| Abdel Ghafar et al.(33), 2022 (Saudi Arabia) |
ASD: 38 individuals, average of 9.57 (±2.08) years (25 MG and 13 FG) |
Posturography with stable and unstable platform, with OE and CE |
ASD group showed a significant increase in postural sway in all conditions tested, especially in conditions in which visual and somatosensory inputs were compromised. |
| TD: 36 individuals, average of 10.84 (±2.91) years (21 MG and 15 FG) |
| Bojanek et al.(34), 2020 (USA) |
ASD: 17 individuals, average of 13.67 (±3.00) years (15 MG and 2 FG) |
Posturography with a stable platform. Static posture tasks, dynamic posture and stepping tasks. |
ASD group showed worse performance in medial lateral displacement. There was no statistically significant difference in the other tasks with posturography. |
| TD: 20 individuals, average of 12.48 (±4.17) years (16 MG and 2 FG) |
| Bucci et al.(35), 2013 (France) |
ASD: 7 individuals, average of 6 (±0.8) years (5 MG and 2 FG) |
Posturography with a stable platform. Tests: visual fixation tasks, saccades and pursuit eye movements. |
ASD group had greater instability in all conditions tested. Stability did not improve during saccades or pursuit eye movements. |
| TD: 7 individuals, average of 6 (±1.7) years (5 MG and 2 FG) |
| Bucci et al.(36), 2017 (France) |
ASD: 23 individuals, average of 10.3 (±0.4) years |
Posturography with stable and unstable platform, with OE and CE |
The ASD group showed lower postural control than the TD group, which worsens in a dynamic environment and when visual information is absent. |
| TD: 23 individuals, average of 10.2 (±0.3) years |
| Percentage of each unspecified gender |
| Bucci et al.(37), 2018 (France) |
ASD: 26 individuals, average of 9.4 (±0.1) years |
Posturography with a stable platform, standing and sitting. Visual tasks: Visually guided saccades, memory-guided saccades and fixation. |
For the fixation task, the ASD group showed worse eye movement performance in the standing condition compared to the sitting condition, while this difference was not found in the TD group. |
| TD: 26 individuals, average of 9.5 (±0.4) years |
| Percentage of each unspecified gender |
| Chen and Tsai(38), 2015 (China) |
ASD: 16 individuals, average of 11.04(±1.275) years (11 MG and 5 FG) |
Posturography with stable platform and manual support, with OE and CE. |
Effect of absence of vision was more prominent in children with ASD. Larger average oscillation on the ML axis. Furthermore, the results showed a significant improvement in postural sway with the aid of touching the support. |
| TD: 16 individuals, average of 10.96(±1.166) years (11 MG and 5 FG) |
| Gepner et al.(39), 1995 (France) |
ASD: 5 individuals, average of 6 (±1.2) years (3 MG and 2 FG) |
Posturography with stable platform, with OE and CE |
Postural instability was greater in the ASD group with both CE and OE. Furthermore, the moving visual stimulus did not cause postural differences in the ASD group, unlike what occurred in the TD group. |
| TD: 12 individuals, average of 5.6 (±0.8) years (8 MG and 4 FG) |
| Gepner and Mestre(40), 2002 (France) |
ASD: 3 individuals, average of 9.5 (±1.1) years (1 MG and 2 FG) |
Posturography with a stable platform. Test with CE and OE with static visual stimulation and dynamic stimuli. |
Overall postural instability was significantly reduced in the ASD group compared to the TD group. |
| AS: 3 individuals, average 7.5 (±2.1) years (all MG) |
| TD: 9 individuals, average of 8.2 (±2.9) years (5 MG and 4 FG) |
| Goulème et al.(41), 2017 (France) |
ASD: 30 individuals, average of 12.1 (±2.9) years (26 MG and 4 FG) |
Posturography with stable and unstable platforms, in three viewing conditions (OE, CE and disturbed vision). Furthermore, sensory integration was analyzed. |
Significantly greater instability in all conditions tested in the ASD group. |
