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Reynard P, Ortega-Solís J, Tronche S, Darrouzet V, Thai-Van H. Guidelines of the French Society of Otorhinolaryngology and Head and Neck Surgery (SFORL) for vestibular rehabilitation in children with vestibular dysfunction. A systematic review. Arch Pediatr 2024; 31:217-223. [PMID: 38697883 DOI: 10.1016/j.arcped.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 01/20/2024] [Accepted: 02/25/2024] [Indexed: 05/05/2024]
Abstract
INTRODUCTION The consequence of complete or partial uncompensated vestibular dysfunction in children is usually balance disorders, with the risk of falls and increased fatigue, particularly during tasks requiring postural control. The aim of these recommendations is to establish guidelines for vestibular rehabilitation (VR) in children with vestibular impairment. MATERIAL AND METHODS The guidelines were developed based on a systematic review of the international literature, validated by a multidisciplinary group of French-speaking otorhinolaryngologists, scientists, and physiotherapists. They are classified as grade A, B, C, or expert opinion according to a decreasing level of scientific evidence. RESULTS A PubMed search of studies published between January 1990 and December 2021 was carried out using the keywords "vestibular," "rehabilitation," and "children". After filtering and reviewing the articles, a total of 10 publications were included to establish the recommendations. CONCLUSION It is recommended that a vestibular assessment be carried out before VR, including a study of vestibulo-ocular reflex, otolithic function, and postural control. In cases of vestibular dysfunction, physiotherapy treatment is recommended from an early age to train different aspects of postural control, including anticipatory and reactive postural adjustments. VR adapted to the pediatric population is recommended for children whose vestibular dysfunction leads to functional disorders or symptoms of vertigo for those who have suffered head trauma. It is recommended that children with bilateral vestibular impairment be treated using gaze stabilization exercises for adaptation and substitution. Optokinetic stimulation and virtual reality are not recommended for children and young adolescents.
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Affiliation(s)
- Pierre Reynard
- Department of Audiology and Otoneurological Evaluation, Hôpital Édouard Herriot & Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69003 Lyon, France; Center for Research and Innovation in Human Audiology (CERIAH), Institut de l'Audition, Institut Pasteur, Inserm, Paris, France; French Society of Vestibular Physiotherapy (SFKV), 31000 Toulouse, France.
| | - José Ortega-Solís
- Department of Audiology and Otoneurological Evaluation, Hôpital Édouard Herriot & Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69003 Lyon, France; French Society of Vestibular Physiotherapy (SFKV), 31000 Toulouse, France
| | - Sophie Tronche
- French Society of Otorhinolaryngology-Head and Neck Surgery (SFORL), 75116 Paris, France
| | - Vincent Darrouzet
- Department of Otolaryngology Head and Neck Surgery, and Skull Base Surgery, University Hospital of Bordeaux, 33000 Bordeaux, France
| | - Hung Thai-Van
- Department of Audiology and Otoneurological Evaluation, Hôpital Édouard Herriot & Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69003 Lyon, France; Center for Research and Innovation in Human Audiology (CERIAH), Institut de l'Audition, Institut Pasteur, Inserm, Paris, France; Université Claude Bernard Lyon 1, 69100 Villeurbanne, France
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Smalling S, Roberts J, Hendrick K, Gray M, Wyrwa JM. Vestibular Testing and Impairments in Postoperative Pediatric Cerebellar Mutism Syndrome: A Case Series. Pediatr Neurol 2024; 154:15-19. [PMID: 38447508 DOI: 10.1016/j.pediatrneurol.2024.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/25/2024] [Accepted: 01/27/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Postoperative pediatric cerebellar mutism syndrome (CMS) may occur following a process affecting the posterior cranial fossa. Recent evidence demonstrates disabling and potentially lasting motor components of this syndrome, including ataxia, hemiparesis, and oculomotor dysfunction. These impairments may contribute to vestibular deficits. METHODS This case series contributes data to quantify vestibular dysfunction in postoperative CMS. The pair consisted of one female and one male. RESULTS Vestibular testing demonstrated both peripheral and central dysfunction. CONCLUSIONS Given these findings, a thorough vestibular assessment may be indicated as part of a comprehensive evaluation following a postoperative CMS diagnosis. Further research is needed to understand the pathophysiology, treatment, and long-term outcomes of postoperative pediatric CMS.
