of web science, Cochrane Library, and AMED database were performed from the earliest to 7 February 2011. Study eligibility criteria included non-interventional studies that addressed postural control, motor skills, and health-related quality of life in children with hearing impairment. For each eligible article, data were extracted using custom-designed forms by a single investigator. Collected data included study demographics, study design, study population, sample size, outcome measures, and results. A total of 11,872 articles were retrieved, and 17 articles were found to be eligible for inclusion. Of the 17 articles included, five articles analyzed health-related quality of life alone, two articles analyzed balance alone, two articles analyzed motor performance alone, two articles analyzed vestibular dysfunction alone, two articles included both vestibular dysfunction and balance, two articles included both motor performance and balance, and two articles investigated vestibular, balance as well as motor impairments. Heterogeneity of the studies prevented us from performing methodological quality assessment and meta-analysis. The results of this review suggest that children with hearing impairment exhibit suboptimal levels of function in postural control, motor skill performance, and health-related quality of life.

The findings of the study suggest that vestibular-specific neuromuscular training programme may improve the motor skills, balance and health-related quality of life in children with hearing impairment.

The MACS could be considered as a standard classification for children with cerebral palsy on the basis of manual abilities. The MACS can be reliably used for children between 4 and 18 years and adults between 18 and 24 years. The use of the MACS is expected to increase; further work is required to explore the use of the MACS in clinical practice.

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