An Overview of the Available Intervention Strategies for Postural Balance Control in Individuals with Autism Spectrum Disorder

Abstract

Background. Postural instability is a prevalent issue among individuals with autism spectrum disorder (ASD) that affects the development of their perceptual-motor skills and social functioning. Visual and somatosensory processing deficits, hypotonia, basal ganglia dysfunction, and anxiety are some of the concurrent disorders in individuals with ASD. Nevertheless, a definite management protocol for postural instability in ASD has not been introduced yet. Hence, we aim to shed light on the available intervention strategies for postural instability in individuals with ASD. Methods. Even though several studies have been conducted on the effects of various interventions for balance control in individuals with ASD, no study has compared their efficacy, limitations, and clinical implications. Results. This review discusses diverse proposed interventions contributing to ASD postural instability, including martial arts, water-based interventions, animal-assisted therapies, trampoline, balance training, vestibular therapy, transcranial direct current stimulation, sports, play, and active recreation for kids (SPARK), and square-stepping exercise (SSE). Conclusion. Enhancing motor skills, cerebellum function, and sensory input integration were some of the main mechanisms of these interventions to improve balance control in ASD. Some interventions, such as water-based exercises and video games, were enjoyable for children with ASD and could raise their treatment adherence. In most studies, small sample sizes and the lack of a control group represented their major limitations. Therefore, future well-designed randomized controlled trials are required to assess the effects of available interventions on postural control in ASD.

Finding Stability—A Case Report on the Benefits of Adapted Kata Training for Children with Autism Spectrum Disorder

“…Moreover, the postural balance improvements identified in this study must be viewed cautiously, as they reflect short-term effects. The study by Hariri et al [25] underlines the importance of examining the retention of these skills over an extended period to ensure the long-term efficacy of such interventions.…”

“…Motor symptoms such as tiptoeing can reduce balance and stamina in children with ASD, increasing the likelihood of falls and leading to more significant fatigue and less participation in social activities, which can negatively impact daily activities such as play, sports, and walking [7][8][9][10][11][12][13][14]. Although traditional treatments have provided moderate improvements in ASD-related behaviors, exercise and physical activities are being increasingly recognized as viable alternative treatments [23][24][25][26][27][28]. These treatments aim to enhance balance by stimulating the sensory systems, including the visual, vestibular, and proprioceptive systems, which have successfully improved joint proprioception and overall motor performance [28][29][30][31][32].…”

“…Given the emerging evidence on the benefits of balance training for individuals with ASD and the variability of results across studies, there is a clear need for further research in this area [7,11,17,32]. This study, therefore, aims to address the gap in research involving children with special needs and examines the effects of an AKTP on balance in a 10-year-old diagnosed with ASD within the context of Türkiye, where there is limited research on supporting special educational needs [18,[23][24][25][26][27][28].…”

Incidence of Otolaryngological Manifestations in Individuals with Autism Spectrum Disorder: A Special Focus on Auditory Disorders

“…Various SI therapies are currently used in clinical practice including swimming, trampolines, martial arts, transcranial direct current stimulation, animal-assisted therapies such as riding, sports, dance, videogames, as well as specific balance training exercises. It has been found that these therapies can enhance an individual’s sensory input integration processes, motor skills and coordination, and cerebellar function, which all help to improve balance control [ 63 ]. SI therapy testing can also be used as a diagnostic tool for clinicians in the early detection of ASD and vestibular dysfunction; however, auditory dysfunction is sometimes wrongly attributed to other neurodevelopmental disorders [ 64 ].…”

Effects of Horseback Riding on the Postural Control of Autistic Children: A Multiple Baseline Across-subjects Design

“…Although results are not conclusive, they have been encouraging with sensory stimulation interventions (Sam et al, 2017), visual feedback through video games (Travers et al, 2018;Hilton et al, 2014;Somogyi et al, 2016;Peña et al, 2020), gymnastic and neuromuscular training (Akyol & Pektas, 2018;Najafabadi et al, 2018;Shavikloo & Norasteh, 2018), therapeutic skating (Casey et al, 2015), Tai Chi Chuan (Sarabzadeh et al, 2019), and also with the help of elephants (Nuntanee & Daranee, 2019) and horses (Portela-Pino et al, 2019). Hariri et al (2022), in a systematic review of the literature, shed light on the available intervention strategies for improving postural control in people with ASD. This study has reported that most interventions affect motor function in ASD by improving cerebellar or balance function, integration and processing of sensory information, muscle strength and correction of body alignment.…”