Airplane Vestibular Repositioning Maneuver (AVRM): A Pediatric Adaptation of the Foster Half-Somersault Maneuver - A Case Report

Abstract Background: Children with histories of extreme prematurity and congenital hypotonia often present with delayed motor development and gait instability. Positional vestibular dysfunction may be underrecognized in this population, and standard canalith repositioning maneuvers are frequently not feasible for toddlers. Case Presentation: This case report describes a 3-year-old child born at 23 weeks gestation with congenital hypotonia and delayed motor milestones who demonstrated limited independent standing and ambulation. Prior to intervention, the child was unable to walk more than approximately 10 feet without assistance. Intervention: A therapist-assisted pediatric modification of the Foster Half-Somersault maneuver, termed the Airplane Vestibular Repositioning Maneuver (AVRM), was performed. The child was supported in an airplane position while guided head and trunk movements analogous to the Foster maneuver were completed over a padded mat. Outcomes: Immediately following the intervention and at one-week follow-up, the child demonstrated clinically meaningful improvements in postural control and mobility, including increased unsupported standing time and independent walking distance. Conclusion: This case suggests that a therapist-supported pediatric adaptation of the Foster Half Somersault maneuver may be a feasible and well-tolerated option for young children who are unable to perform traditional positional maneuvers. Further systematic investigation is warranted.