A systematic review of vestibular stimulation in cerebral palsy

Abstract

Identify the types and dosage of vestibular stimulation interventions in persons with cerebral palsy (CP), and establish the efficacy of these interventions on balance and function. Materials and Methods Thissystematic review followed Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols to search for studies evaluating vestibular stimulation interventions in persons with CP. Information sources included MEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials, clinicaltrials.gov and the World Health Organisation registry. Methodological quality was assessed by two independent reviewers using the Methodological Index of Non-Randomised Studies (MINORS) and Cochrane Risk of Bias Tool. ResultsFive articles were included. Three randomised studies were judged to have high risk of bias in at least one domain of the Cochrane Risk of Bias Tool. Two non-randomised studies were rated as low methodological quality using the MINORS tool. All studies used exercise-based vestibular stimulation, but there was little homogeneity regarding dosage. Findings related to efficacy of vestibular stimulation were inconsistent. ConclusionsClinical practice recommendations cannot be made due to lack of high quality studies and heterogeneity of treatment protocols. Future research should address theory-driven selection of intervention, establish dosage, use psychometrically robust tools and include all ages of persons with CP.

Improving Motor Proficiency in Children with Developmental Delays: A Meta-Analysis Evaluating the Impact of Motor Skills Interventions

“…A compromised motor skill makes it difficult for these children to perform dayto-day activities competently [7], including coordination, dexterity, balance, posture, gait, strength, speed, and agility [8]. However, it is a fact that these complications are not left unattended and have been addressed using numerous effective physical therapy techniques such as neurodevelopmental therapies [9], strength conditioning [10,11], balance and vestibular training [12], goal-directed motor learning [13], and virtual reality [14].…”

Acceptability and feasibility of a vestibular nerve stimulation headset protocol in children with cerebral palsy

“…Improvements in postural stability in children with CP have been demonstrated by stimulating the vestibular system via specific exercises [ 9 – 11 ]. However, a recent systematic review of the efficacy of vestibular stimulation in improving balance and function in people with CP highlighted contradictory results and methodological concerns in the underpinning literature [ 12 ]. All of the studies in the latter review evaluated vestibular stimulation in the form of exercise and movement: no studies were identified that evaluated electrical Vestibular Nerve Stimulation (VeNS) in CP.…”

“…VeNS is typically delivered via a headset that delivers electrical current via self-adhesive pads on the mastoid processes [ 19 ]. It can be conveniently delivered in the home environment [ 12 ], may be better tolerated than more traditional spinning and swinging exercises, and has the potential to impact on postural stability in children with CP.…”