Department of Audiology and Otoneurological Evaluation, Hôpital Édouard Herriot & Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69003 Lyon, France; Center for Research and Innovation in Human Audiology (CERIAH), Institut de l'Audition, Institut Pasteur, Inserm, Paris, France; French Society of Vestibular Physiotherapy (SFKV), 31000 Toulouse, France.
Department of Audiology and Otoneurological Evaluation, Hôpital Édouard Herriot & Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 69003 Lyon, France; French Society of Vestibular Physiotherapy (SFKV), 31000 Toulouse, France.
Arch Pediatr. 2024 May;31(4):217-223. doi: 10.1016/j.arcped.2024.02.006. Epub 2024 May 1.
The consequence of complete or partial uncompensated vestibular dysfunction in children is usually balance disorders, with the risk of falls and increased fatigue, particularly during tasks requiring postural control. The aim of these recommendations is to establish guidelines for vestibular rehabilitation (VR) in children with vestibular impairment.
The guidelines were developed based on a systematic review of the international literature, validated by a multidisciplinary group of French-speaking otorhinolaryngologists, scientists, and physiotherapists. They are classified as grade A, B, C, or expert opinion according to a decreasing level of scientific evidence.
A PubMed search of studies published between January 1990 and December 2021 was carried out using the keywords "vestibular," "rehabilitation," and "children". After filtering and reviewing the articles, a total of 10 publications were included to establish the recommendations.
It is recommended that a vestibular assessment be carried out before VR, including a study of vestibulo-ocular reflex, otolithic function, and postural control. In cases of vestibular dysfunction, physiotherapy treatment is recommended from an early age to train different aspects of postural control, including anticipatory and reactive postural adjustments. VR adapted to the pediatric population is recommended for children whose vestibular dysfunction leads to functional disorders or symptoms of vertigo for those who have suffered head trauma. It is recommended that children with bilateral vestibular impairment be treated using gaze stabilization exercises for adaptation and substitution. Optokinetic stimulation and virtual reality are not recommended for children and young adolescents.
儿童完全或部分未代偿的前庭功能障碍的后果通常是平衡障碍，有跌倒和疲劳增加的风险，尤其是在需要姿势控制的任务中。这些建议的目的是为儿童前庭功能障碍患者的前庭康复（VR）制定指南。
指南是基于对国际文献的系统回顾制定的，由一组讲法语的耳鼻喉科医生、科学家和物理治疗师组成的多学科小组进行了验证。根据科学证据的逐渐减少，它们被分类为 A、B、C 级或专家意见。
使用“前庭”、“康复”和“儿童”等关键词，对 1990 年 1 月至 2021 年 12 月期间发表的研究进行了 PubMed 搜索。经过筛选和审查文章，共纳入 10 篇文献来制定建议。
建议在 VR 之前进行前庭评估，包括前庭眼反射、耳石功能和姿势控制研究。在存在前庭功能障碍的情况下，建议从早期开始进行物理治疗，以训练姿势控制的不同方面，包括预期和反应性姿势调整。建议为因前庭功能障碍导致功能障碍或眩晕症状的儿童以及头部受伤的儿童提供适合儿科人群的 VR。对于双侧前庭功能障碍的儿童，建议使用注视稳定练习进行适应和替代治疗。不建议儿童和青少年使用视动刺激和虚拟现实。
