Journal of Exercise Physiology in Special Populations

Comparison of Balance in Blind, Deaf, and Normal Children Aged 6–12 Years Using the Berg Balance Scale

Document Type : Original Article

Author

Assistance professor, Department of Sport Science Education, Farhangian University, P.O box: 14665-889, Tehran, Iran. email: sh.aali@cfu.ac.ir

Abstract

Background and Objective: Human balance requires the coordinated interaction of sensory and motor systems. Blind and deaf children, due to the lack of certain sensory inputs, may face challenges in maintaining balance and motor control. The purpose of this study was to examine and compare the balance performance of blind, deaf, and typically developing children using the Pediatric Balance Scale (PBS).

Materials and Methods: This descriptive–comparative study included purposive samples of blind, deaf, and typically developing children. Balance was assessed using the PBS, which consists of 14 items related to daily functional activities. Data were analyzed using the Kolmogorov–Smirnov test, one-way analysis of variance (ANOVA), and Bonferroni post hoc test.

Results: The mean balance scores were 55.14 for typically developing children, 54.63 for deaf children, and 48.25 for blind children. One-way ANOVA indicated significant differences among the groups (p < 0.001). Post hoc Bonferroni analysis revealed significant differences between blind and deaf children (-6.38, p < 0.001) and between blind and typically developing children (-6.89, p < 0.001), while no significant difference was observed between deaf and typically developing children (-0.51, p = 0.243). These results suggest that visual impairment has a greater negative impact on balance performance compared to hearing impairment.

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Conclusion: These findings indicate that visual impairment has a greater negative impact on balance performance compared to hearing impairment. Therefore, the results highlight the need for designing and implementing targeted educational and rehabilitation programs to improve balance and quality of life in children with visual impairments.

Keywords

  1. Müjdeci B, Çekiç Ş, Mecit Karaca H, Özdemir S, Şenli FD. Evaluation of the Pediatric Clinical Test of Sensory Interaction for Balance in Children Aged 6–9 Years. J Acad Res Med. 2025;15(1):24–34.
  2. Bronstein AM. Multisensory integration in balance control. In: Handbook of Clinical Neurology. 2016. p. 57–66.
  3. Mbhele S, Rogers C, Saman Y. Clinical balance assessment tools for children with hearing loss: a scoping review. BMC Pediatr. 2025;25(1):218.
  4. Varedi M, Lu L, Phillips NS, Partin RE, Brinkman TM, Armstrong GT, et al. Balance impairment in survivors of pediatric brain cancers: risk factors and associated physical limitations. J Cancer Surviv. 2021;15(2):311–24.
  5. Božanić Urbančič N, Battelino S, Vozel D. Appropriate vestibular stimulation in children and adolescents—A prerequisite for normal cognitive, motor development and bodily homeostasis—A review. Children. 2023;11(1):2.
  6. Nardini M, Cowie D. The development of multisensory balance, locomotion, orientation, and navigation. In: Multisensory Development. Oxford University Press; 2012. p. 137–58.
  7. Horowitz G, Ungar OJ, Levit Y, Himmelfarb M, Handzel O. The impact of conductive hearing loss on balance. Clin Otolaryngol. 2020;45(1):106–10.
  8. Vitkovic J, Le C, Lee SL, Clark RA. The contribution of hearing and hearing loss to balance control. Audiol Neurootol. 2016;21(4):195–202.
  9. Zarei H, Norasteh AA, Lieberman LJ, Brian A. Balance recovery strategy in children with and without hearing or visual impairments. Motor Control. 2024;28(1):1–14. [In Persian].
  10. Wolter NE, Gordon KA, Campos J, Vilchez Madrigal LD, Papsin BC, Cushing SL. Impact of the sensory environment on balance in children with bilateral cochleovestibular loss. Hear Res. 2021;400:108134.
  11. Sival D. Application of pediatric balance scales in children with cerebral palsy. Neuropediatrics. 2012;43(6):305–6.
  12. Her JG, Woo JH, Ko J. Reliability of the pediatric balance scale in the assessment of the children with cerebral palsy. J Phys Ther Sci. 2012;24:301–5.
  13. Erden A, Acar Arslan E, Dündar B, Topbaş M, Cavlak U. Reliability and validity of Turkish version of pediatric balance scale. Acta Neurol Belg. 2021;121(3):669–75.
  14. Laspa V, Besios T, Xristara A, Tsigaras G, Milioudi M, Mauromoustakos S, et al. Reliability and clinical significance of the pediatric balance scale (PBS) in the Greek language in children aged 4 to 18 years. Open J Prev Med. 2020;10(5):73–81.
  15. Hazen M, Cushing SL. Vestibular evaluation and management of children with sensorineural hearing loss. Otolaryngol Clin North Am. 2021;54(6):1241–51.
  16. Yassin O, Elshafey M, Hamdy B, Gamal R, Abdelazeim F. Comprehensive evaluation of vestibular dysfunction in deaf children. J Crit Rev. 2021.
  17. Martens S, Dhooge I, Dhondt C, Vanaudenaerde S, Sucaet M, Rombaut L, et al. Vestibular infant screening (VIS)–Flanders: results after 1.5 years of vestibular screening in hearing‑impaired children. Sci Rep. 2020;10(1):21011.
  18. Chisari D, Vitkovic J, Clark R, Rance G. Vestibular function and balance performance in children with sensorineural hearing loss. Int J Audiol. 2024;63(11):875–83.
  19. Bednarczuk G, Bandura W, Rutkowska I, Starczewski M. Balance level and fundamental motor skills of youth with visual impairments: pilot study. J Clin Med. 2025;14(10).
  20. Ebrahimi AA, Movallali G, Jamshidi AA, Haghgoo HA, Rahgozar M. Balance performance of deaf children with and without cochlear implants. Acta Med Iran. 2016;54(11). [In Persian].
  21. Zarei H, Norasteh AA, Lieberman LJ, Ertel MW, Brian A. The efficiency of sensory systems in postural control of children with and without hearing or visual impairments. PLoS One. 2025;20(5):e0321065. [In Persian].
  22. Alimili E, Kalantari M, Nazeri AR, Akbarzade Baghban A. Test–retest and inter‑rater reliability of Persian version of pediatric balance scale in children with spastic cerebral palsy. Iran J Child Neurol. 2019;13(4):163–71. [In Persian].
  23. Daneshmandi H, Norasteh AA, Zarei H. Balance in the blind: a systematic review. USWR. 2021;11(1):1–12. Available from: http://ptj.uswr.ac.ir/article-1-442-en.html. [In Persian].
  24. Kral A, Sharma A. Crossmodal plasticity in hearing loss. Trends Neurosci. 2023;46(5):377–93.
  25. Lazzouni L, Lepore F. Compensatory plasticity: time matters. Front Hum Neurosci. 2014;8. Available from: http://journal.frontiersin.org/article/10.3389/fnhum.2014.00340.
  26. Aali S, Reza Zadeh F. Comparison of physical fitness in blind and deaf children with their normal peers. J Sports Med Stud. 2013;5(14):135–50. [In Persian].
  27. Zhou Y, Qi J. Effectiveness of interventions on improving balance in children and adolescents with hearing impairment: a systematic review. Front Physiol. 2022;13.
  28. Zarei H, Norasteh AA. Effects of exercise training programs on balance of blind children and adolescents: a systematic review and meta‑analysis. J Bodyw Mov Ther. 2022;30:187–95. [In Persian].

 

Journal of Exercise Physiology in Special Populations
Volume 3, Issue 1
April 2026
Pages 1-17