Sway In Children Research Articles

Web Searches for “Vaccination” May Yield Anti-immunization Sites

Source: Davies P, Chapman S, Leask J. Antivaccination activists on the world wide web. Arch Dis Child. 2002;87:22–25.In the US, 55% of adults with internet access utilize it to obtain health information.1 Recognizing the internet’s potential for disseminating information to a vast audience, the authors from the University of Sydney, Australia evaluated the internet as an information source on immunization. They accessed 7 search engines and entered the search terms “vaccination” and “immunisation OR immunization.” (The 7 included Google, Netscape, Altavista, GoTo, HotBot, Lycos, and Yahoo.) The first 10 hits on each were examined to determine whether they promoted or opposed vaccination. The authors then performed another search on Google, using the term “vaccination,” which returned 845 sites; of these, 44 were antivaccination. These 44 antivaccination sites included links to an additional 56 sites, making up a group of 100 sites with antivaccination messages. The authors analyzed these 100 sites for their explicit messages and for the tone in which they were conveyed.In the first portion of the study, 43% of the 70 hits from the 7 search engines conveyed antivaccination messages. Searching with “vaccination” was more likely to return an antivaccination site than searching with “immunisation OR immunization.” Thus, anyone utilizing the internet for information about vaccinations is highly likely to encounter antivaccination sites and messages.In the second portion of the study, the authors analyzed the 100 antivaccination sites identified using Google. The authors noted and categorized the explicit claims and rhetorical appeals on each site. Most antivaccination sites presented themselves as legitimate authorities with scientific credibility. Sites that promoted themselves as “unbiased” and presenting “both sides” of the vaccination “debate” rarely offered links to pro-vaccination sites (such as www.aap.org). Emotional appeals using “horror stories” about babies allegedly damaged by vaccination were commonly presented. Some sites made explicit claims about the dangers of vaccination either without any references or with reference to self-published work, television interviews, letters to the editors of newspapers, or other indiscriminate sources. In some cases, reference to medical journal articles included conclusions that differed from those of the authors. Conspiracies were often asserted or implied, and webmasters occasionally claimed to have privileged information suggesting that the medical profession is not telling the truth or is not aware of the truth about vaccinations.2The authors conclude that anyone searching the internet for information on vaccination will be readily exposed to a strong antivaccination message. The authors suggest several methods of counteracting this bias.This article contains a very useful summary of the various rhetorical appeals — “scientific,” emotional, conspiratorial — and explicit claims of antivaccination sites. The authors suggest an interesting approach to counteracting the disinformation about vaccination on the internet. In essence, if you can’t beat ’em, join ’em. For example, since emotional appeals hold great sway, images and stories of children damaged by vaccine-preventable illness might be effective.3 This may be troubling to some since it involves using a tactic many find repugnant.All of us are seeing better-informed parents in our practices. However, some are misinformed. We must keep our cool and help parents evaluate the information they download. Parents must be helped to understand not only the matters of fact at issue, but also the manner by which information is conveyed and how that might influence their understanding.An antivaccine movement followed close upon the heels of Jenner’s seminal 1798 publication and has been a constant, albeit unwelcome, companion to public health immunization in one or another form for 200 years. So it is here to stay. What is new is that the experience of many vaccine-preventable diseases such as diphtheria, polio and even measles is no longer part of the cultural consciousness of most parents in developed nations; that there now is potential for substantial financial rewards for successful litigation related to alleged adverse events; and that any group or individual can gain inexpensive, instantaneous worldwide access via the internet. To counter the above, the Immunization Action Coalition regularly publishes stories of children affected by vaccine-preventable diseases. In addition, websites offering scientifically credible vaccine information include cdc.gov/nip nip, aap.org, immunize.org, vaccine.chop.edu edu, vaccinesafety.edu, and immunizationinfo.org. The CDC also offers a useful guide to assessing immunization information on the web: cdc.gov/od/nvpo/people.htm. In the past it was Caveat Emptor, today Caveat Webtor.

