Sensory Organization Test- Article Summary
Updates: All the above information was reviewed and is up to date.
Article Review: The Effect of Vestibular Rehabilitation Therapy Program on Sensory Organization of Deaf Children With Bilateral Vestibular Dysfunction
Ebrahimi AA, Jamshidi AA, Movallali G, Rahgozar M, Haghgoo HA. The Effect of Vestibular Rehabilitation Therapy Program on Sensory Organization of Deaf Children With Bilateral Vestibular Dysfunction. Acta Medica Iranica; Tehran. 2017;55(11):683-689.
Purpose: Children with bilateral vestibular impairment have demonstrated deficits in postural control, however little research has been done to determine interventions for improving postural control in this population. The purpose of this study was to determine the effectiveness of an intervention to improve visual and somatosensory input on sensory organization and postural control in children with bilateral vestibular impairment and sensorineural hearing loss.
Study Population: Participants consisted of 24 children (ages 7-12, 3 female, 21 male) with profound sensorineural hearing loss and vestibular impairment. Exclusion criteria included children with additional visual, physical, neurological or cognitive impairments. Hearing loss was determined via audiogram and vestibular impairment was determined via the Bruininks-Oseretsky test of Motor Performance (BOTMP) balance sub-scale, occulography, cervical vestibular evoked myogenic potential (c-VEMP), and video head impulse test (V-Hit).
Methods/Intervention: Twelve children were randomly assigned to the control group, and 12 to the intervention or “exercise” group. The exercise group underwent 8 weeks of vestibular rehabilitation therapy (VRT) for 45 minutes sessions 3 times per week, while the control group received no intervention. VRT included adaptation, eye-head coordination, and substitution exercises, with the goal of improving gaze stabilization and postural stability. The exercises were progressed based on individual performance. Progression included increasing duration, increasing background/distraction, increasing speed, and increasing challenge of position (ie: static standing to standing on balance board). Postural control was assessed in all participants before and after the 8 week period. Paired t-tests were used to compare the scores of the outcome measures before and after the intervention.
Outcome Measures: Postural control was assessed using the Sensory Organization Test (SOT) and Limits of Stability (LOS) eyes open on firm surface condition.
Results: There were no significant differences in pre- and post- test scores for the children in the control group. Children in the exercise group demonstrated significant improvement from pre- to post-intervention in area on the Limits of Stability test. They also demonstrated significant improvements on the Sensory Organization Test (SOT) in: anterior/posterior control in conditions 5 and 6, anterior/posterior vestibular ratio, and anterior/posterior and medial/lateral global scores. In condition 5 of the SOT, vision is absent (eyes closed) and somatosensory input is inaccurate (foam surface). In condition 6, vision and somatosensory input are inaccurate (moving visual scene and foam surface). The vestibular ratio compares the results of condition 5 to condition 1 (eyes open, firm surface) to determine the change in postural control when somatosensory and visual input is limited. The global score is a composite score of all conditions. The results indicate that the VRT intervention was successful in improving vestibular function and sensory organization for postural control, especially in the anterior/posterior direction.
Major Strengths: The authors broke down the analysis of the SOT results into the specific conditions and ratios. This allowed them to analyze the impact of the intervention on postural control on specific systems (somatosensory, visual, vestibular).
Major Limitations: The authors were very vague in the description of the intervention exercises. The authors described the interventions as similar to those in cited articles, however they did not describe the specific exercises used with the children in this study. This makes it challenging to reproduce these results. Additionally, the authors did not assess the participants on the BOTMP balance sub-scale after the 8 week intervention period.
Conclusion: The vestibular rehabilitation therapy intervention used in this study can be effective in improving sensory organization and postural control in children with bilateral sensorineural hearing loss and vestibular impairment.
3 responses to “Sensory Organization Test- Article Summary”
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Interesting article! Vestibular hypofunction disorders often develop compensations over time that can diminish the impairments caused by the hypofunction. Did the researchers mention any compensations for postural control that these kids may have developed?
Great question, Annelise! In the introduction, the authors did mention that children with vestibular impairments often become dependent on other methods for postural control. However, they did not mention if their participants demonstrated any compensation strategies. I think the lack of qualitative detail overall in this study is a major limitation.
Very thorough review Emily! I thought it was interesting that the SOT sounds like a more objective version of the mCTSIB. We used the mCTSIB with many of our patients in vestibular therapy during one of my clinical rotations. Also, the intervention in this study that was designed for children was similar to one that would be prescribed to an adult with vestibular impairments. Although, there were improvements in the VRT group it would have been interesting to see if there was any long term carryover by doing a follow up assessment weeks or months after the treatment.