Vestibular Stimulation: Intervention Protocols, Efficacy and Therapeutic Application in Children Rehabilitation (a Narrative Study)

Purpose: According to the widespread application of vestibular stimulation in clinics, organized treatment protocols seem to be necessary. This narrative article aimed to investigate the evidence-based current protocols and to guide this clinical flow into structured direction. Methods: In this narrative study, valid sites and databases such as PubMed, Web of science, Scopus, Medline and Google scholar were searched from 1972 till 2014. The Key words were “Mechanical Vestibular Stimulation”, “Children”, “Semicircular Canals”, “Otolits” and “Rehabilitation”. Results: 203 articles were found and finally, 34 studies were analyzed according to the inclusion criteria. Their treatment protocols were discussed. Most studies have proved vestibular stimulation to be an effective treatment method and the overall evidence suggests the efficacy of the vestibular interventions in improvement of children with disability. Additionally, suggested protocols are categorized and presented. Studies showed that treatment would be effective if all the vestibular receptors including utricle, saccule and all semicircular canals were stimulated in different positions such as prone, supine, side lying, quadruped, sitting, kneeling and standing. Conclusion: In the light of the present evidence about the efficacy of mechanical vestibular stimulation, organized vestibular stimulation with specialized protocol is strongly recommended to be as one part of children therapeutic schedule in order for empowering rehabilitation process. It is suggested to be careful about the age in which stimulation is received, type of diagnosis, intensity of deficits, history of receiving stimulation, head position control, type of stimulation, frequency, amplitude and sequence of stimulation. Direction of stimulation, length of stimulation, even the duration of each single stimulation during one session and number of sessions, body position during receiving the stimulation, the break and stop intervals immediately after each movement, the delay between two back to back stimulations, health of peripheral and central vestibular system itself along with suitable assessment tools are better to be considered in defining and designing clinical intervention protocol of vestibular stimulation.