A randomized clinical trial on evaluation of the effectiveness of original methods for the restoration of post-stroke postural disorders


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Background. Currently, about 9 million people in the world suffer from cerebrovascular diseases. Existing methods for the rehabilitation of postural disorders are based on the displacement of the gravity center of a person in the horizontal and/or sagittal planes. Objective. Evaluation of the effectiveness of the original method in the correction of static and locomotor functions, based on the use of vertical oscillations, in patients with post-stroke postural disorders. Methods. 54 patients with moderate-to-severe vestibulocerebellar syndrome in the recovery period of ischemic stroke (IS) were randomized into 3 groups. In the group 1 (n=18), the static locomotor functions were corrected according to the proposed method, based on the shift of the patient’s gravity center in the vertical plane. In the group 2 (n=18), the balance and walking functions were corrected by applying a sports trampoline. In the group 3 (n=18), patients underwent a course of neurorehabilitation using a stabilometric platform with biofeedback (BFB). Before and after the rehabilitation course, all patients underwent an assessment of the clinical and neurological status, assessment of balance by computer stabilometry (CS), the Berg Balance Scale (BBS) and the International Cooperative Ataxia Rating Scale (ICARS), as well as the evaluation of walking parameters using a laser analyzer of kinematic walking parameters (LA-1) and the Dynamic Gait Index (DGI). Results. After the rehabilitation course, all three groups showed a statistically significant change in the main indicators according to LA-1, CS, BBS, ICARS, and DGI scales, which confirms the improvement in walking and balance. Conclusion. The proposed technique with the original design in the form of a swing is comparable in effectiveness with training with bio feedback and the “Rebound" method (trampoline), which makes it possible to recommend it in the complex rehabilitation treatment of patients with post-stroke postural disorders.

Full Text

Restricted Access

About the authors

Saikal B. Ismailova

Krasnoyarsk State Medical University n.a. prof. V.F. Voino-Yasenetsky

Email: sbismailova@gmail.com
SPIN-code: 9218-5679
Teaching Assistant/Postgraduate Student at the Department of Nervous Diseases with a Course of Medical Rehabilitation

S. A Subocheva

Krasnoyarsk State Medical University n.a. prof. V.F. Voino-Yasenetsky

SPIN-code: 1541-8273
Department of Nervous Diseases with a Course of Medical Rehabilitation

M. V Abroskina

Krasnoyarsk State Medical University n.a. prof. V.F. Voino-Yasenetsky

SPIN-code: 6011-2040
Department of Nervous Diseases with a Course of Medical Rehabilitation

V. S Ondar

Krasnoyarsk State Medical University n.a. prof. V.F. Voino-Yasenetsky

SPIN-code: 1158-1711
Department of Nervous Diseases with a Course of Medical Rehabilitation

A. D Karpenkova

Krasnoyarsk State Medical University n.a. prof. V.F. Voino-Yasenetsky

Department of Nervous Diseases with a Course of Medical Rehabilitation

M. A Khramchenko

Krasnoyarsk State Medical University n.a. prof. V.F. Voino-Yasenetsky

Department of Nervous Diseases with a Course of Medical Rehabilitation

P. S Pidyukov

Krasnoyarsk State Medical University n.a. prof. V.F. Voino-Yasenetsky

Department of Nervous Diseases with a Course of Medical Rehabilitation

S. V Prokopenko

Krasnoyarsk State Medical University n.a. prof. V.F. Voino-Yasenetsky

SPIN-code: 1279-7072
Department of Nervous Diseases with a Course of Medical Rehabilitation

References

  1. Schmidt H., Werner C., Bernhardt R., et. al. Gait rehabilitation machines based on programmable footplates. J. Neuroengineering Rehabilitation. 2007;4(2):1-7. doi: 10.1186/1743-0003-4-2.
  2. Kwakkel G., Kollen B.J., Wagenaar R.C. Therapy Impact on Functional Recovery in Stroke Rehabilitation. A critical review of the literature. Physiotherapy. 1999;85:377-91. Doi: 10.1016/ S0031-9406(05)67198-2.
  3. Evers S.M., Struijs J.N., Ament A.J., et. al. International comparison of stroke cost studies. Stroke. 2004;35:1209-15. doi: 10.1161/01. STR.0000125860.48180.48.
  4. Schaechter J.D. Motor rehabilitation and brain plasticity after hemiparetic stroke. Progress in neurobiology. 2004;73:61-72. Doi: 10.1016/j. pneurobio.2004.04.001.
  5. Аброськина М.В., Прокопенко С.В., Живаев В.П. Исследование кинематических особенностей ходьбы у здоровых испытуемых и пациентов с постинсультной атаксией. Журнал неврологии и психиатрии им. С.С. Корсакова. 2015;9:42-45.
  6. Horac F.B., Nashner L.M., Diener H.C. Postural strategies associated with somatosensory and vestibular. Experimental Brain Research. 1990;82:167-77. doi: 10.1007/BF00230848.
  7. Шток В.Н., Иванова-Смоленская И.А., Левин О.С. Экстрапирамидные расстройства. Руководство по диагностике и лечению. М.: МЕДпресс-информ, 2002. 606 с.
  8. Ting L.H., Chiel H.J., Trumbower R.D., et al. Neuromechanical principles underlying movement modularity and their implications for rehabilitation. Neuron. 2015;86(1):38-54. Doi: 10.1016/j. neuron.2015.02.042.
  9. Watterston R., Delahunty M.A. Pilot Study Investigating the Use of Rebound Therapy for Clients with a Learning Disability. Part of: Huddersfield Functional Index: Rebound Therapy Outcome Measures Toolkit. Huddersfield: Huddersfield NHS Trust. 2001.
  10. Ляпин А.В., Ондар В.С., Аброськина М.В. и др. Возможности применения метода объективной оценки параметров ходьбы с использованием лазерного дальномера у неврологических больных. Сибирское медицинское обозрение. 2011;3(69):46-50.
  11. Скворцов Д.В. Диагностика двигательной патологии инструментальными методами: анализ походки, стабилометрия. М., 2007. 640 с.
  12. Herman T., Inbar-Borovsky N., Brozgol M., et al. Dynamic Gait Index in healthy older adults: the role of stair climbing, fear of falling and gender. Gait & Posture. 2009;2:237-41. Doi: 10.1016/j. gaitpost.2008.08.013.
  13. Trouillas P., Takayanagi T., Hallett M.J., et al. International Cooperative Ataxia Rating Scale for pharmacological assessment of the cerebellar syndrome. The Ataxia Neuropharmacology Committee of the World Federation of Neurology J. Neurol. Sci. 1997;145(2):205-11.
  14. Таровская А.М., Прокопенко С.В. Применение метода CI терапии в нейрореабилитации. Сибирское медицинское обозрение. 2015;3(93):33-37.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2019 Bionika Media