Dynamic Balance Perception and Sensory Integration in Children with Non-Progressive Brain Injury: The Role of Visual Input and Foot Pressure

BackgroundPostural control in children with non-progressive brain injury (NPBI), such as cerebral palsy, is often impaired due to deficits in vestibular and somatosensory integration. While static balance has been studied, few have assessed how these children perceive anterior-posterior dynamic tilt and how this sensory dependance differs from children with typically developing (TD).ObjectiveThis study aimed to examine how visual input and foot pressure influence anterior-posterior dynamic balance perception in children with NPBI, aiming to predict their consequences for postural control strategies and to characterize their sensory-motor integration compared to children with TD.MethodsThirteen children with NPBI and fifteen children with TD performed ascending and descending tilt tasks on an anterior-posterior dynamic tilt table under visual input (VI) and visual blocking (VB) conditions. Stopping angles and perception errors were recorded. Static balance was assessed using foot pressure distribution and vestibular sway on a force plate. Wilcoxon signed-rank and Mann-Whitney U tests compared conditions, and Spearman's rank correlation examined associations among variables.ResultsChildren with NPBI showed significant differences between VI and VB across dynamic tasks (p < 0.05), while children with TD differed only in ascending trials. Vestibular sway was unaffected by vision. Between-group comparisons revealed greater errors during descending tasks and reduced heel pressure in children with NPBI. Higher forefoot pressure correlated with increased sway, and lower heel pressure with greater postural displacement.ConclusionChildren with NPBI rely more on visual input for anterior-posterior dynamic balance, especially during posterior tilt. The findings support interventions promoting sensory reweighting and heel contact to improve stability.