Effectiveness of Vestibular Versus Dual-Task Training on Balance in Children with Diplegic Cerebral Palsy

Background: Cerebral palsyis a neurodevelopmental disorder that caused by non-progressive lesion to the immature brain, this lesion causes permanent motor disability that presents with or without other associated disorders. Diplegia is a CP'S subtype where the four limbs of the body affected with more affection in both lower limbs. Balance problems are major problems faced by these children. Aim of Study: The purpose of the current study was to investigate which is more effective and has a better impact on balance in diplegic CP. Subjects and Methods: Thirty-four children with diplegic Cerebral Palsy of both genders, aged from 5 to 11 years with spasticity ranged from grade 1 or 1+ according to Modified Ashworth Scale and they were at level I or II on Gross Motor Function Classification System participated in the study. They were randomly assigned into 2 equal groups; All the included children received traditional physical therapy program while group (A) received additional vestibular training program, and group (B) received additional dual-task training program. Balance was assessed before and after the study using HUMAC balance system and pediatric balance scale. Results: There was significant increase in all variables that represent balance ( p >0.001), center of pressure, eye open firm surface, eye closed firm surfaceand pediatric balance scale in both group post treatment compared with pretreatment results, but there was no significant difference betweenall these variablesin the between groups comparison pre or post treatment ( p >0.05). Conclusion: Both vestibular training and dual task training improve balance of diplegic children mostly to the same extent, therefore, we can recommend them as basic protocols that should be included in the treatment plan for diplegic children.