Exploring persistent complaints of imbalance after mTBI: Oculomotor, peripheral vestibular and central sensory integration function

BACKGROUND: Little is known on the peripheral and central sensory contributions to persistent dizziness and imbalance following mild traumatic brain injury (mTBI). OBJECTIVE: To identify peripheral vestibular, central integrative, and oculomotor causes for chronic symptoms following mTBI. METHODS: Individuals with chronic mTBI symptoms and healthy controls (HC) completed a battery of oculomotor, peripheral vestibular and instrumented posturography evaluations and rated subjective symptoms on validated questionnaires. We defined abnormal oculomotor, peripheral vestibular, and central sensory integration for balance measures among mTBI participants as falling outside a 10-percentile cutoff determined from HC data. A X-squared test associated the proportion of normal and abnormal responses in each group. Partial Spearman’s rank correlations evaluated the relationships between chronic symptoms and measures of oculomotor, peripheral vestibular, and central function for balance control. RESULTS: The mTBI group (n = 58) had more abnormal measures of central sensory integration for balance than the HC (n = 61) group (mTBI: 41% –61%; HC: 10%, p’s < 0.001), but no differences on oculomotor and peripheral vestibular function (p > 0.113). Symptom severities were negatively correlated with central sensory integration for balance scores (p’s < 0.048). CONCLUSIONS: Ongoing balance complaints in people with chronic mTBI are explained more by central sensory integration dysfunction rather than peripheral vestibular or oculomotor dysfunction.

Evaluating Sensory Integration/Sensory Processing Treatment: Issues and Analysis

For more than 50 years, “Sensory Integration” has been a theoretical framework for diagnosing and treating disabilities in children under the umbrella of “sensory integration dysfunction” (SID). More recently, the approach has been reframed as “the dimensions of sensory processing” or SPD in place of SID, so the review herein describes this collective framework as sensory integration/sensory processing treatment (SI/SP-T) for ASD. This review is not focused on diagnosis of SI/SPD. Broadly, the SI/SPD intervention approach views a plethora of disabilities such as ADHD, ASD, and disruptive behavior as being exacerbated by difficulties in modulating and integrating sensory input with a primary focus on contributions from tactile, proprioceptive, and vestibular systems which are hypothesized to contribute to core symptoms of the conditions (e.g., ASD). SI/SP intervention procedures include sensory protocols designed to enhance tactile, proprioceptive, and vestibular experiences. SI/SP-T procedures utilize equipment (e.g., lycra swings, balance beams, climbing walls, and trampolines), specific devices (e.g., weighted vests, sensory brushes) and activities (e.g., placing hands in messy substances such as shaving cream, sequenced movements) hypothesized to enhance sensory integration and sensory processing. The approach is reviewed herein to provide a framework for testing SI/SP-T using widely accepted clinical trials and event coding methods used in applied behavior analysis (ABA) and other behavioral interventions. Also, a related but distinct neuroscientific paradigm, multisensory integration, is presented as an independent test of whether SI/SP-T differentially impacts sensory integration and/or multisensory integration. Finally, because SI/SP-T activities include many incidental behavioral events that are known as developmental facilitators (e.g., contingent verbal models/recasts during verbal interactions), there is a compelling need to control for confounds to study the unique impact of sensory-based interventions. Note that SI/SP-T includes very specific and identifiable procedures and materials, so it is reasonable to expect high treatment fidelity when testing the approach. A patient case is presented that illustrates this confound with a known facilitator (recast intervention) and a method for controlling potential confounds in order to conduct unbiased studies of the effects of SI/SP-T approaches that accurately represent SI/SP-T theories of change.

Sensory Integration Dysfunction in Children with Learning Difficulties

<p>W artykule przedstawiono wnioski z projektów badawczych przeprowadzonych w ciągu kilku dekad. Dotyczą one współwystępowania różnych dysfunkcji sensorycznych (w tym genetycznych) oraz trudności w uczeniu się. Opisano pomiary efektywności podjętych działań terapeutycznych z zakresu terapii integracji sensorycznej.</p>

Pilot study: Sensory integration processing disorders in children with optic nerve hypoplasia spectrum

This study aimed to explore the sensory processing profiles of children with the spectrum of optic nerve hypoplasia (ONH). Caregivers completed the Short Sensory Profile (SSP), the Social Communication Questionnaire (SCQ), and the Vineland Adaptive Behaviour Scale (VABS) interview. The study demonstrated that children with ONH present with sensory integration dysfunction (SID), in their intact senses, and that autistic spectrum condition (ASC) was the best predictor of SID, rather than visual loss, or level of intellectual disability in these children. The results indicate that assessment and monitoring of SID in children with ONH is crucial.

The occurrence and significance of coexisting diseases and disorders in the process of diagnosis and treatment of sensory integration disorders – preliminary report

Therapy of sensory processing disorders is becoming more widespread and available as a therapeutic method, and supports the development of a child. Recently, the availability of classes conducted using this method has greatly increased, and more and more children are beginning to take part in these therapeutic activities. Sensory processing disorders have signifi cant impact on the functioning of a child. The study was conducted to answer the question of whether and how co-existing diseases and disorders can affect the process of diagnosis and therapy in the fi eld of sensory processing disorders. The study included a group of children reported to diagnosis for sensory integration disorders at the Center for Sensory Integration Disorders and Rehabilitation in Lublin between 2012-2014. All subjects lived in the Lublin Voivodeship. We analyzed records of 40 children aged 2 years 6 months to 9 years 8 months, for whom the diagnosis was carried out in the direction of sensory processing disorders, and their diagnosis indicated a sensory integration dysfunction. At the time of beginning therapy, on the basis of interviews conducted with parents/legal guardians, co-existing diseases or disorders related to 37% of those undergoing therapy. Additional tests and consultations, conducted already in the course of therapy, showed co-existing disorders or diseases for a larger group of children - data collected during the 6-month period from the beginning of treatment showed that 65% of children required care of a specialist clinic. The largest group were children who required additional orthoptic therapy. Knowledge of co-existing diseases and disorders is a condition making the therapy safe and effective. Cite this article as: Zdzienicka-Chyła A.M. The occurrence and significance of coexisting diseases and disorders in the process of diagnosis and treatment of sensory integration disorders – preliminary reports. Med Rehabil 2016; 20(2): 20-24.