Vestibular Infant Screening - Rehabilitation: A pilot study assessing preliminary effectiveness and feasibility of vestibular rehabilitation therapy in children with peripheral vestibular dysfunction.

OBJECTIVES

This pilot study aims to evaluate the preliminary effects and feasibility of the Vestibular Infant Screening - Rehabilitation (VIS-REHAB) protocol, a structured Vestibular Rehabilitation Therapy (VRT) program combining postural and gaze stability exercises, in children with peripheral vestibular dysfunction.

METHODS

Four children (aged 4-14 years) with peripheral vestibular dysfunction were recruited from the Ghent University Hospital and enrolled in a two-parallel-group randomized controlled crossover trial comparing the VIS-REHAB protocol with a no-therapy control. The VIS-REHAB protocol consisted of structured exercises targeting postural (20 min) and gaze stability (10 min), delivered in 30-min sessions twice weekly over nine weeks. Primary and secondary outcome measures included postural stability, gaze stability, motor performance, and quality of life. Descriptive analyses were conducted for each participant.

RESULTS

All participants demonstrated improvements in the postural (Bruininks-Oseretsky Test of Motor Proficiency (BOT-2) Balance Subtest) and gaze stability (Gaze Stabilization Test) during therapy, while changes during the no-therapy period were more variable and generally less pronounced. Among the secondary outcomes, improvements were observed in the Pediatric Modified Dynamic Gait Index, BOT-2 Bilateral Coordination Subtest, and Dynamic Visual Acuity Test. Children and caregivers reported better balance, a perceived reduction in falls, and increased participation in daily life. The protocol was feasible and well-tolerated, though some age-related limitations were noted.

CONCLUSIONS

The protocol is feasible and may improve postural and gaze stability in children with peripheral vestibular dysfunction. A larger trial is planned to confirm these findings. This research presents an important first step towards developing evidence-based guidelines for pediatric VRT.