Force measurements of postural sway and rapid arm lift in seated children with and without MMC

Objective. The aim was to investigate the horizontal ground reaction forces of seated postural sway and rapid arm lift in children with and without myelomeningocele. Background. It is unclear whether children with myelomeningocele have limited control of body posture entirely caused by the impairment in the legs or also by other dysfunction. Methods. 11 children with myelomeningocele, 10–13 years, and 20 children without physical impairment were investigated. Data were collected by force plate measurements during quiet sitting and during rapid arm lift. The forces were expressed as the corresponding acceleration of the centre of mass. The amplitude and the frequency of the centre of mass acceleration quantified the sway. Movement time, onset and anteroposterior peak acceleration were analysed during arm lift. Results. The children with myelomeningocele had a low sway frequency under both conditions: eyes open and eyes closed. The movement time was longer for these children compared to the controls. The onset of initial anteroposterior centre of mass acceleration preceded the arm lift and was directed forward in both groups. The peak centre of mass acceleration was usually directed backward. Conclusions. The control of postural sway was different in children with myelomeningocele compared to children without disabilities and this could not be explained by the cele level. The children with myelomeningocele had a slow motor performance of the seated sway and during arm lift. Relevance Slow motor performance involves functional limitations in the individual child and is important for the therapy program.

Developmental changes in postural sway in children at high and low risk for developing alcohol-related disorders

Background: To utilize the power of latent growth analysis to evaluate changes in postural sway during development in children who are either at high or low risk for developing alcoholism. Methods: A total of 629 assessments of postural sway have been performed in children and adolescents ( n = 126) who were evaluated annually over a 7-year period. Results: Latent curve models indicated that these children/adolescents show a linear decrease in sway with age. Moreover, significantly different rates of change in the amount of sway between high- and low-risk offspring were seen. With the exception of one of the four stances tested, high-risk boys consistently showed a slower rate of improvement with respect to the amount of sway exhibited compared to low-risk boys. In girls, similar rates of improvement with age were seen in high- and low-risk individuals, though in one stance the high-risk girls showed a deterioration (greater sway with increasing age). Conclusions: Previous reports of increased postural sway in high-risk offspring most likely reflect a developmental delay (high-risk children have greater sway than is appropriate for their age based on normative values by age).

Visual-Induced Postural Sway in Children with and without Otitis Media

Children with otitis media with effusion (OME) have been shown to have a significantly higher velocity of sway than normal children. To further evaluate the effect of OME on balance, we studied visual dependency for balance by investigating the influence of optic flow on postural sway. The results of this preliminary study suggest that children with OME may be more visually dependent for balance than healthy age-matched controls. This was particularly evident for higher-frequency stimulus conditions (0.25 Hz) as opposed to lower-frequency stimulus conditions (0.10 Hz). These findings indicate that OME may affect vestibular function in children, thereby causing excessive reliance on other, nonvestibular sensory cues to maintain balance. Further studies are needed to define the role of vestibular function in the management of children with OME.

Children's postural sway in response to low- and high-frequency visual information for oscillation.

Two experiments examined postural responses of 3- to 6-year-old children to visual information for oscillation. In Experiment 1, children saw oscillations of the surround, with these movements ranging in frequency between 0.2 and 0.8 Hz. Analyses of anterior-posterior postural sway revealed that, similar to previous developmental investigations, the frequency of sway matched the frequency of oscillations. Analyses of sway amplitude and timing, however, revealed patterns of results more in keeping with research on adults. Experiment 2 extended these findings, presenting oscillations in which the frequency changed during the trial. Analyses of anterior-posterior sway revealed that sway frequency matched both speeds of movement. In contrast, amplitude and timing measures were again in line with adult data. These results suggest that the postural sway of children contains both adultlike and nonadult-like parameters of balance control.

Changes with aging in head and center of foot pressure sway in children

To quantitate the development of equilibrium in children, we investigated movements of the head and of the center of foot pressure (COF) in standing subjects, using a cephalograph, a force measuring platform, and a technical computer. We studied 126 subjects, 105 healthy children, aged 4–18 years, and 21 adults, aged 20–28 years. Each subject stood with their feet together on a platform for 60 s each with eyes open or closed. The area and total length of head and COF movements decreased with increasing age, and were significantly greater in children under 12 years than in adults. The ratio of the lengths of head to COF movements was significantly larger in children under 9 years than in adults. The ratio of the anteroposterior to lateral movement of COF was also larger in children under 9 years. These observations suggested that body sway in children was not only larger than that in adults, but different in nature.