| TD: 30 individuals, average of 11.08 (±0.5) years (26 MG and 4 FG) |
| Graham et al.(42), 2014 (USA) |
ASD: 26 individuals, average of 13.0 (±3.2) years (22 MG and 4 FG) |
Posturography with a stable platform. Tests: (1) OE, and bipedal support; (2) CE and bipedal support; (3) OE, and single leg support; and (4) CE and single-leg support. |
Children with ASD showed greater postural instability in all conditions, with worse performance in the CE condition and single-leg support. |
| TD: 18 individuals, average of 13.4 (±1.9) years (16 MG and 2 FG) |
| Kohen-Raz et al.(43) 1992 (Israel, USA and France) |
ASD: 91 individuals, ages between 6 and 20 years (65 MG and 26 FG) |
Posturography with stable platform and OE |
Stability limit lower than the TD group, worse performance in tests in the age group of 10 to 13 years in the ASD group. |
| TD: 166 individuals, ages between 4 and 11 years old (percentage of genders not specified) |
| Li et al.(44), 2019 (USA) |
ASD: 11 individuals, average of 8.8 (±2.3) years (10 MG and 1 FG) |
Posturography with stable and unstable platforms, with OE and CE. |
Greater displacement on an unstable surface, with CE in the ASD group. |
| TD: 11 individuals, average of 8.7 (±2.3) years (9 MG and 2 FG) |
| Li et al.(45), 2020 (USA) |
ASD: 25 individuals, average of 6.9 (±1.8) years (11 MG and 14 FG) |
Posturography with stable and unstable platforms, with OE and CE. |
Significantly greater displacement in the AP and ML axes, in addition to a greater total area of displacement in the ASD group, in all tests. |
| TD: 25, average of 7.2 (±2.0) years (15 MG and 10 FG) |
| Lidstone et al.(46), 2020 (USA) |
ASD: 23 individuals, average of 12.4 (±2.8) years (19 MG and 4 FG) |
Posturography with a stable platform, with OE, without dynamic visual stimulation. |
Significantly greater displacement in the AP and ML axes, in addition to a greater total area of displacement in the ASD group, in all tests. |
| TD: 22 with TD, average of 11.7 (±2.7) years (14 MG and 8 FG) |
| Mache and Todd(47), 2016 (USA) |
ASD: 11 individuals, average of 113.5 (±30.0) months (10 MG and 1 FG) |
Posturography with stable and unstable platforms, with OE and fixed gaze on visual stimulus. |
There was greater displacement in the ASD group on both platforms, with worse results on the unstable platform. |
| TD: 11 individuals, average of 112.2 (±28.9) months (9 MG and 2 FG) |
| Memari et al.(26), 2013 (Iran) |
ASD: 21 individuals, average 11.5 (±1.6) years old, all MG |
Posturography with stable force platform and OE. |
ASD group presented worse results for all analyses, with greater instability in the AP direction. |
| TD: 30 individuals, average 11.6 (±1.9) years, all MG |
| Memari et al.(27), 2014 (Iran) |
ASD: 19 individuals, average 11.9 (±1.6) years old, all MG |
Posturography with a stable platform and OE, with visual stimulation, performing a cognitive task associated with vision and hearing |
The ASD group showed greater instability in all conditions tested, with greater postural oscillation in the task of chasing the moving visual stimulus. |
| TD: 28 individuals, mean 11.8 (±1.7) years old, all MG |
| Miller et al.(29), 2019 (USA) |
ASD: 10 individuals, average 13 (±2.54) years (9 MG, 1 FG) |
Posturography with a stable platform using a belt, with moving images. |
ASD group showed higher speed values and lower acceleration in the ML direction, which indicates slower and less precise movements to adjust the CoP. |
| TD: 8 individuals, average of 10.2 (±3.41) years (4 MG 1 FG) |
| Molloy et al.(25), 2003 (USA) |
ASD: 8 individuals, average of 124.8 (±26.3) months, all MG |
Posturography with stable and unstable platforms with OE and CE. |
Worse performance was observed with CE on both platforms in the ASD group. |
