# Case Report: Multi-sensory integration treatment for preschool children with intermittent exotropia and idiopathic scoliosis comorbidity

## TL;DR

A new treatment combining vision and physical therapy improved both eye and spine issues in two young children with overlapping conditions.

## Contribution

A novel multi-sensory integration training protocol that simultaneously addresses comorbid intermittent exotropia and idiopathic scoliosis in preschool children.

## Key findings

- Visual acuity of the amblyopic eye improved, exotropia magnitude decreased, and stereopsis recovered after MSIT.
- Cobb angles reduced significantly from 10° and 13° to 3° and 0°, respectively, after 3 months of treatment.
- A transient treatment plateau was observed in one case before subsequent normalization of eye position metrics.

## Abstract

This case report evaluates a novel multi-sensory integration training (MSIT) protocol, combining binocular disparate vision perception training with physiotherapeutic scoliosis-specific exercises in two pediatric patients (aged 4 and 5 years) with comorbid non-syndromic strabismus and idiopathic scoliosis. Both patients presented with intermittent exotropia, amblyopia, and thoracic scoliosis (Cobb angles of 10° and 13°, respectively). Following the individualized MSIT intervention, marked improvements were observed in both visual and spinal parameters: visual acuity of the amblyopic eye improved, exotropia magnitude decreased, stereopsis recovered, and Cobb angles substantially reduced to 3° and 0°, respectively, after 3 months. A transient “treatment plateau” in perceptual eye position metrics was observed in one case before subsequent normalization. These findings suggest that MSIT, by simultaneously addressing aberrant visual and proprioceptive inputs, effectively improves both visual function and spinal alignment in this comorbid population, potentially through promoting central nervous system recalibration of multi-sensory integration for postural control. This integrated approach highlights the importance of interdisciplinary management for children presenting with both strabismus and spinal deformities.