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Affiliation(s)
- Stephanie Smalling
- Department of Physical Therapy, Children's Hospital Colorado, Aurora, Colorado
| | - Jeremy Roberts
- Department of Physical Medicine & Rehabilitation, Department of Pediatric Rehabilitation, Children's Hospital Colorado, University of Colorado, Aurora, Colorado.
| | - Karen Hendrick
- Department of Audiology, Children's Hospital Colorado, Aurora, Colorado
| | - Margot Gray
- Department of Physical Therapy, Children's Hospital Colorado, Aurora, Colorado
| | - Jordan M Wyrwa
- Department of Physical Medicine & Rehabilitation, Department of Pediatric Rehabilitation, Children's Hospital Colorado, University of Colorado, Aurora, Colorado
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Rodríguez-Villalba R, Caballero-Borrego M. Normative values for the video Head Impulse Test in children without otoneurologic symptoms and their evolution across childhood by gender. Eur Arch Otorhinolaryngol 2023; 280:4037-4043. [PMID: 36892616 PMCID: PMC10382384 DOI: 10.1007/s00405-023-07900-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/22/2023] [Indexed: 03/10/2023]
Abstract
PURPOSE The video Head Impulse Test is routinely used to assess semicircular canal function in adults, but to date, pediatric reference values are scarce. This study aimed to explore the vestibulo-ocular reflex (VOR) in healthy children at different development stages and to compare the obtained gain values with reference to those in an adult population. METHODS This prospective, single-center study recruited 187 children from among patients without otoneurological diseases, healthy relatives of these patients, and staff families from a tertiary hospital. Patients were divided into three groups by age: 3-6 years, 7-10 years, and 11-16 years. The vestibulo-ocular reflex was assessed by video Head Impulse Test, using a device with a high-speed infrared camera and accelerometer (EyeSeeCam®; Interacoustics, Denmark). RESULTS We found a lower vestibulo-ocular reflex gain of both horizontal canals in the 3-6-year-old group when compared with the other age groups. No increasing trend was found in the horizontal canals from age 7-10 years to age 11-16 years, and no differences were found by sex. CONCLUSION Gain values in the horizontal canals increased with age until children reached age 7-10 years and matched the normal values for adults.
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Affiliation(s)
- Rosana Rodríguez-Villalba
- Department of Otorhinolaryngology, Hospital Sant Joan de Déu, Barcelona, Spain
- Department of Otorhinolaryngology, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain
| | - Miguel Caballero-Borrego
- Otorhinolaryngology-Head and Neck Surgery Department, Hospital Clínic, University of Barcelona, C/Villarroel, 170, Esc. 8, 2ª, 08036, Barcelona, Spain.
- Institut d'Investigacions Biomèdiques Agusti Pi Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
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Biesieda V. Correction system effectiveness of the children physical development of early and younger preschool age with psychomotor disorders (on the example of posture). HEALTH, SPORT, REHABILITATION 2022. [DOI: 10.34142/hsr.2022.08.04.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Purpose: to reveal the reliability of the effectiveness of the developed author's system for correcting the physical development of young and preschool children with psychomotor disorders.
Material and methods. A total of 208 children of early (2-3 years) and younger preschool (3-4 years) age with psychomotor disorders took part in the study. Specially organized studies of the effectiveness of the system of corrective physical education for children of early and younger preschool age with psychomotor disorders were conducted during 2019 - 2021. They took place in specialized preschool education institutions, as well as kindergartens of the combined type in the city of Odesa, Odesa region, as well as in the cities of Kramatorsk, Kharkiv, Mykolaiv, Balaklia (Kharkiv region). I also summarized my own long-term (over 25 years) experience of individual rehabilitation activities with the specified contingent of children in the Odessa Movement Rehabilitation Center. All children were divided into two groups: 108 from experimental groups and 100 from control groups.
Results. Summarizing the analysis of the results of the dynamics of physical development indicators of children with psychomotor disorders (on the example of the study of their posture), we should conclude that almost all the indicators of children from the experimental groups had a marked improvement in results, which in the absolute majority of cases was confirmed statistically (P<0,01‒0,05). Children from control groups also demonstrated some improvement of physical development indicators, but it was by no means confirmed by the methods of mathematical statistics (P>0,05).
