EquilÃbrio corporal em crianças e adolescentes com Transtorno do Espectro do Autismo: revisão sistemática
Postural balance in children and adolescents with Autism Spectrum Disorder: a systematic review
Rebeca Cardona Santa Helena; Viviann Magalhães Silva Borges; Pricila Sleifer
Resumo
Este artigo acompanha material suplementar.
Palavras-chave
Abstract
Purpose: A literature review on the findings of ocular and cervical vestibular evoked myogenic potentials (oVEMP and cVEMP), Video Head Impulse Test (vHIT) and dynamic posturography in children and adolescents with Autism Spectrum Disorder (ASD) compared to typical individuals was carried out in order to analyze the postural balance of this population.
Research strategy: Review registered in PROSPERO under number CRD42024460328. Original studies published in peer-reviewed journals; involving only human beings; with the aim of assessing the vestibular system in children and adolescents with ASD compared to neurotypical individuals, from zero to seventeen years and eleven months were considered eligible.
Selection criteria: PubMed, Lilacs, Web of Science, Embase, Scopus, CINAHL, PEDro and OTseeker databases were consulted. Methodological quality was assessed using the Joanna Briggs Institute checklist and studies were analyzed and selected using Endnote and Rayyan software.
Results: Twenty-seven studies were included in this review, all of which used posturography. No studies with cVEMP, oVEMP or vHIT that matched eligibility were identified. Children and adolescents with ASD had greater postural instability, particularly with eyes closed, compared to neurotypical individuals, regardless of age group. Data suggest impaired sensory information integration in these individuals, but the review did not find any studies that specifically assessed the vestibular system in order to rule out any dysfunction in this system.
Conclusion: Posturography showed that individuals with ASD have more postural instability. However, the assessment of postural balance in this population should be conducted using a broader battery of tests.
Keywords
References
1 APA: American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5-TR. 5th ed. Washington, D.C.: APA; 2022.
2 WHO: World Health Organization. Autism [Internet]. Geneva: WHO; 2023 [citado em 2023 Agosto 7]. DisponÃvel em:
3 Maenner MJ, Warren Z, Williams AR, Amoakohene E, Bakian AV, Bilder DA, et al. Prevalence and characteristics of autism spectrum disorder among children aged 8 years: autism and developmental disabilities monitoring network, 11 Sites, United States, 2020. MMWR Surveill Summ. 2023;72(2):1-14.
4 Minshew NJ, Sung K, Jones BL, Furman JM. Underdevelopment of the postural control system in autism. Neurology. 2004;63(11):2056-61.
5 Oster LM, Zhou G. Balance and vestibular deficits in pediatric patients with Autism Spectrum Disorder: an underappreciated clinical aspect. Autism Res Treat. 2022;2022:7568572.
6 Hirota T, King BH. Autism spectrum disorder: a review. JAMA. 2023;329(2):157-68.
7 van Hecke R, Danneels M, Dhooge I, van Waelvelde H, Wiersema JR, Deconinck FJA, et al. Vestibular function in children with neurodevelopmental disorders: a systematic review. J Autism Dev Disord. 2019;49(8):3328-50.
8 van Hecke R, Deconinck FJA, Wiersema JR, Clauws C, Danneels M, Dhooge I, et al. Balanced Growth project: a protocol of a single-centre observational study on the involvement of the vestibular system in a child’s motor and cognitive development. BMJ Open. 2021;11(6):e049165.
9 Cusin FS, Tomaz A, Ganança CF, Monsanto RC. Posturografia em crianças. In: Cabral A, editor. Tratado de otoneurologia infantil. Ribeirão Preto: BookToy; 2023. p. 305-27.
10 Weber KP, MacDougall HG, Halmagyi GM, Curthoys IS. Impulsive testing of semicircular-canal function using video-oculography. Ann N Y Acad Sci. 2009;1164(1):486-91.
