The maturation of balance in children

Development of postural control and maturation of sensory systems in children of different ages a cross-sectional study

OBJECTIVE

To evaluate the stability, postural adjustments and contributions of sensory information for postural control in children.

METHODS

40 boys and 40 girls were equally divided into groups of 5, 7, 9 and 12 years (G5, G7, G9 and G12). All children were submitted to dynamic posturography using a modified sensory organization test, using four sensory conditions: combining stable or sway referencing platform with eyes opened, or closed. The area and displacements of the center of pressure were used to determine stability, while the adjustments were used to measure the speed of the center of pressure displacements. These measurements were compared between groups and test conditions.

RESULTS

Stability tends to increase with age and to decrease with sensory manipulation with significant differences between G5 and G7 in different measures. G7 differed from G12 under the conditions of stable and sway platform with eyes open. G9 did not differ from G12. Similar behavior was observed for adjustments, especially in anterior-posterior directions.

CONCLUSION

Postural stability and adjustments were associated with age and were influenced by sensory manipulation. The ability to perform anterior-posterior adjustments was more evident and sensory maturation occurred firstly on the visual system, then proprioceptive system, and finally, the vestibular system, reaching functional maturity at nine years of age. Seven-year-olds seem to go through a period of differentiated singularity in postural control.

Reference Values of Static Balance in Spanish Preschool Children

The purpose of this study was to examine age and sex differences in static balance (SB) and to determine norm-referenced values for Spanish preschool children. A total of 3,575 children, aged 3-6 years (age = 56.08 ± 11.11 months; body mass index = 15.94 ± 1.91 kg/m²; 1,759 girls and 1,816 boys) were selected from 51 schools in southern Spain. To measure SB, we used the Stork Balance Stand Test, averaging both right and left foot data for determining SB normative values, expressed in percentiles. Girls exhibited a better performance than boys at four years of age ( p = .010, Cohen's d = -0.165), but a poorer performance at six years ( p = .002, Cohen's d = 0.247). SB performance of the entire sample was higher with increased age, except for 5-6 years.

Balance and postural control in basketball players

Abstract Introduction: Basketball is one of the most popular sports involving gestures and movements that require single-leg based support. Dorsiflexion range of motion (DROM), balance and postural control may influence the performance of this sport. Objective: To compare and correlate measures of balance, postural control and ankle DROM between amateur basketball athletes and non-athletes. Methods: Cross-sectional study, composed by 122 subjects allocated into one control group (CG = 61) and one basketball group (BG = 61). These groups were subdivided into two other groups by age: 12-14 years and 15-18 years. The participants were all tested for postural balance with the Star Excursion Balance Test (SEBT), postural control with the Step-down test and DROM with the Weight-bearing lunge test (WBLT). Between-groups differences were compared using repeated-measures multivariate analysis of variance. Normalized reaching distances were analyzed and correlated with the WBLT and Step-down test. Results: There was no difference in the scores of WBLT (P = .488) and Step-down test (P =. 916) between the groups. Scores for the anterior reach (P = .001) and total score of SEBT (P = .030) were higher in BG. The values for the posterolateral (P = .001) and posteromedial reach (P = .001) of SEBT were higher in BG at the age of 15-18. The correlation between the anterior reach of the SEBT and WBLT was significant in BG between 12-14 years (r = 0.578, P = .008), and in the CG between 15-18 years (r = 0.608, P=.001). Conclusion: The balance was better in the BG, although adolescents between 15-18 years have better balance control for the posteromedial and posterolateral reaches of the SEBT.

Influence of Age on Postconcussive Postural Control Measures and Future Implications for Assessment

OBJECTIVE

To examine the influence of age, sex, attention-deficit hyperactivity disorder (ADHD) status, previous history of concussion, and days since injury on postconcussion postural control assessment in adolescents who have suffered a concussion.

DESIGN

Prospective cohort study.

SETTING

Hospital-based outpatient clinic.

PARTICIPANTS

Seventy-one participants (42 males; 29 females) with mean age 14.14 ± 2.44.

INDEPENDENT VARIABLES

Age, sex, previous concussion history, ADHD status, total and severity of postconcussion symptoms, and days since injury.

MAIN OUTCOME MEASURES

Total Balance Error Scoring System score, path length, center-of-pressure (COP) area, sample entropy, and Romberg quotient.