| TD: 8 individuals, average of 126.5 (±25.7) months, all MG |
| Reinert et al.(32), 2015 (USA) |
ASD: 5 individuals, average of 9.2 (±0.45) years |
Posturography with stable and unstable platforms with OE and CE. |
ASD group with more instability, highlighting greater difficulty on the unstable platform and CE, and greater displacement in the AP direction in all tests. |
| TD: 5 individuals, average of 7.4 (±2.06) years |
| The percentage of each gender was not specified. |
| Shabana et al.(48), 2012 (Egypt) |
ASD: 20 individuals, average 8.95 (±2.98) years (13 MG and 7 FG) |
Posturography with stable and unstable platforms, with OE and CE and fixed and moving visual stimuli. |
There was a significant impairment in postural balance control in the ASD group, even in conditions with fewer stimuli. |
| TD: 15 individuals, average of 9 (±1.6) years (9 MG and 6 FG) |
| Somogyi et al.(49), 2016 (Hungary) |
ASD: 18 individuals, average of 94 (±18.5) months (14 MG and 4 FG) |
Posturography with stable platform and OE, with and without visual stimulation. |
Postural stability was lower in children with ASD, on the stable platform with OE, without visual stimulation. With visual stimulation there was an improvement in performance, but it was still inferior. |
| TD: 12 individuals, average of 96 (±9.6) months (8 MG and 4 FG) |
| Stania et al.(31), 2023 (Poland) |
ASD: 16 individuals, average of 8.13 (±1.54) years (11 MG and 5 FG) |
Posturography with stable and unstable platforms with OE. |
There was greater AP displacement on the stable and unstable platforms in the ASD group. |
| TD: 16 individuals, average of 7.93 (±0.88) years (9 MG and 7 FG) |
| Stins et al.(50), 2015 (Netherlands) |
ASD: 9 individuals, average of 10.8 (±1.2) years (8 MG and 1 FG) |
Posturography with stable and unstable platforms, OE and CE, with associated cognitive task. |
The ASD group performed worse in conditions with CE and also in conditions in which they needed to perform a cognitive task, with OE and CE. |
| TD: 9 individuals, average of 10.8 (±1.2) years (8 MG and 1 FG) |
| Travers et al.(28), 2018 (USA) |
ASD: 21 individuals, average of 9.63 (±2.09) years (18 MG and 3 FG) |
Posturography with stable and unstable platforms with OE |
There was greater displacement in the ASD group in both conditions, with worse performance on unstable surfaces. |
| TD: 16 individuals, average of 9.64 (±2.78) years (14 MG and 2 FG) |
| Wang et al.(51), 2016 (USA) |
ASD: 22 individuals, average of 12.72 (±3.64) years (19 MG and 3 FG) |
Posturography with stable and unstable platforms, with OE and CE. |
ASD Group presented worse performance in all conditions, especially with unstable platform |
| TD: 21 individuals, average of 11.67 (±4.53) years (18 MG and 3 FG) |
| Zoccanté et al.(30), 2021 (Italy) |
ASD: 20 individuals, average of 10.7 (±2.0) years (16 MG 4 FG) |
Posturography. Patients were subjected to 7 different sensory situations to identify sensory integration. |
Worse performance on an unstable platform with CE and on an unstable platform with moving visual stimuli in the ASD group. |
| TD: 23 individuals, average 12.3 years (±2.6) (10 MG 13 FG) |
Postural balance in children and adolescents with Autism Spectrum Disorder: a systematic review
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Subtitle: Y = yes; N = no; U = undefined; 1 = Were the criteria for inclusion in the sample clearly defined?; 2 = Were the study subjects and the setting described in detail?; 3 = Was the exposure measured in a valid and reliable way?; 4 = Were objective, standard criteria used for measurement of the condition?; 5 = Were confounding factors identified?; 6 = Were strategies to deal with confounding factors stated?; 7 = Were the outcomes measured in a valid and reliable way?; 8 = Was appropriate statistical analysis used?