Postural control in children receiving intervention using the Astronaut Training Protocol

Abstract

ABSTRACT INTRODUCTION: The vestibular system plays an important role in postural control and an upright posture when seated at a table. Some children have difficulty with their in-seat posture resulting in increased in-seat movement. This research investigated the effect of the Astronaut Training Protocol on a child's vestibular processing and postural control, and by extension their in-seat behaviour METHOD: A case study research design with multiple data sources was used with four participants identified presenting with dysfunction in in-seat posture and in-seat movement. Data were collected over three phases: Pre-Astronaut Training (Baseline), Post-Astronaut Training (Intervention) and Withdrawal. The Pre-Astronaut Training and Withdrawal phases consisted of four sessions of sensory-based occupational therapy while the intervention phase included eight Astronaut Training sessions in addition to regular sensory-based occupational therapy. Four assessments were used to determine vestibular and postural control changes at each phase: Movement ABC one-leg balance, Post-rotary Nystagmus (PRN) test, in-seat posture assessment (designed for the purpose of this study), and in-seat movement through the collection of data using an accelerometer RESULTS: Participants' scores differed, depending on their initial ability to tolerate rotary input. This research showed that change in vestibular function and postural control differed for participants who could tolerate rotary input and those who were over-reactive to rotary input at the start of the study. Generally, the participants who were over-reactive to rotary input showed greater improvement Post-Astronaut Training with continued smaller improvements into the Withdrawal phase. Participants who could tolerate rotary input showed improvement in in-seat posture and in-seat movement during the Post-Astronaut training phase and deteriorated during the Withdrawal phase CONCLUSION: The Astronaut Training Protocol can improve vestibular function and postural control in children with poor in-seat posture and in-seat movement, although the frequency and intensity of the programme still need to be confirmed Keywords: vestibular processing, in-seat movement, in-seat posture, reaction to vestibular input, sensory-based occupational therapy, Astronaut Training Protocol.