Improving Postural Control in Early Rehabilitative Treatment of Children with Acquired Brain Injury


Massimo Stortini


Guerrino Rosellini
Giuseppe D'Aniello
Soffiani Valentina



Neuromotor impairment and postural difficulties are common sequelae of severe acquired brain injury (ABI), yet the existing literature provides sparse observational data.

Longitudinal reports on the rate and extent of recovery from neuromotor impairment are particularly limited.
Walker W and Picket T (2007), Swaine B (2007) showed that motor function improved markedly between the first and sixth weeks after ABI. Others (Sosnoff J et al., 2011) have reported the now well-established fact that motor function usually improves during post-acute rehabilitation. Postural control is so fundamental and integral to daily functioning, involving all levels of the nervous system and all of the senses, yet it rarely reaches conscious awareness until it is challenged, disrupted or begins to deteriorate. Postural problems not only interfere with motility, they also affect social interaction; the way a person sits, stands or walks has an effect on the way the person acts and is perceived. It is thus of great importance to understand the postural problems of children with CNS acquired injuries.

The symposium introduces partecipants to the importance of postural control for the achivement of everyday life activities. Many children after-injuried have problems regarding walking and reaching/grasping because of their insufficient repertoire regarding postural balance; maintenance of stability is a critical factor in all movements and daily life activities.

The instructors will include information about the theoretical frameworks influencing the context strategy as well as the assesment and intervention methods developed to train postural control. We identified 3 serial domains of postural control: head, trunk and stance that necessitate of specific evaluation scales and suited training experiences. We present also an oscillating platform bearing on a central pin with reference to variable elastic fields: an instrument that allows to apply controlled sways and imbalances to the child posture. Intensive practice is carried out in standing or sitting posture accordingly the level of child’s impairment, training reactive or proactive balance.

The symposium will include case-studies (at least 4) to demonstrate the patient selection principles, treatment decisions and outcomes. The objective is giving the bases for using an original training model.
Our next aim is a multicentric study to collect enough data to support the evidence of postural change more than preliminary data.


Learning Objectives:

  1. Examine an original assessment and intervention approach for babies and young children with acquired neurological impairment that focuses on treatment strategies for improving postural control inside the global rehabilitative practice.
  2. Estimate which assessment scale protocol is adequate to measure the updated postural control level during the recovery ongoing (head, trunk, stance) of each patient in treatment for appling suited rehabilitation program.

  3. Discuss the rehabilitative choices and the application of specific orthoses in each of 4 case-studies presented.