Conclusions: the conducted formative pedagogical experiment confirmed the reliability of the effectiveness of the developed author's system of correction of physical development of children of early and early preschool age with psychomotor disorders in comparison with the traditional system of their education.
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Application of Virtual Reality Rehabilitation System for the assessment of postural control while standing in typical children and peers with neurodevelopmental disorders. Gait Posture 2022; 92:364-370. [PMID: 34923256 DOI: 10.1016/j.gaitpost.2021.12.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 12/01/2021] [Accepted: 12/07/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The assessment of postural control in children is crucial, due to its central role in their overall development. However, a tool that objectively quantifies the difference in postural control between typical and atypical developing children is lacking. In this study, we introduce a new technology (Virtual Reality Rehabilitation System, VRRS) for assessing children's postural control. RESEARCH QUESTION Is this new assessment tool capable to highlight the differences between typical development (TD) and atypical development, (children with Developmental Coordination Disorder (DCD) and Cerebral Palsy (CP))? METHODS 30 TD children, 20 children with DCD and 27 with CP (mean ages: 6.29 ± 2.74; 9.11 ± 2.65; 10.07 ± 3.89 years) were tested with the VRRS Tablet with stabilometric balance platform. Postural parameters, related to the movements of the Centre of Pressure (COP) were collected. A multivariate analysis of variance (MANOVA) followed by a post-hoc analysis has been carried out. Moreover, the influence of age, sex, clinical scores and sub-diagnoses on parameters of interest has been explored. RESULTS COP distance and sway area in the three groups (TD: 7.35 ± 2.32 mm, 101.70 ± 64.16 mm2/s; DCD: 12.05 ± 8.19 mm, 188.46 ± 231.23 mm2/s; CP: 13.25 ± 8.09 mm, 239.13 ± 313.83 mm2/s, respectively) and all other VRRS parameters were significantly different among the three groups (p-values between 0.028 and <0.001). The TD group showed significantly different values than CP (p from < 0.03 to < 0.001) but not than DCD (p = n.s.). Clinical scores showed to correlate with the COP distances and Root Mean Square distances in all subgroups (p < 0.05). For age, only an influence was found within the TD group (p < 0.01); sex did not show to affect the outcomes (p = n.s.). SIGNIFICANCE An objective tool for quantitative measurement of postural control in childhood is needed. Our proposed VRRS tool could support the traditional assessment tests, highlighting differences between typical and atypical development.
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Harrabi MA, Fendri T, Ayed R, Rebai H, Chaari F, Turki M, Ayadi F, Sahli S. Iron deficiency anemia induces postural control disorders in young women. J Trace Elem Med Biol 2021; 68:126868. [PMID: 34597961 DOI: 10.1016/j.jtemb.2021.126868] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 09/05/2021] [Accepted: 09/20/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Due to menstruation and restrictive dietary practices, women are at a particular risk of iron deficiency anemia (IDA). This hematologic manifestation could impair postural control as it induces fatigue, muscle weakness, cognitive and neurological functions alteration. AIM This study aimed to investigate IDA effects on postural control in young women in comparison to healthy counterparts. MATERIAL AND METHODS Twenty-four young women with IDA and twenty-four controls participated in this study. Center of pressure (CoP) excursions, in the bipedal and semi-tandem postures on the firm and foam surfaces in the eyes opened (EO) and closed (EC), were recorded, and Romberg index was calculated to evaluate postural control. Besides physical performance, attentional capacity, fatigue, and heart and respiratory rates were assessed. RESULTS Young women with IDA had significantly higher CoP velocity (CoPv) values in the bipedal posture in both vision and surface conditions (EO [firm: P < 0.001 and foam: P < 0.01]; EC: P < 0.001), as well as in the semi-tandem posture (EO [firm: P < 0.01 and foam: P < 0.001]; EC: P < 0.001) compared to controls indicating that they had worse postural control than their peers. In addition, values of the respiratory rate (P < 0.001), attentional capacity (P < 0.001), physical performance (P < 0.001), fatigue (P < 0.001), and Romberg index on the foam surface in both postures (P < 0.05) were significantly higher in young women with IDA compared to controls. CONCLUSIONS Physical performance, fatigue, tachypnea and attentional capacity resulting from IDA may explain postural control disorder in young women.
