The Effect of the combination of active vestibular interventions and occupational therapy on Balance in Children with Bilateral Spastic Cerebral Palsy: A pilot randomized Controlled trial.

Abstract

The current study aimed to examine the effect of the combined administration of active vestibular interventions and occupational therapy on balance and the relationship between balance changes and Activity of Daily Living in school-aged children with cerebral palsy (CP). Twenty-four children with Spastic CP, at the level I and II (according to the "Gross Motor Function Classification System) aged 7-12 years were enrolled and randomly assigned into control and intervention groups. Pediatric Balance Scales and Bruininks-Oseretsky Test of Motor Proficiency II were employed to assess the functional balance changes as well as Force Plate (eyes closed and open) to assess changes in the parameters of balance (e.g. center of pressure excursion). The activity of Daily Living was assessed by "Activity Scales for Kids (performance version)". Participants in the intervention group received active vestibular intervention for 20 min and a regular occupational therapy program for 25 min. The control group received a regular occupational therapy program for 45 min. Interventions were provided 3 d/week for 6 weeks in each group. The participants were assessed in three stages: baseline, immediately after, and eight weeks after the intervention. Data were analyzed by ANOVA and linear regression. The results demonstrated that only functional balance, according to Pediatric Balance Scales scores, was significantly increased in the active vestibular interventions group (p=0.02). There was no significant association between functional balance and Activity of Daily Living (P>0.05). The combined administration of active vestibular interventions and occupational therapy could improve the functional balance in children with spastic CP. It may be related to the reorganization of the vestibular system with a controlled and precise application of stimuli.