Short-Term Effects of Vestibular Training on Gross Motor Function in Children and Youth with Cerebral Palsy: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Abstract

Aims

To review the literature on the effects of vestibular training on motor function and balance in children and youth with cerebral palsy.

Methods

Eight databases (MEDLINE-PubMed, PEDro, Cochrane Library, OTSeeker, Web of Science, Scopus Database, CINAHL and SPORTDiscus.) were searched up to May 15th, 2023. Studies comparing vestibular training with other types of interventions. The DerSimonian and Laird method was employed using random effects models to calculate the pooled estimate of the effect size with confidence intervals of 95%. The risk of bias was assessed with the Cochrane Collaboration’s tool and the Grading of Recommendations Assessment, Development and Evaluation approach was used to judge the certainty of the evidence for all outcomes.

Results

Eight studies were included comprising 226 participants with cerebral palsy. The meta-analyses demonstrated significant standardized mean differences in favor of vestibular training program compared to other technique(s) for Gross Motor Function Measure (−0.471; 95% confidence intervals: −0.919 to −0.023) and balance (−0.546; 95% confidence intervals: −0.916 to −0.176).

Conclusions

Vestibular training has potential benefits in the short-term as a therapeutic approach for improving gross motor function and the balance in children and youth with cerebral palsy, but further research is needed.

Keywords:

• Balance
• cerebral palsy
• function
• meta-analysis
• systematic review
• vestibular training

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

María Coello-Villalón

María Coello-Villalón is a pediatric physical therapist. She participates in the development of several projects related to neurological and pediatric physiotherapy in the Research in Pediatric Physiotherapy and Neurology Group, ImproveLab, Toledo, Spain.

Purificación López-Muñoz

Purificación López Muñoz, PhD. Master in Neurological Pathology. She is currently dedicated to teaching and research at the Faculty of Physiotherapy and Nursing of the University of Castilla La Mancha. She participates in the development of several projects related to neurological and pediatric physiotherapy, fields in which she also has extensive training and clinical experience. She has published several articles and a book chapter related to neurological physiotherapy.

Rocío Palomo-Carrión

Rocío Palomo-Carrión is Physiotherapist, Master in Pediatric physiotherapy and Doctor from the Salamanca University in Spain. Professor of the Department of Nursing, Physiotherapy and Occupational Therapy. Faculty of Physiotherapy and Nursing in Toledo, Castilla-La Mancha University. She has a wide clinical, teaching and research experience in Neurological Physiotherapy in the child, specifically about the affected upper limb’s assessment and treatment in hemiplegia.

Álvaro Hidalgo-Robles

Álvaro Hidalgo-Robles is a pediatric physical therapist. Since 2016, he has worked in early intervention with children aged 0–3. He earned his master's degree in physical therapy at University of Castilla-La Mancha (Toledo, Spain) and his MSc in pediatric physical therapy in University CEU San Pablo (Madrid, Spain). As a member of the Early Intervention Research Group (INAT) and the Toledo Research in Physical Therapy (GIFTO), he is researching for babies born preterm or with brain injury, specializing in early cerebral palsy detection and intervention. He is a professor at the International University of La Rioja (Spain). He is a member of the AACPDM Communications Committee, and participated in the scientific committee for the EACD Annual Meeting 2021 Thematic Day ‘User-Professional Partnership’, and ALDID 2021 Conference ‘Collaborating with a world in transition’.

Javier Merino-Andrés

Javier Merino Andrés is Physiotherapist, Master in Motor Neurocontrol and Doctor from the Castilla-La Mancha University in Spain. Professor of the Department of Nursing, Physiotherapy and Occupational Therapy. Faculty of Physiotherapy and Nursing in Toledo, Castilla-La Mancha University. He works in early intervention. He is researching for babies born preterm or with brain injury, specializing in early cerebral palsy detection and intervention.