RESULTS

Pearson product-moment correlation coefficients were calculated to test for potential associations between the continuous participant characteristics and the postural control variables. Spearman correlation was used to test the association between symptom severity and the postural control variables. Standard multiple regression was used to model the extent to which participant characteristics accounted for the variance in the postural sway variables. Age was significantly associated with all of the postural sway variables except COP area for the eyes open condition and sample entropy in the anterior-posterior direction for the eyes closed condition. Sex, ADHD status, and previous concussion history did not significantly predict postural control scores.

CONCLUSIONS

Age significantly influences scores on common postconcussion postural control assessments.

CLINICAL RELEVANCE

This study demonstrates that age is a critical factor that needs to be accounted for to improve the clinical appropriateness and utility of current postconcussion postural control assessments.

Superior short-term learning effect of visual and sensory organisation ability when sensory information is unreliable in adolescent rhythmic gymnasts

Rhythmic gymnasts specialise in dynamic balance under sensory conditions of numerous somatosensory, visual, and vestibular stimulations. This study investigated whether adolescent rhythmic gymnasts are superior to peers in Sensory Organisation test (SOT) performance, which quantifies the ability to maintain standing balance in six sensory conditions, and explored whether they plateaued faster during familiarisation with the SOT. Three and six sessions of SOTs were administered to 15 female rhythmic gymnasts (15.0 ± 1.8 years) and matched peers (15.1 ± 2.1 years), respectively. The gymnasts were superior to their peers in terms of fitness measures, and their performance was better in the SOT equilibrium score when visual information was unreliable. The SOT learning effects were shown in more challenging sensory conditions between Sessions 1 and 2 and were equivalent in both groups; however, over time, the gymnasts gained marginally significant better visual ability and relied less on visual sense when unreliable. In conclusion, adolescent rhythmic gymnasts have generally the same sensory organisation ability and learning rates as their peers. However, when visual information is unreliable, they have superior sensory organisation ability and learn faster to rely less on visual sense.

Examination of Age-Related Differences on Clinical Tests of Postural Stability

BACKGROUND

The modified Balance Error Scoring System (mBESS) and Y-Balance Test are common clinical measurements of postural control, but little is known about the effect of age on performance of these tasks. The purpose of this study was to examine how healthy child and adolescent athletes perform on 2 common clinical measurements of postural control.

HYPOTHESIS

Younger athletes would demonstrate poorer postural control compared with older athletes.

STUDY DESIGN

Cross-sectional study.

LEVEL OF EVIDENCE

Level 3.

METHODS

Three hundred eighty-nine athletes between the ages of 10 and 18 years underwent an evaluation of postural control. Each participant completed the mBESS in the double-leg, single-leg, and tandem stances as well as the Y-Balance Test. Postural stability data were analyzed between age groups (10-12, 13-15, and 16-18 years) using univariate analyses of covariance.

RESULTS

The youngest athletes (10-12 years) had a greater mean number of errors in the single-leg stance of the mBESS than the 13- to 15-year-old and 16- to 18-year-old athletes (3.8, 3, and 2.5 errors, respectively; P < 0.01). They also had greater right to left asymmetry compared with the 16- to 18-year-old athletes on the Y-Balance Test in the posterolateral (6.8 and 3.8 cm, respectively; P = 0.006) and posteromedial (5.3 and 3.6 cm, respectively; P = 0.014) directions of movement.

CONCLUSION

Athletes between the ages of 10 and 12 years performed worse on the single-leg stance of the mBESS and demonstrated more asymmetry on the Y-Balance Test in the posterolateral and posteromedial directions compared with older athletes.

CLINICAL RELEVANCE

In the absence of a baseline balance test for athletes younger than the age of 13 years, caution should be used in interpreting postural stability assessments, as age may be a modifying factor in performance.

Age-related changes in postural sway in preschoolers

OBJECTIVES

The present study aimed to investigate age-related differences of postural sway in 3- to 6-year-old typically developing children in different sensory conditions and subsequently to provide reference values for global descriptive sway parameters in preschoolers.

METHODS

Ninety-six typically developing children, between 3 and 5 years of age, participated in this cross-sectional study. Postural sway was measured for 40s in four conditions (eyes open/eyes closed on stable ground/foam) by using a force plate. Global descriptive sway parameters were calculated and analysed using a 2 × 2 × 3 (surface × vision × age group) MANOVA (p<0.05) in the children that were able to complete the task (40s).