11 Macdougall HG, McGarvie LA, Halmagyi GM, Curthoys IS, Weber KP. The video Head Impulse Test (vHIT) detects vertical semicircular canal dysfunction. PLoS One. 2013;8(4):e61488.
12 Halmagyi GM, Chen L, MacDougall HG, Weber KP, McGarvie LA, Curthoys IS. The Video Head Impulse Test. Front Neurol. 2017;8:258.
13 Hamilton SS, Zhou G, Brodsky JR. Video head impulse testing (VHIT) in the pediatric population. Int J Pediatr Otorhinolaryngol. 2015;79(8):1283-7.
14 Cabral A, Carnaúba ATL, Amary M, Menezes PL. Testes para avaliação da função otolÃtica: VEMPS. In: Cabral A, editor. Tratado de otoneurologia infantil. Ribeirão Preto: BookToy; 2023. p. 279-304.
15 Souza MEDCA, Carnaúba ATL, Menezes PDL. Potencial Evocado Miogênico Vestibular pelo ramo inferior e seus pontos de captação. In: Menezes PDL, editor. Tratado de eletrofisiologia para a audiologia. Ribeirão Preto: BookToy; 2018. p. 287-301.
16 Levisohn PM. The autism-epilepsy connection. Epilepsia. 2007;48(Suppl 9):33-5.
17 Lord C, Brugha TS, Charman T, Cusack J, Dumas G, Frazier T, et al. Autism spectrum disorder. Nat Rev Dis Primers. 2020;6(1):5.
18 Bigelow RT, Agrawal Y. Vestibular involvement in cognition: visuospatial ability, attention, executive function, and memory. J Vestib Res. 2015;25(2):73-89.
19 van Hecke R, Danneels M, Deconinck FJA, Dhooge I, Leyssens L, van Acker E, et al. A cross-sectional study on the neurocognitive outcomes in vestibular impaired school-aged children: are they at higher risk for cognitive deficits? J Neurol. 2023;270(9):4326-41.
20 Brasil. Ministério da Saúde. Diretrizes metodológicas: elaboração de revisão sistemática e metanálise de estudos observacionais comparativos sobre fatores de risco e prognóstico [Internet]. BrasÃlia: Ministério da Saúde; 2014 [citado em 2023 Agosto 7]. DisponÃvel em:
21 Helena RCS, Borges VMSB, Sleifer P. Assessment of vestibular system in children and adolescents with Autism Spectrum Disorder: a systematic review [Internet]. London: NIHR; 2024 [citado em 2023 Agosto 7]. DisponÃvel em:
22 Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372(71):n71.
23 McHugh ML. Interrater reliability: the kappa statistic. Biochem Med. 2012;22(3):276-82.
24 Moola S, Munn Z, Tufanaru C, Aromataris E, Sears K, Sfetcu R, et al. Systematic reviews of etiology and risk. In: Aromataris E, Munn Z, editores. JBI manual for evidence synthesis [Internet]. Adelaide: JBI; 2020. chap. 7 [citado em 2023 Agosto 7]. DisponÃvel em:
25 Molloy CA, Dietrich KN, Bhattacharya A. Postural stability in children with autism spectrum disorder. J Autism Dev Disord. 2003;33(6):643-52.
26 Memari AH, Ghanouni P, Gharibzadeh S, Eghlidi J, Ziaee V, Moshayedi P. Postural sway patterns in children with autism spectrum disorder compared with typically developing children. Res Autism Spectr Disord. 2013;7(2):325-32.
27 Memari AH, Ghanouni P, Shayestehfar M, Ziaee V, Moshayedi P. Effects of visual search vs. auditory tasks on postural control in children with autism spectrum disorder. Gait Posture. 2014;39(1):229-34.
28 Travers BG, Mason A, Gruben KG, Dean DC 3rd, McLaughlin K. Standing balance on unsteady surfaces in children on the autism spectrum: the effects of IQ. Res Autism Spectr Disord. 2018;51:9-17.
