Effects of Cawthorne–Cooksey Exercises on Balance and Quality of Life in Children with Hearing Deficits

Abstract

Background: Balance deficits and impaired sensory organization are common in children with severe-to-profound sensorineural hearing loss (SNHL), frequently reflecting vestibular dysfunction that can limit functional participation and health-related quality of life (HRQOL). Objective: To determine the effects of adding Cawthorne–Cooksey vestibular rehabilitation exercises to Swiss ball training on balance and HRQOL in children with SNHL. Methods: A randomized controlled trial was conducted in a school for deaf children in Lahore. Thirty children aged 7–12 years with SNHL (PTA >90 dB) were randomized into Group A (Swiss ball exercises) or Group B (Cawthorne–Cooksey exercises plus Swiss ball exercises). Training was delivered for 45 minutes, three times weekly for eight weeks. Balance and HRQOL were assessed pre- and post-intervention using the Pediatric Balance Scale (PBS), Four Square Step Test (FSST), and a pediatric HRQOL questionnaire. Non-parametric analyses were applied. Results: Mean age was 9.20 ± 1.74 years in Group A and 9.80 ± 1.90 years in Group B. Shapiro–Wilk testing confirmed non-normality of outcomes (p ≤ 0.001). Wilcoxon signed-rank testing showed significant improvement in FSST (p < 0.001) and HRQOL (p = 0.005), while PBS change was not significant (p = 0.102). Mann–Whitney U testing demonstrated significant post-intervention differences for PBS (p = 0.035) and HRQOL (p = 0.002). Conclusion: Vestibular rehabilitation incorporating Cawthorne–Cooksey exercises may improve dynamic balance performance and HRQOL in children with severe-to-profound SNHL.