Rewiring the Senses: The Impact of Sensory Integration Therapy on Balance and Cognition in Cerebral Palsy.
Hande Yılmaz, Feyza Şule Badıllı Hantal
PMID 42267458WHAT IT FOUND
Adding sensory integration therapy to balance exercises did not significantly outperform balance exercises alone on the balance scale, but did produce significantly larger gains in cognitive scores across all measured domains in children with CP aged 6–10.
Key findings
01Both groups improved on the Pediatric Berg Balance Scale (maximum 56 points) over 12 weeks; the SI group gained 4.1 points versus 2.1 for controls, but the between-group difference was not statistically significant.
02Significant between-group differences in pre-to-post change scores were found across all DOTCA-Ch cognitive domains (orientation, spatial perception, praxis, visuomotor construction, immediate and long-term memory, and thinking operations), with larger changes in the SI group.
03Between-group differences in change scores were significant for the Seeking, Sensitivity, and Avoiding subscales of the Sensory Profile, with larger changes in the SI group, but not for the Registration subscale.
STILL TO COME
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What it does not show
Only 22 children completed the study (28 recruited), and the authors' own power analysis required 10 per group, so the study was minimally powered and any true effect could easily be missed or inflated. The authors did not perform a formal group-by-time interaction analysis; they used separate within-group and between-group nonparametric tests, which they acknowledge limits causal interpretation and increases the risk of false-positive findings. Both groups received the same balance and coordination exercises and both improved substantially, so it is impossible to tell how much of the SI group's gains came from the sensory integration component versus the shared balance training or simple practice effects. The control group was significantly heavier and had a higher BMI at baseline, which could confound the comparison. Sessions were once per week for 45 minutes over 12 weeks; the authors note that higher frequency or longer duration might produce different results. All participants were GMFCS I or II, so the findings cannot be extended to children with more severe motor impairment. The intervention was delivered by a single physiotherapist in a single private facility, limiting generalisability.
Declared interests
No funding was received. The authors declare no conflicts of interest. The study was conducted at a private special education and rehabilitation centre (Altın Adımlar), which is a potential source of bias not addressed in the conflict-of-interest statement.
The easy way to misread this
Do not read the significant between-group differences in cognitive and sensory scores as proof that sensory integration therapy adds to balance training for children with CP. The balance outcome, the one named in the title, showed no significant between-group difference, both groups improved substantially on every measure, and the authors themselves state that formal group-by-time interaction analyses were not performed, so the apparent advantage of the SI group may reflect practice effects, regression, or the shared balance programme rather than a specific sensory-integration effect.