幼児期の身体動揺に視覚が及ぼす影響の動揺方向による差異

The purpose of this study was to clarify the difference of visual influences on lateral and fore-aft body sway in pre-school children. The subjects were 67 children aged 3 to 6 years and 50 adults. Body sway was measured on a force platform in the Romberg position with the eyes open or shut. The RMS value for 512 points of A/D converted data at 50 msec intervals was calculated as an index of magnitude for each of the 2 types of directional sway.(1) The RMS value of lateral sway was significantly higher with the eyes shut than with the the eyes open in 5-and 6-year-old children. The RMS value of fore-aft sway with the eyes open or shut did not differ obviously in the children tested. In adult subjects, the visual conditions had a great influence on both sway directions. The RMS value was significantly higher with the eyes shut.(2) It was also found that under both visual conditions lateral sway showed a definite decrease with age, whereas fore-aft sway did not decrease in preschool children.

Cyclic: a laboratory software package for the analysis of electromyographic patterns in cyclic movements

Static posturography can serve as an easy and fast way to determine whether a child possesses sufficient balance control in different sensory conditions. Therefore, the aim of this review is to map age-related differences in postural sway during childhood in typically developing children, using static posturography and to provide an overview of the available (age-specific) reference values in scientific literature.The search strategy was performed in five databases (Pubmed, Web of Science, ScienceDirect, Cochrane Clinical Trials, Medline (Ovid)) November 2nd 2014 and updated twice: March 16th 2015 and July 20th 2015. The following keywords were used: (children OR child) AND (“postural control” OR “postural stability” OR equilibrium OR posture OR “postural balance”[mesh]) AND (“quiet stance” OR standing OR stance OR “quiet stance” OR static) AND (“postural sway” OR posturography OR “body sway” OR stabilography OR “trunk sway” OR “medio-lateral sway” OR “antero-posterior sway”). Relevant studies were identified using predefined selection criteria, applied on title and abstract (phase 1) and on full text (phase 2), supplemented with reference screening after the second phase.A total of 14 studies met the criteria. This review showed three main findings: 1) during natural bipedal stance with the eyes open, all studies reported a decrease in postural sway with increasing age, with conflicting results on the (non-)linearity of its development, 2) with eyes closed, all children show more sway than with eyes open and 3) only four studies reported numeric sway values that could serve as reference values, mainly focusing on children aged five and older.Considerable disagreement exists on the (non-)linearity of the development of postural sway in children. By choosing arbitrary age categories, it remains unclear between which age groups differences are situated. Future research is necessary to determine for which age groups age-specific reference values are relevant.

Estimation of two-joint muscle length

Static posturography can serve as an easy and fast way to determine whether a child possesses sufficient balance control in different sensory conditions. Therefore, the aim of this review is to map age-related differences in postural sway during childhood in typically developing children, using static posturography and to provide an overview of the available (age-specific) reference values in scientific literature.The search strategy was performed in five databases (Pubmed, Web of Science, ScienceDirect, Cochrane Clinical Trials, Medline (Ovid)) November 2nd 2014 and updated twice: March 16th 2015 and July 20th 2015. The following keywords were used: (children OR child) AND (“postural control” OR “postural stability” OR equilibrium OR posture OR “postural balance”[mesh]) AND (“quiet stance” OR standing OR stance OR “quiet stance” OR static) AND (“postural sway” OR posturography OR “body sway” OR stabilography OR “trunk sway” OR “medio-lateral sway” OR “antero-posterior sway”). Relevant studies were identified using predefined selection criteria, applied on title and abstract (phase 1) and on full text (phase 2), supplemented with reference screening after the second phase.A total of 14 studies met the criteria. This review showed three main findings: 1) during natural bipedal stance with the eyes open, all studies reported a decrease in postural sway with increasing age, with conflicting results on the (non-)linearity of its development, 2) with eyes closed, all children show more sway than with eyes open and 3) only four studies reported numeric sway values that could serve as reference values, mainly focusing on children aged five and older.Considerable disagreement exists on the (non-)linearity of the development of postural sway in children. By choosing arbitrary age categories, it remains unclear between which age groups differences are situated. Future research is necessary to determine for which age groups age-specific reference values are relevant.