29 Miller HL, Caçola PM, Sherrod GM, Patterson RM, Bugnariu NL. Children with Autism Spectrum Disorder, Developmental Coordination Disorder, and typical development differ in characteristics of dynamic postural control: a preliminary study. Gait Posture. 2019;67:9-11.
30 Zoccanté L, Ciceri ML, Chamitava L, Di Gennaro G, Cazzoletti L, Zanolin ME, et al. Postural control in childhood: investigating the neurodevelopmental gradient hypothesis. Int J Environ Res Public Health. 2021;18(4):1693.
31 Stania M, Emich-Widera E, Kazek B, Kamieniarz A, Swatowska-Wenglarczyk M, Juras G. Modulation of center-of-pressure signal in children on the autism spectrum: a case- control study. Gait Posture. 2023;103:67-72.
32 Reinert S, Jackson K, Bigelow K. Using posturography to examine the immediate effects of vestibular therapy for children with autism spectrum disorders: a feasibility study. Phys Occup Ther Pediatr. 2015;35(4):365-80.
33 Abdel Ghafar MA, Abdelraouf OR, Abdelgalil AA, Seyam MK, Radwan RE, El-Bagalaty AE. Quantitative assessment of sensory integration and balance in children with autism spectrum disorders: cross-sectional study. Children (Basel). 2022;9(3):353.
34 Bojanek EK, Wang Z, White SP, Mosconi MW. Postural control processes during standing and step initiation in autism spectrum disorder. J Neurodev Disord. 2020;12(1):1.
35 Bucci MP, Doyen C, Contenjean Y, Kaye K. The effect of performing a dual task on postural control in children with autism. ISRN Neurosci. 2013;2013:796174.
36 Bucci MP, Goulème N, Stordeur C, Acquaviva E, Scheid I, Lefebvre A, et al. Discriminant validity of spatial and temporal postural index in children with neurodevelopmental disorders. Int J Dev Neurosci. 2017;61(1):51-7.
37 Bucci MP, Goulème N, Dehouck D, Stordeur C, Acquaviva E, Septier M, et al. Interactions between eye movements and posture in children with neurodevelopmental disorders. Int J Dev Neurosci. 2018;71(1):61-7.
38 Chen FC, Tsai CL. A light fingertip touch reduces postural sway in children with autism spectrum disorders. Gait Posture. 2016;43:137-40.
39 Gepner B, Mestre D, Masson G, de Schonen S. Postural effects of motion vision in young autistic children. Neuroreport. 1995;6(8):1211-4.
40 Gepner B, Mestre DR. Brief report: postural reactivity to fast visual motion differentiates autistic from children with Asperger syndrome. J Autism Dev Disord. 2002;32(3):231-8.
41 Goulème N, Scheid I, Peyre H, Maruani A, Clarke J, Delorme R, et al. Spatial and temporal analysis of postural control in children with high functioning autism spectrum disorder. Res Autism Spectr Disord. 2017;40:13-23.
42 Graham SA, Abbott AE, Nair A, Lincoln AJ, Müller RA, Goble DJ. The influence of task difficulty and participant age on balance control in ASD. J Autism Dev Disord. 2015;45(5):1419-27.
43 Kohen-Raz R, Volkman FR, Cohen DJ. Postural control in children with autism. J Autism Dev Disord. 1992;22(3):419-32.
44 Li Y, Mache MA, Todd TA. Complexity of center of pressure in postural control for children with autism spectrum disorders was partially compromised. J Appl Biomech. 2019;35(3):190-5.
45 Li Y, Mache MA, Todd TA. Automated identification of postural control for children with autism spectrum disorder using a machine learning approach. J Biomech. 2020;113:110073.
46 Lidstone DE, Miah FZ, Poston B, Beasley JF, Dufek JS. Examining the specificity of postural control deficits in children with Autism Spectrum Disorder using a cross-syndrome approach. Res Autism Spectr Disord. 2020;72:101514.
