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Exploring the Feasibility of a Vestibular/Oculomotor Caregiver-Supervised Exercise Program in Children Post
Gilad Sorek1, Isabelle Gagnon, Kathryn Schneider
1Department of Physical Therapy, School of Health Sciences, Ariel University, Ariel, Israel (Dr Sorek); Montreal Children's Hospital, McGill University Health Center, Montreal, Canada (Dr Gagnon); School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada (Dr Gagnon); Sport Injury Research Prevention Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada (Dr Schneider); Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada (Dr Schneider); Hotchkiss Brain Institute, University of Calgary, Calgary, Canada (Dr Schneider); Sorbonne Université, Laboratoire d'Imagerie Biomédicale, LIB, Inserm, CNRS, Paris, France (Dr Chevignard); Sorbonne Université, GRC 24 Handicap Moteur et Cognitif et Réadaptation, HaMCRe, Paris, France (Dr Chevignard); Rehabilitation Department for Children with Acquired Neurological Injury, Saint Maurice Hospitals, Saint Maurice, France (Dr Chevignard); Alyn Children's Hospital and Rehabilitation Center, Jerusalem, Israel (Ms Stern); Children Rehabilitation Department, Lowenstein Rehabilitation Medical Center Ra'anana, Israel (Ms Fadida, Dr Shaklai); Department of Physical Therapy, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel (Dr Kalderon, Dr Katz-Leurer).
Insights
A caregiver-supervised vestibular/oculomotor exercise program for children with moderate-severe traumatic brain injury (TBI) was safe but showed low adherence. This suggests feasibility challenges for this intervention in pediatric TBI recovery.
Area of Science:
- Pediatric rehabilitation
- Neuroscience
- Clinical trials
Background:
- Moderate-to-severe traumatic brain injury (TBI) in children can lead to persistent vestibular and oculomotor deficits.
- Vestibular and oculomotor impairments significantly impact functional recovery and quality of life in pediatric TBI survivors.
Purpose of the Study:
- To assess the feasibility of an 8-week vestibular/oculomotor exercise program supervised by caregivers for children recovering from moderate-to-severe TBI.
- To evaluate safety, adherence, and the impact on vestibular/oculomotor function and balance.
Main Methods:
- A randomized controlled trial involving 37 children (aged 6-18 years) with moderate-to-severe TBI.
- Intervention group: 8-week caregiver-supervised vestibular/oculomotor exercises. Control group: standard care.
- Feasibility assessed via adverse events, adherence rates (≥80% practice completion), and assessment completion. Vestibular/oculomotor function, balance, and gait were measured.
Main Results:
- No adverse events were reported, indicating the program's safety.
- All participants completed the assessments.
- Low adherence was observed, with only 6 participants (in the intervention group) completing ≥80% of prescribed exercises.
- Significant improvements in vestibular/oculomotor function and balance were noted in both groups, with no significant between-group differences.
Conclusions:
- The caregiver-supervised vestibular/oculomotor exercise program is safe for children post-TBI.
- Low adherence rates highlight significant feasibility challenges for implementing this intervention.
- Further research is needed to optimize adherence and effectiveness in pediatric TBI rehabilitation.
Purpose:
To explore the feasibility of a vestibular/oculomotor caregiver-supervised exercise program in children post moderate-severe traumatic brain injury (TBI).
Methods:
The study included 37 children aged 6-18 years, with a median of 42-days post moderate-severe TBI. The intervention-group participated in a vestibular/oculomotor caregiver-supervised exercise program for 8 weeks; the control-group continued with standard-care only. Feasibility was evaluated based on the number of adverse-events and practices reported, and the ability to perform assessments. Vestibular/oculomotor function was evaluated by the number abnormal tests in the Vestibular/Ocular-Motor-Screening. Balance was evaluated by the Pediatric Balance Scale and Functional-Gait-Assessment.
Results:
All participants completed the tests and no adverse-events were observed during the study. However, only 6 participants in the intervention-group performed ≥80% of the recommended practice. All assessments were significantly improved (P < .05) in both groups, with no significant differences between them.
Conclusions:
Although the vestibular/oculomotor caregiver-supervised intervention program was safe, the cooperation-rate was low, indicating difficulties with feasibility.
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