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Affiliation(s)
- Mohammed A Harrabi
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, 3000, Tunisia.
| | - Thouraya Fendri
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, 3000, Tunisia
| | - Rahma Ayed
- Laboratory of Biochemistry, CHU Habib Bourguiba, University of Sfax, 3000, Tunisia
| | - Haithem Rebai
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, 3000, Tunisia
| | - Fatma Chaari
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, 3000, Tunisia
| | - Mouna Turki
- Laboratory of Biochemistry, CHU Habib Bourguiba, University of Sfax, 3000, Tunisia
| | - Fatma Ayadi
- Laboratory of Biochemistry, CHU Habib Bourguiba, University of Sfax, 3000, Tunisia
| | - Sonia Sahli
- Research Laboratory Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, 3000, Tunisia
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Vestibulo-ocular reflex assessed with Video Head Impulse Test in children with Vestibular Migraine: Our experience. Int J Pediatr Otorhinolaryngol 2020; 137:110161. [PMID: 32739603 DOI: 10.1016/j.ijporl.2020.110161] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/28/2020] [Accepted: 05/29/2020] [Indexed: 11/22/2022]
Abstract
UNLABELLED Vestibular Migraine in children can mimic other disorders, especially at presentation. Outcome is hard to predict and management may be challenging due to the fact that many of the patients are too young to describe their symptoms and these are not always accompanied by headache. OBJECTIVE To assess vestibulo-ocular reflex (VOR) in pediatric patients who meet criteria for defined Vestibular Migraine and to compare results to healthy controls. METHODS Twenty-one patients aged 11-16 years were included in this prospective multicentric study. VOR was assessed using the video Head Impulse Test by EyeSeeCam®(Interacoustics, Denmark). RESULTS Patients with Vestibular Migraine (VM) have higher values of gain compared to asymptomatic patients. CONCLUSION Video Head Impulse Test (vHIT) is a useful and relatively fast-to-perform examination in children compared to other vestibular tests. Patients with VM seem to have higher values of gain at vHIT.
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Dasgupta S, Mandala M, Salerni L, Crunkhorn R, Ratnayake S. Dizziness and Balance Problems in Children. Curr Treat Options Neurol 2020. [DOI: 10.1007/s11940-020-0615-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Abstract
PURPOSE This case report assesses gaze stability, postural control, and balance pre- and post-physical therapy intervention, including vestibular rehabilitation, in a 4-year-old child with posterior fossa syndrome following gross total resection of a juvenile astrocytoma brain tumor. SUMMARY OF KEY POINTS The child in this case study had improved balance and gaze stability, as determined by the Pediatric Balance Scale and the Dynamic Visual Acuity test upon completion of the 10-week intervention. STATEMENT OF CONCLUSION AND RECOMMENDATIONS FOR CLINICAL PRACTICE:: This case provides preliminary support of the need for vestibular screening in children with a diagnosis of posterior fossa syndrome. The success of the intervention suggests that vestibular rehabilitation exercises can be modified for use in preschool-aged children, and the specific intervention outlined in this case report can be easily replicated in a variety of treatment settings.
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Abstract
BACKGROUND A 9-year-old child with a 9-month history of complaints of dizziness, headache, and motion sensitivity came to physical therapy. The child complained of difficulties playing on a playground, running, riding in a car, watching "action movies," sitting under fluorescent lights, and making quick head movements. METHODS An initial evaluation included a clinical oculomotor examination, vergence testing, static and dynamic visual acuity testing, head impulse testing, subjective visual vertical, balance testing, the pediatric vestibular symptom questionnaire, the Dizziness Handicap Inventory-child caregivers version (DHI-PC) and a visual vertigo analog scale. Physical therapy included virtual reality with Xbox games plus adaptation, habituation, and balance exercises. She was seen once per week and given a home program of exercises 2 to 3 times a day. RESULTS After 10 treatment sessions, she reported that playing was easier, headaches had reduced, she could travel as a passenger in a car for long distances without complaints, and that she could watch 3-dimensional action movies without symptoms. Her pediatric vestibular symptom questionnaire scores had reduced from 0.7 to 0.1. The DHI-PC had decreased from 22 to 12 points and her visual vertigo analog scale scores were improved. CONCLUSIONS Vestibular rehabilitation improved this child's quality of life. She was able to return to her daily living activities with fewer symptoms.
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