47 Mache MA, Todd TA. Gross motor skills are related to postural stability and age in children with autism spectrum disorder. Res Autism Spectr Disord. 2016;23:179-87.
48 Shabana MI, El Shennawy AM, El Dessouky TM, Sabry SA. Assessment of postural control system in autistic patients. Egypt J Otolaryngol. 2012;28(1):44-8.
49 Somogyi E, Kapitány E, Kenyeres K, Donauer N, Fagard J, Kónya A. Visual feedback increases postural stability in children with autism spectrum disorder. Res Autism Spectr Disord. 2016;29-30:48-56.
50 Stins JF, Emck C, de Vries EM, Doop S, Beek PJ. Attentional and sensory contributions to postural sway in children with autism spectrum disorder. Gait Posture. 2015;42(2):199-203.
51 Wang Z, Hallac RR, Conroy KC, White SP, Kane AA, Collinsworth AL, et al. Postural orientation and equilibrium processes associated with increased postural sway in autism spectrum disorder (ASD). J Neurodev Disord. 2016;8(1):43.
52 Zanon RB, Backes B, Wagner F, Silva MA. Técnicas de avaliação em casos de suspeita de transtorno do neurodesenvolvimento. In: Oliveira SES, Trentini CM, editores. Avanços em psicopatologia: avaliação e diagnóstico baseados na CID-11. Porto Alegre: Artmed; 2023.
53 Walsh MJM, Wallace GL, Gallegos SM, Braden BB. Brain-based sex differences in autism spectrum disorder across the lifespan: a systematic review of structural MRI, fMRI, and DTI findings. Neuroimage Clin. 2021;31:102719.
54 Cioni G, Sgandurra G. Normal psychomotor development. Handb Clin Neurol. 2013;111:3-15.
55 Oliveira PF, Hernandez CP, Guedes-Granzotti RB, Cabral A. Desenvolvimento auditivo, neuropsicomotor, da linguagem e da aprendizagem. In: Cabral A, editor. Tratado de otoneurologia infantil. Ribeirão Preto: BookToy; 2023. p. 55-73.
56 Andrade CLO, Souza MGC, Soares IA, Cabral A. Impacto da tontura no desenvolvimento infantil. In: Cabral A, editor. Tratado de otoneurologia infantil. Ribeirão Preto: BookToy; 2023. p. 105-22.
57 Lim YH, Lee HC, Falkmer T, Allison GT, Tan T, Lee WL, et al. Effect of optic flow on postural control in children and adults with autism spectrum disorder. Neuroscience. 2018;393:138-49.
58 Nishino LK, Rocha GD, Souza TSA, Ribeiro FAQ, Cóser PL. Protocol for static posturography with dynamic tests in individuals without vestibular complaints using the Horus system. CoDAS. 2021;33(3):e20190270.
59 Doumas M, McKenna R, Murphy B. Postural control deficits in autism spectrum disorder: the role of sensory integration. J Autism Dev Disord. 2016;46(3):853-61.
60 Schaaf RC, Mailloux Z, Ridgway E, Berruti AS, Dumont RL, Jones EA, et al. Sensory phenotypes in autism: making a case for the inclusion of sensory integration functions. J Autism Dev Disord. 2023;53(12):4759-71.
61 Travers BG, Lee L, Klans N, Engeldinger A, Taylor D, Ausderau K, et al. Associations among daily living skills, motor, and sensory difficulties in autistic and nonautistic children. Am J Occup Ther. 2022;76(2):7602205020.
62 Kilroy E, Aziz-Zadeh L, Cermak S. Ayres theories of autism and sensory integration revisited: what contemporary neuroscience has to say. Brain Sci. 2019;9(3):68.
Submitted date:
05/22/2024
Accepted date:
01/31/2025
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email