EFFECTIVENESS OF VESTIBULAR STIMULATION EXERCISE IN IMPROVING BALANCE IN CHILDREN WITH SPASTIC DIPLEGIC CEREBRAL PALSY

Background: Cerebral palsy is associated with disorders of movement and posture and may be accompanied by impaired balance and limitations in functional activities. Vestibular stimulation may provide an additional sensory input for postural control and balance. Objective: To evaluate the effectiveness of vestibular stimulation exercise in improving balance in children with spastic diplegic cerebral palsy. Methods: Thirty children with spastic diplegic cerebral palsy were included and randomly assigned to an experimental group (n=15) or control group (n=15). Both groups received conventional physiotherapy. The experimental group additionally received vestibular stimulation exercises for 30 minutes per day, 5 sessions per week, for 16 weeks. Balance and gross motor functional level were assessed before and after treatment using the Pediatric Balance Scale (PBS) and Gross Motor Function Classification System (GMFCS). Within- group changes were analyzed using paired statistical tests, and between-group comparisons were performed using independent-group tests. Results: PBS scores improved significantly in both groups. In the experimental group, the mean PBS score increased from 37.40 ± 1.80 to 39.20 ± 1.74 (paired t=5.08, p=0.001). In the control group, the mean PBS score increased from 34.67 ± 1.88 to 36.80 ± 1.70 (paired t=5.88, p=0.001). The post-treatment PBS score was significantly higher in the experimental group than in the control group (unpaired t=3.82, p=0.001). GMFCS median score improved from 2 to 1 in the experimental group (Wilcoxon z=3.32, p=0.001), while the control group remained at a median of 2, although the within-group test was statistically significant (z=2.23, p=0.025). The post-treatment GMFCS comparison favored the experimental group (Mann–Whitney z=2.16, p=0.031). Conclusion: The findings of the study indicate that vestibular stimulation exercise, when added to conventional physiotherapy, may improve balance and gross motor functional level more than conventional physiotherapy alone in children with spastic diplegic cerebral palsy. Keywords: Cerebral palsy, spastic diplegia, vestibular stimulation, balance, Pediatric Balance Scale, GMFCS, physiotherapy