Tests & Measures: A Resource for Pediatric Physical Therapy Practitioners

Sensory Organization Test – Article Summary

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Article Summary:

Fong SSM, Tsang WWN, Ng GYF. Altered postural control strategies and sensory organization in children with developmental coordination disorder. Human Movement Sciences. 2012; 31: 1317-1327.

The purpose of this cohort study was to compare standing balance ability and motor control strategies of children with and without DCD using the sensory organization test. The experimental group consisted of twenty-two children with a formal diagnosis of DCD, but no other co-morbidities, who were selected from a local child assessment center. The control group consisted of nineteen children with normal development who were recruited from the community. Children in both the experimental and control groups were of similar ages. Each child was tested by standing barefoot on the platform of a computerized dynamic posturography machine with a security harness. Three trials of the six different conditions (1. eyes open with fixed support, 2. eyes closed with fixed support, 3. sway referenced vision with fixed support, 4. eyes open with sway-referenced support, 5. eyes closed with sway-referenced support, and 6. sway-referenced vision and support) were assessed for each child and the means was calculated to determine the somatosensory, visual, and vestibular ratios. The trajectory of the center of pressure on the platform was also captured which was used to calculate the equilibrium score, which determined the child’s peak amplitude of anterior-posterior sway to the theoretical limits of anterior-posterior stability.

The equilibrium scores showed the overall balance ability in the six conditions were 24.2% lower in the DCD group than in the control group with condition 2, 4, 5, and 6 demonstrating a statistically significant difference between the experimental and control groups. With the comparison of the three sensory ratios, the visual and vestibular ratios showed statistically significant differences, with the DCD group lower than the control group; however, the somatosensory ratio had no statistical significance. For the motor strategies, there was no statistically significant difference between the groups for conditions 1-4; however, for the DCD group, conditions 5 and 6 were statistically significantly lower compared to the experimental group.

Based on this data, children with DCD swayed more when forced to rely more heavily on visual or vestibular inputs in order to maintain standing posture. Children with DCD also relied more on hip strategies, especially when vestibular inputs were impaired. This is clinically relevant due to necessary  individualization of postural control training with emphasis on visual and vestibular inputs and appropriate use of hip and ankle strategies during rehabilitation for children with DCD.