Sensory organization for postural control in children with strabismus-A systematic review and meta-analysis

Prasath Jayakaran; Wali Aman; Udari Fernando; Kristen Hackfath; Alastair McPherson; Mike Williams; Logan Mitchell

doi:10.1016/j.gaitpost.2021.05.008

Sensory organization for postural control in children with strabismus-A systematic review and meta-analysis

Gait Posture. 2021 Jul:88:94-104. doi: 10.1016/j.gaitpost.2021.05.008. Epub 2021 May 9.

Authors

Prasath Jayakaran¹, Wali Aman², Udari Fernando², Kristen Hackfath², Alastair McPherson², Mike Williams², Logan Mitchell³

Affiliations

¹ School of Physiotherapy, University of Otago, Dunedin, New Zealand. Electronic address: prasath.jayakaran@otago.ac.nz.
² School of Physiotherapy, University of Otago, Dunedin, New Zealand.
³ Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; Marinato Clinic (Ophthalmology), Dunedin, New Zealand.

PMID: 34015547
DOI: 10.1016/j.gaitpost.2021.05.008

Abstract

Background: Postural control requires the interaction of somatosensory, vestibular and visual systems to prevent disequilibrium. Children with strabismus have an impaired visual input which can lead to postural control deficits.

Research question: Does strabismus affect sensory organization for postural control in children?

Methods: A systematic comprehensive search of multiple electronic databases for relevant articles was performed using a predetermined search strategy. Peer-reviewed journal publications that assessed sensory organization and postural performance in children with strabismus were included in this review. Methodological quality of the articles was evaluated using the modified Downs and Black quality assessment tool. A total of 10 articles were included in this review.

Results: Eight of the 10 articles reviewed were included in the meta-analysis. Meta-analysis for Centre of Pressure CoP velocity (n = 3) (eyes open, stable support), was statistically significant (P = 0.01) in favor of controls over children with strabismus (MD, 3.08; 95 % CI -0.66, 5.51). Meta-analysis for CoP surface area (n = 5) (eyes open, stable support) was also statistically significant (P < 0.001) in favor of the control group (MD, 130.14; 95 % CI 70.01, 190.260). Meta-analysis with standardized mean difference (n = 6) for eyes open vs closed, stable support was statistically significant (P = 0.02) in favor of eyes open (MD, -0.94; 95 % CI, -1.74, -0.15). Overall, there was a high level of heterogeneity throughout the studies.

Significance: This is the first systematic review of its kind to collate and synthesize evidence on the effect of strabismus on postural control in children. This review suggests that postural control performance in children with strabismus is inferior to that of age-matched control children. Further investigation is needed to understand the influence of the three sensory systems.

Keywords: Children; Postural control; Sensory organization; Strabismus; Vision.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Child
Humans
Postural Balance
Sensation Disorders
Strabismus*
Vestibule, Labyrinth*