Vestibular function and postural control in children receiving intervention with the austronaut training protocol
Date
2019
Authors
Katzenellenbogen, Gabrielle
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
The vestibular system plays an important role in postural control and an upright posture
at the table. Some children have difficulty in their in-seat posture resulting in increased
in-seat movement. This research investigated the effect of the Astronaut Training
Protocol on a child’s vestibular processing and postural control, and therefore by
extension their in-seat behaviour, as well as whether there would be carry over after
the protocol was terminated.
A single subject quasi experimental ABA research design was used with five
participants who were identified with dysfunction in in-seat posture and in-seat
movement. Data was collected over three phases: pre-Astronaut Training (A), post-
Astronaut Training (B), and Withdrawal phase (A). The Pre Astronaut Training phase
consisted of four sessions of sensory integration based occupational therapy, with the
Intervention phase following consisting of eight Astronaut Training sessions during
which regular sensory integration occupational therapy remained constant, while the
Withdrawal phase comprised of four sessions of regular sensory integration based
occupational therapy.
Four assessments were used to determine vestibular and postural control change at
each phase: Movement ABC one-leg balance, Postrotary Nystagmus (PRN) test, inseat
posture assessment (designed for the purpose of this study), and in-seat
movement through the collection of data using an accelerometer. Repeated measures
of the prone extension and supine flexion positions were used at each therapy session
to measure both vestibular processing and postural control.
Improvements in postural control and vestibular function were seen in prone extension
and supine flexion quality and time for most participants post-Astronaut Training (B).
A large effect size indicating a clinical change for in-seat posture and in-seat movement
was found post-Astronaut Training (B), indicating improved posture with less fidgeting
at the table. Vestibular improvements were seen at Withdrawal phase (A) for balance
and PRN with a medium effect size on balance and large effect size for PRN.
Participants’ in-seat posture and in-seat movement did not continue to improve and
deteriorated slightly in this phase although this differed depending on their responsivity
to PRN and diagnosis.
Description
A dissertation submitted to the Faculty of Health Sciences, University of the
Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree
of Master of Science in Occupational Therapy.
Johannesburg,
2019