Review Paper: Introduction of Pediatric Balance Therapy in Children with Vestibular Dysfunction: Review of Indications, Mechanisms, and Key Exercises

Abstract

The vestibular system is important for the development of normal movement reactions, motion tolerance, and motor control for postural alignment, balance, and vision. A vestibular system that is damaged by disease or injury in childhood can have a major impact on a child's development. In addition, the emergence of vestibular lesions may also lead to cognitive deficits, including attention deficit. Despite the advances in testing and documentation of vestibular deficits in children, the vestibular problems continue to be an overlooked entity. Many children do not receive treatment that could significantly improve function and address the developmental delays caused by vestibular disorders. Vestibular rehabilitation therapy (VRT) has been defined as an effective modality for most individuals with disorders of the vestibular or central balance system disorders. The basis for the success of VRT is the use of existing neural mechanisms in the human brain for adaptation, plasticity, and compensation. The vestibular system cannot be considered as a separate entity ignoring other balance subsystems. Hence, a modified VRT program, named pediatric balance therapy with special modifications in exercises, was developed for children with vestibular disorders, in accordance to the whole balance system.

Effect of vestibular rehabilitation therapy on visual and motor functions in children with dyspraxia

“…The vestibular system cannot be considered as a separate entity ignoring other balance subsystems. Hence, a modified VRT program, named pediatric balance therapy with special modifications in exercises, was developed for children with vestibular disorders, in accordance to the whole balance system [14] . Also, Melo et al (2019) [15] stated that Vestibular rehabilitation is a therapeutic resource applied to patients with balance disorders of vestibular origin and its proposal is based on the central mechanisms of neuroplasticity, known as adaptation, habituation and substitution, whose final objective is vestibular compensation.…”

Vestibular therapy improved motor planning, attention, and balance in children with attention deficit hyperactivity disorders: a randomized controlled trial

“…All subjects in the experimental group participated in a comprehensive Vestibular Rehabilitation Therapy (VRT) program [31] containing overall balance and gate, postural stability, and eye movement exercises [31,32]. Exercises were modified in consideration of the age of the subjects and their balance abilities and attention capacities to enhance gaze stability, postural stability, and daily living activities.…”

Proposal for a body balance training program for children through an integrative literature review

“…In the BB training program proposed in Chart 2, guided and playful activities were developed, as indicated by some authors 11 , the first of which progressively increased the degree of difficulty 8,[12][13][14] .…”

“…However, activities require a certain motor and cognitive demand, in addition to the child's active participation, and are not suitable for children under four years old 11 .…”

“…National 6,7 and international [8][9][10][11][12][13] studies have proposed rehabilitating children from VR, with some proving that this treatment is effective and safe for children 8,9 .…”