RESULTS

When sensory information was altered, a significantly smaller number of 3- and 4-year-olds was able to complete the task. Significant main effects of vision (p<0.05), surface (p<0.001) and an interaction effect between vision and surface (p<0.05) on all postural sway parameters were found. A significant main effect of age was found for antero-posterior amplitude (p=0.047), medio-lateral root mean square (p=0.012) and area (p=0.009) between 3- and 5-year-olds and 4- and 5-year-olds. No interaction effects (surface × vision × age group) were found.

CONCLUSIONS

During natural stance, the amount of postural sway distinguishes 5-year-olds from 3- and 4-year-olds, highlighting the need for age-specific reference values for specific balance-related sway parameters (e.g. RMS_ml). Regarding test conditions with altered sensory input, a larger number of 5-year-old children are able to perform more difficult tasks. Nevertheless, if 3- or 4-year-olds are able to perform the more difficult tasks, their performance can be compared to the older children.

Reliability of postural control measures in children and young adolescents

Although many studies have been carried out regarding postural stability during pediatric age, reliable information and a complete analysis of all age groups are still lacking. The purpose of this study was to verify the test-retest reliability of posturographic parameters in four sensory conditions and provide normative values for children and young adolescents. 289 subjects, aged 6-14 years, were assessed by means of the static posturography system SVeP. 173 elementary school pupils (114 males and 59 females, aged 6-10 years; mean age 8.80 ± 1.53) and 116 middle school students (60 males and 56 females, aged 11-14 years; mean age 12.6 ± 0.9) underwent static posturography in two consecutive trials with four testing conditions: eyes open and eyes closed with and without foam pads. The participants were divided into nine age groups. Thirty healthy young adults were also recruited for comparison. The analysis of test-retest reliability demonstrated an excellent reliability of velocity measurement and a moderate reliability of area measurement. Velocity and area decreased significantly with age in all sensory conditions, indicating an improvement in postural control from childhood to adolescence. Postural stability had not reached the adult level by the age of 13-14 years. Reliable information regarding postural stability can be obtained in children and young adolescents by means of stabilometric parameters. These data can be used as a reference for early detection of atypical postural development and for the assessment of dizziness and balance disorders in children.

Diurnal changes in postural control in normal children: Computerized static and dynamic assessments

Mild traumatic brain injury (mTBI) causes postural control deficits and accordingly comparison of aberrant postural control against normal postural control may help diagnose mTBI. However, in the current literature, little is known regarding the normal pattern of postural control in young children. This study was therefore conducted as an effort to fill this knowledge gap. Eight normal school-aged children participated. Posture assessment was conducted before (7–8 a.m. in the morning) and after (4–7 p.m. in the afternoon) school on regular school days using the Balance Master® evaluation system composed of 3 static tests and 2 dynamic balance tests. A significant difference in the weight-bearing squats was detected between morning hours and afternoon hours (P < 0.05). By end of afternoon, the body weight was borne mainly on the left side with the knee fully extended and at various degrees of knee flexion. A significantly better directional control of the lateral rhythmic weight shifts was observed at the end of the afternoon than at morning hours (P < 0.05). In summary, most of our findings are inconsistent with results from previous studies in adults, suggesting age-related differences in posture control in humans. On a regular school day, the capacity of postural control and laterality or medio-lateral balance in children varies between morning and afternoon hours. We suggest that posturographic assessment in children, either in normal (e.g., physical education and sports training) or in abnormal conditions (e.g., mTBI-associated balance disorders), be better performed late in the afternoon.

Posturography characteristics of obese children with and without associated disorders

A group of 59 obese children ages 6-12 years were interviewed for current medical diagnoses (e.g., Attention Deficit Hyperactivity Disorder- ADHD, and clumsiness) and later were examined posturographically for balance and stability. General stability of all the obese children deviated significantly from norms. 32.2% of the obese children had a pattern of balance that could indicate orthopedic problems. Obese children with ADHD or perceived clumsiness had significantly worse balance and postural performance compared to other obese children. Balance and posture among obese children without suspicion of problems were similar to non-obese controls. In conclusion, obese children with associated disorders (such as ADHD and perceived clumsiness) manifested disturbance in balance control. Thus, physical activity interventions for these children should include safety measures to decrease the chances of falling and subsequent injury.

