Subjective Visual Vertical and Postural Capability in Children Born Prematurely

Abstract

PurposeWe compared postural stability and subjective visual vertical performance in a group of very preterm-born children aged 3-4 years and in a group of age-matched full-term children.Materials and MethodsA platform (from TechnoConcept) was used to measure postural control in children. Perception of subjective visual vertical was also recorded with posture while the child had to adjust the vertical in the dark or with visual perturbation. Two other conditions (control conditions) were also recorded while the child was on the platform: for a fixation of the vertical bar, and in eyes closed condition.ResultsPostural performance was poor in preterm-born children compared to that of age-matched full-term children: the surface area, the length in medio-lateral direction and the mean speed of the center of pressure (CoP) were significantly larger in the preterm-born children group (p < 0.04, p < 0.01, and p < 0.04, respectively). Dual task in both groups of children significantly affected postural control. The subjective visual vertical (SVV) values were more variable and less precise in preterm-born children.Discussion-ConclusionsWe suggest that poor postural control as well as perception of verticality observed in preterm-born children could be due to immaturity of the cortical processes involved in the motor control and in the treatment of perception and orientation of verticality.

Developmental study identifies the ages at which the processes involved in the perception of verticality and in postural stability occur

“…We have suggested that the scarce subjective visual vertical performance we observed in younger children could have been due to immaturity of the cortical and central areas involved. This hypothesis is in line with the results of recent research conducted by our group (14,23), which explored the subjective visual vertical in healthy and preterm born children. More specifically, Gaertner et al (14) showed that the accuracy of verticality at six to eight years old was scarce because children in that study were more dependent on visual information, so that the poor estimation of the SVV may have been caused by imperfect or incomplete integration of visual information.…”

“…More specifically, Gaertner et al (14) showed that the accuracy of verticality at six to eight years old was scarce because children in that study were more dependent on visual information, so that the poor estimation of the SVV may have been caused by imperfect or incomplete integration of visual information. Bucci et al (23), on the other hand, reported that preterm born children were more unstable than full-term born children and showed poor perceptions of verticality, probably due to the immaturity of the cortical processes involved in their motor control and in their treatment of perception and orientation of verticality.…”

The effect of head roll and soft surface on Virtual SVV in healthy subjects: A normalization study

“…It was reported that SVV and postural stability were impaired in preterm born children. [21] It is believed that SVV has a limited sensitivity for centrally compensated disease, however findings of the present study showed that there were SVV abnormalities in the long run. [1] When the perception of verticality fails, postural instability is the most common symptom, and it is also a significant factor for falling.…”

Physiotherapy intervention for 4-5 year old children born extremely preterm and/or extremely low birth weight

“…However, other studies have demonstrated similar findings at younger ages (Bucci et al, 2015;Burns et al, 1999;Lorefice et al, 2014;Lorefice et al, 2012a;Matiello & Woollacott, 1997). In a study of infants born between 26-33 weeks' gestational age, it was identified that at two years corrected age, infants who had bronchopulmonary dysplasia (also referred to as chronic neonatal lung disease) had significantly poorer postural control .…”

“…When adjusting for growth, amongst children with a history of bronchopulmonary dysplasia, those whose weight was less than the 10th percentile demonstrated significant differences in postural control compared to those whose growth was within normal limits. More recently, Bucci et al confirmed that postural control at three to four years of age in children born very preterm (25-27 weeks' gestational age) is reduced compared to age-matched full-term peers (Bucci et al, 2015).…”