Postural sway in children: A literature review

Static posturography can serve as an easy and fast way to determine whether a child possesses sufficient balance control in different sensory conditions. Therefore, the aim of this review is to map age-related differences in postural sway during childhood in typically developing children, using static posturography and to provide an overview of the available (age-specific) reference values in scientific literature.

The search strategy was performed in five databases (Pubmed, Web of Science, ScienceDirect, Cochrane Clinical Trials, Medline (Ovid)) November 2nd 2014 and updated twice: March 16th 2015 and July 20th 2015. The following keywords were used: (children OR child) AND ("postural control" OR "postural stability" OR equilibrium OR posture OR "postural balance"[mesh]) AND ("quiet stance" OR standing OR stance OR "quiet stance" OR static) AND ("postural sway" OR posturography OR "body sway" OR stabilography OR "trunk sway" OR "medio-lateral sway" OR "antero-posterior sway"). Relevant studies were identified using predefined selection criteria, applied on title and abstract (phase 1) and on full text (phase 2), supplemented with reference screening after the second phase.

A total of 14 studies met the criteria. This review showed three main findings: 1) during natural bipedal stance with the eyes open, all studies reported a decrease in postural sway with increasing age, with conflicting results on the (non-)linearity of its development, 2) with eyes closed, all children show more sway than with eyes open and 3) only four studies reported numeric sway values that could serve as reference values, mainly focusing on children aged five and older.

Considerable disagreement exists on the (non-)linearity of the development of postural sway in children. By choosing arbitrary age categories, it remains unclear between which age groups differences are situated. Future research is necessary to determine for which age groups age-specific reference values are relevant.