Assessment of postural control in children with cerebral palsy: a review

This paper aimed to review studies that assessed postural control (PC) in children with cerebral palsy (CP) and describe the methods used to investigate postural control in this population. It also intended to describe the performance of children with CP in postural control. An extensive database search was performed using the keywords: postural control, cerebral palsy, children, balance and functionality. A total of 1065 papers were identified and 25 met the inclusion criteria. The survey showed that PC is widely studied in children with CP, with reliable methods. The link between postural control and functionality was also evident. However, a lack of studies was observed assessing postural control in these children by means of scales and functional tests, as well as exploring postural control during daily functional activities. Thus research addressing these issues can be a promising field for further research on postural control.

Balancing on a Slackline: 8-Year-Olds vs. Adults

Children are less stable than adults during static upright stance. We investigated whether the same holds true for a task that was novel for both children and adults and highly dynamic: single-legged stance on a slackline. We compared 8-year-olds with young adults and assessed the following outcome measures: time on the slackline, stability on the slackline (calculated from slackline reaction force), gaze movement, head-in-space rotation and translation, trunk-in-space rotation, and head-on-trunk rotation. Eight-year-olds fell off the slackline quicker and were generally less stable on the slackline than adults. Eight-year-olds also showed more head-in-space rotation and translation, and more gaze variability around a visual anchor point they were instructed to fixate. Trunk-in-space and head-on-trunk rotations did not differ between groups. The results imply that the lower postural stability of 8-year-olds compared to adults – as found in simple upright stance – holds true for dynamic, novel tasks in which adults lack the advantage of more practice. They also suggest that the lack of head and gaze stability constitutes an important limiting factor in children’s ability to master such tasks.

Performance of children on the Community Balance and Mobility Scale

This study describes the performance of children 8-11 years of age on the Community Balance and Mobility Scale (CB&M) and associations between performance and age, body mass index (BMI), and sex. A convenience sample of 84 was recruited. The CB&M was administered using instructions we developed for children. Mean CB&M total scores (95% confidence intervals) for age groups were 8: 70.1 (64.2, 76.1); 9: 72.8 (68.7, 76.8); 10: 79.2 (76.6, 81.7); and 11: 82.9 (79.2, 86.5). None of the children achieved the maximum score. Scores increased with age, and overweight/obese children had relatively lower scores. There were no significant differences between males and females. A regression analysis found 28.1% of the variation in the CB&M total scores was explained by age (p < .001), BMI (p < .01), and sex (p = .25) suggesting that other factors contribute to variation in balance and mobility proficiency. The modified instructions and scoring patterns from this study can assist in using the CB&M in children of ages 8-11 years.

Influência do gênero no equilíbrio postural de crianças com idade escolar

OBJETIVO: avaliar a relação entre o gênero e o nível de desenvolvimento dos sistemas responsáveis pelo equilíbrio postural em crianças de seis a dez anos de idade. MÉTODO: composto por 282 crianças, divididas em três grupos:geral (meninas e meninos), feminino com 146 crianças, e masculino composto por 136 crianças na faixa etária entre os seis e os dez anos de idade. Para avaliação do equilíbrio postural utilizou-se a posturografia dinâmica foam-laser que avalia os sistemas sensoriais por meio de seis testes distintos. Os dados foram submetidos à estatística descritiva e a testes conforme a normalidade dos dados. RESULTADOS: nos Testes de Organização Sensorial, pode-se observar que os valores encontrados para as meninas foram maiores que os valores encontrados para meninos nas variáveis Teste de Organização Sensorial I e na Média destes. Porém, esses valores para os grupos de meninos e meninas foram inferiores aos valores de referência da Foam-Laser Posturography para adultos. Quando foi realizada a comparação entre os gêneros dentro de cada faixa etária, foram observadas diferenças estatisticamente significantes no Teste de Organização Sensorial I aos oito anos de idade, no Teste de Organização Sensorial V aos nove anos e no Teste de Organização Sensorial VI e na Média dos Testes de Organização Sensorial aos oito anos. CONCLUSÃO: o equilíbrio postural de meninas foi melhor que nos meninos, mas ambos os grupos tiveram valores inferiores aos considerados normais em adultos indicando que a maturação neuronal dos sistemas responsáveis pelo equilíbrio postural ainda não está completa.