Plegic limb classification using cluster analysis

Static posturography can serve as an easy and fast way to determine whether a child possesses sufficient balance control in different sensory conditions. Therefore, the aim of this review is to map age-related differences in postural sway during childhood in typically developing children, using static posturography and to provide an overview of the available (age-specific) reference values in scientific literature.The search strategy was performed in five databases (Pubmed, Web of Science, ScienceDirect, Cochrane Clinical Trials, Medline (Ovid)) November 2nd 2014 and updated twice: March 16th 2015 and July 20th 2015. The following keywords were used: (children OR child) AND (“postural control” OR “postural stability” OR equilibrium OR posture OR “postural balance”[mesh]) AND (“quiet stance” OR standing OR stance OR “quiet stance” OR static) AND (“postural sway” OR posturography OR “body sway” OR stabilography OR “trunk sway” OR “medio-lateral sway” OR “antero-posterior sway”). Relevant studies were identified using predefined selection criteria, applied on title and abstract (phase 1) and on full text (phase 2), supplemented with reference screening after the second phase.A total of 14 studies met the criteria. This review showed three main findings: 1) during natural bipedal stance with the eyes open, all studies reported a decrease in postural sway with increasing age, with conflicting results on the (non-)linearity of its development, 2) with eyes closed, all children show more sway than with eyes open and 3) only four studies reported numeric sway values that could serve as reference values, mainly focusing on children aged five and older.Considerable disagreement exists on the (non-)linearity of the development of postural sway in children. By choosing arbitrary age categories, it remains unclear between which age groups differences are situated. Future research is necessary to determine for which age groups age-specific reference values are relevant.

Postural sway in children from pedigrees exhibiting a high density of alcoholism

A total of 98 children participated in a study of the neurobehavioral characteristics of individuals from pedigrees in which there was a high density of alcoholism. Two groups of children were evaluated (High and Low Risk) using a sensitive movement platform and a variety of methods to challenge the motor system. High-Risk children showed a greater decrement in postural steadiness when visual input was removed than did Low-Risk children. Additionally, the monopedal stances revealed hemispheric differences in postural sway as a function of risk status. The amount of sway exhibited was correlated with the latency of P300 recorded using a visual task. Both appear to be indicators of neuropathological changes. The present results suggest that postural sway may be a neurobehavioral marker for alcoholism risk.

An Investigation of Postural Sway in Sitting of Normal Children and Children with Neurological Disorders

This study was focused upon the evaluation of postural sway in sitting of normal and neurologically impaired children. A postural tracking system was used to monitor stability (trunk sway) during static sitting on a conventional horizontal seat base, and to examine the effects of two seat base positions (flat and forward inclined) on sway of children with cerebral palsy and children with traumatic head injury. A linear relationship was observed between sway while sitting on a flat seat base and age of normal children. The exponential nature of decrease in sway with age was no evident, and appeared to be a linear function. When comparing age matched neurologic and normal groups of children, no significant differences were noted in the amount of sway recorded. In comparing the effects of seat base positions on sway, no difference was evident for either group level. Individual data inspection, however, revealed differences between children with cerebral palsy and head injury. Qualitative analysis indicated tat in some children, a forward inclined seat produced an increase in sway resulting in a more upright and stable sitting posture, while in other children, a decrease in sway resulted in similar postural changes. The underlying assumption that a reduction in sway is necessary for achieving improved postural control in sitting in certain groups of neurologically disabled individuals is questioned, and implication for future research are discussed.

Imbalance and Chronic Secretory Otitis Media in Children: Effect of Myringotomy and Insertion of Ventilation Tubes on Body Sway

We studied balance in 34 children with chronic secretory otitis media and compared them with 34 age- and sex-matched control children between the ages of 3 and 5 years. In addition to history and examination, objective measurements were obtained by use of a fixed force plate body sway platform in both the control group and the group with chronic secretory otitis media. We took measurements in both groups at an interval of 4 months to ensure that any improvement in body sway could not be attributed to normal maturation. Eight parameters of body sway were compared, including three new parameters not described elsewhere (mean squared velocity, the number of intersections, and velocity moment). Our study showed that balance is significantly worse in children with chronic secretory otitis media compared to a control group. Furthermore, the increased body sway of children with chronic secretory otitis media was returned to the normal range by myringotomy and insertion of ventilation tubes.