Taekwondo training improves sensory organization and balance control in children with developmental coordination disorder: a randomized controlled trial

Children with developmental coordination disorder (DCD) have poorer postural control and are more susceptible to falls and injuries than their healthy counterparts. Sports training may improve sensory organization and balance ability in this population. This study aimed to evaluate the effects of three months of Taekwondo (TKD) training on the sensory organization and standing balance of children with DCD. It is a randomized controlled trial. Forty-four children with DCD (mean age: 7.6±1.3 years) and 18 typically developing children (mean age: 7.2±1.0 years) participated in the study. Twenty-one children with DCD were randomly selected to undergo daily TKD training for three months (1 h per day). Twenty-three children with DCD and 18 typically developing children received no training as controls. Sensory organization and standing balance were evaluated using a sensory organization test (SOT) and unilateral stance test (UST), respectively. Repeated measures MANCOVA showed a significant group by time interaction effect. Post hoc analysis demonstrated that improvements in the vestibular ratio (p=0.003) and UST sway velocity (p=0.007) were significantly greater in the DCD-TKD group than in the DCD-control group. There was no significant difference in the average vestibular ratio or UST sway velocity between the DCD-TKD and normal-control group after three months of TKD training (p>0.05). No change was found in the somatosensory ratio after TKD training (p>0.05). Significant improvements in visual ratios, vestibular ratios, SOT composite scores and UST sway velocities were also observed in the DCD-TKD group after training (p≤0.01). Three months of daily TKD training can improve sensory organization and standing balance for children with DCD. Clinicians can suggest TKD as a therapeutic leisure activity for this population.

Taekwondo training speeds up the development of balance and sensory functions in young adolescents

OBJECTIVES

This study aimed (1) to identify the developmental status of balance and sensory functions in young adolescents as compared to adults and, (2) to explore the effect of Taekwondo (TKD) training on the development of balance and sensory systems in young adolescents.

DESIGN

Cross-sectional controlled trial.

METHODS

Sixty-six participants including 42 adolescents (21 TKD practitioners, 21 non-TKD practitioners) and 24 adults were tested. The sway velocity of centre of gravity was recorded during standing on the non-dominant leg on a Smart Equitest ® system. The somatosensory, vestibular and visual ratios were also measured with the machine.

RESULTS

Adult participants swayed slower than both TKD and non-TKD adolescent groups during single leg stance with eyes open (p=0.007 and p<0.001, respectively). The TKD adolescent group, in turn, swayed slower than the non-TKD adolescent group (p<0.001). Adult participants had better visual ratio than both TKD and non-TKD adolescents (p=0.001 and p<0.001, respectively) while there was no difference between the TKD and non-TKD adolescents (p=0.164). For the vestibular ratio, there was no significant difference between adult participants and TKD adolescents (p=0.432). Adolescents who did not practice TKD showed significantly lower vestibular ratio than TKD adolescents and adults (p=0.003 and p<0.001, respectively). In addition, there was no significant difference in the somatosensory ratio among the 3 participant groups (p=0.711).

CONCLUSIONS

Participation in TKD appears to speed up the development of postural control and vestibular function in adolescents. Clinicians might advocate TKD exercise as a therapeutic intervention for young people with balance or vestibular dysfunctions.

Static balance function in children with cochlear implants

OBJECTIVE

This study aimed to assess the static balance function in deaf adolescents with cochlear implants.

METHODS

We included 24 adolescents who had received unilateral cochlear implantation for at least 5 years. Each subject underwent stabilometry testing under 4 different conditions: (A) firm surface with eyes open; (B) firm surface with eyes closed; (C) foam pad with eyes open; and (D) foam pad with eyes closed. All of them received tests with their cochlear implant turned on and off. Another 24 age- and sex-matched adolescents with normal hearing were tested in the same way for comparison. Sway velocity and circular area were measured and analyzed.

RESULTS

The mean sway velocity of the cochlear implant group under conditions A-D was 1.68, 1.98, 2.36, and 5.25 cm/s, respectively, and the mean circular area of the cochlear implant group under conditions A-D was 7.39, 6.68, 12.21, and 34.27 cm(2), respectively. Both of the parameters showed statistical significance between the cochlear implant group and the normal hearing group for conditions A, C and D (p<0.05). Furthermore, there was no significant balance function change among cochlear implant group with their implant "on" and "off".

CONCLUSIONS

This study showed that the static balance function in adolescents with long-term use of cochlear implants was worse than those of normal hearing peers. The difference between the cochlear implant group and normal hearing group was the highest when both visual and somatosensory inputs were disrupted. The postural stability was similar whether or not the cochlear implant was activated.

Balance ability of 7 and 10 year old children in the population: results from a large UK birth cohort study

OBJECTIVE

The literature contains many reports of balance function in children, but these are often on atypical samples taken from hospital-based clinics and may not be generalisable to the population as a whole. The purpose of the present study is to describe balance test results from a large UK-based birth cohort study.

METHODS

Data from the Avon Longitudinal Study of Parents and Children (ALSPAC) were analysed. A total of 5402 children completed the heel-to-toe walking test at age 7 years. At age 10 years, 6915 children underwent clinical tests of balance including beam-walking, standing heel-to-toe on a beam and standing on one leg. A proportion of the children returned to the clinic for retesting within 3 months allowing test-retest agreement to be measured.

RESULTS

Frequency distributions for each of the balance tests are given. Correlations between measures of dynamic balance at ages 7 and 10 years were weak. The static balance of 10 year old children was found to be poorer with eyes closed than with eyes open, and poorer in boys than in girls for all measures. Balance on one leg was poorer than heel-to-toe balance on a beam. A significant learning effect was found when first and second attempts of the tests were compared. Measures of static and dynamic balance appeared independent. Consistent with previous reports in the literature, test-retest reliability was found to be low.

CONCLUSIONS

This study provides information about the balance ability of children aged 7 and 10 years and provides clinicians with reference data for balance tests commonly used in the paediatric clinic.

Evaluating the injury incidence from skate shoes in the United States

OBJECTIVES

The goals of this study were to evaluate whether the increased use of skate shoes may lead to an increase in injuries for children and adolescents aged 5 to 14 years in the United States and to describe the types of injuries reported by emergency departments as a result of skate shoe use.

METHODS

Retrospective analysis of the National Electronic Injury Surveillance System database from January 1, 2002 to December 31, 2006 for injuries resulting from footwear in children and adolescents aged 5 to 14 years. Injuries resulting from skate shoe use were identified by manual review of the data.

RESULTS

For the 5-year period, an estimated 3525 patients between 5 and 14 years of age were treated in United States emergency departments for injuries resulting from skate shoe use. The percentage of injuries resulting from skate shoes of total footwear-related injuries varied by year, however, with 1.0%, 1.0%, 0.8%, and 1.9% occurring in 2002 to 2005, respectively, and 11.8% occurring in 2006. This substantial increase in 2006 accounts for 73.6% of skate shoe-related injuries and is statistically significant (chi, P = <0.0001). This rising trend in 2006 paralleled national skate shoe sales, with a correlation coefficient of 0.9982.Most of the injured children and adolescents were white, and there was a slight, nonsignificant predominance of boys. Most injuries in all 5-year-olds were fractures (46.7%), followed by contusions (17.9%) and sprains (17.2%). The most frequent site of fracture was the forearm (38.4%), followed by the wrist (35.1%) and the leg (14.9%). Other injuries included lacerations (7.3%), concussions (6.6%), internal organ injuries (0.9%), hematomas (0.2%), dislocations (0.2%), and injuries not otherwise specified (3.1%). Based on national estimates, 104 (0.01%) patients required admission to the hospital. No injuries recorded in the National Electronic Injury Surveillance System database resulted in death.

CONCLUSIONS

As the first study analyzing injury rates as a result of skate shoe use in the United States, this study demonstrated a recent increase in injuries to children and adolescents using skate shoes, which paralleled the products' sales increase. The types of injuries are primarily a wide range of non-life threatening bone and soft tissue injuries.

Pediatric vestibulopathy and pseudovestibulopathy: differential diagnosis and management

PURPOSE OF REVIEW

Evaluation of children with vestibular complaints may be challenging. The approach to these patients is often quite different than the approach to adults with similar complaints. This review will discuss the evaluation of pediatric vestibular disease with an emphasis on recent evidence in the literature

RECENT FINDINGS

Recent evidence has elucidated the most common etiologies of vertigo in children, documented the utility and feasibility of objective diagnostic testing such as electronystagmography and vestibular evoked myogenic potentials in this population, and demonstrated the efficacy of new therapies such as rizatriptan for the treatment of migraine in children.

SUMMARY

An evidence-based approach to the evaluation of pediatric vestibular dysfunction may improve diagnostic yield and facilitate timely initiation of appropriate therapy.