小児の重心動揺と頭部動揺におよぼす視運動刺激の影響

We evaluated the effects of horizontal and vertical optokinetic stimulation on head movement (HM) and body sway (BS) in children and adults, using a Jung type optokinetic stimulator, a strain gauge-platform, and a encephalography. Twenty healthy children aged 7 to 9 years and twenty healthy adults aged 20 to 26 years were instructed to stand with feet close together on the platform with eyes open with and without optokinetic stimulation for 60 seconds. In all subjects, optokinetic stimulation significantly increased the total lengths of HM and BS. In addition, optokinetic stimulation significantly increased the areas of HM and BS in children, but not in adults. Although the ratio of the anteroposterior component to the lateral component in BS was significantly higher in children than in adults, the value of HM was not. Children exhibited a characteristic BS in which the anteroposterior swaying velocity was larger than the lateral swaying velocity. In the anteroposterior component, averaged divisional frequencies of BS were significantly larger in children than in adults. However, averaged divisional frequencies in the lateral component of BS and those in the anteroposterior and lateral components of HM did not differ between the two age groups. The ratio of the total length of HM to that of BS was significantly higher in children than in adults. These results suggest that HM and BS of children are readily affected by optokinetic stimulation, and that in children, the BS velocity in the anteroposterior direction is higher than that in the lateral direction.

Visual fixation and postural sway in children.

Adults are able to use a visual target to reduce quiet-standing postural sway (Lee & Lishman, 1975). The present study was designed to determine whether children, under varying postural conditions, are also able to use a visual target to reduce postural sway. A second purpose was to determine the ability of children to visually fixate under different postural conditions. An inability to visually fixate may limit the usefulness of a visual target. The results indicate that, like adults, children are able to reduce sway in the presence of a visual target. Young children are less able than older children and adults to visually fixate. In addition, children show more spontaneous visual saccades in the no-target condition than in the target condition and more saccades in the Romberg stance than in a feet-together stance. The fact that saccades decrease with increasing age, even in the seated, head-stabilized condition, precludes the possibility that increased instability of the young children is the only cause of increased number of saccades.

小児の重心動揺および頭部動揺の年齢的変動

To evaluate quantitatively the development of equilibrium function in children, the author investigated head movement (H. M.) and movement of the body's center of gravity (M. C. G.) in six agegroups of children and adults, using a cephalograph to record H. M., a straingauge-platform to record M. C. G., and a technical computer. One hundred twenty-six healthy subjects aged 4 to 28 years were instructed to stand with feet close together on the platform with eyes open and with eyes closed for 60 seconds each.1. The area and total length of H. M. and M. C. G. decreased with age. They were significantly larger in children younger than 12 years of age than in adults. Changes in the swaying velocities of H. M. and M. C. G. in 8 directions paralleled the area and total length of sway.2. The averaged divisional frequencies of H. M. and M. C. G. decreased with age both in the lateral component and in the anteroposterior component. They were significantly larger in children younger than 9 years of age than in adults.3. In all six agegroups the total length, swaying velocities and averaged divisional frequencies of H. M. were smaller than those of M. C. G.4. The ratio of the anteroposterior component to the lateral component in H. M. did not differ among the agegroups. On the other hand this ratio in M. C. G. was significantly larger in children younger than 9 years of age than in adults.5. The ratio of the total length of H. M. to that of M. C. G. was significantly larger in children younger than 9 years of age than in adults.6. The ratio of the area and total length of H. M. and M. C. G. with eyes closed to those with eyes open did not differ among the agegroups.These results suggest that the body sway of children is not only larger than that of adults, but also different from it in nature. It appears that the ratio of H. M. to M. C. G. is larger in children than in adults, and that the ratio of the anteroposterior component to the lateral component in M. C. G. is also larger in children than in adults.

Postural sway and gait of children with convergent strabismus: by P. Odenrick, P. Sandstedt, and G. Lennerstrand. Dev Med Child Neurol 26: 495–499, 1984

Postural sway and gait of children with convergent strabismus: by P. Odenrick, P. Sandstedt, and G. Lennerstrand. Dev Med Child Neurol 26: 495–499, 1984