Neck muscle vibration and prism adaptation fail to improve balance disturbances after stroke: A multicentre randomised controlled study.

Autor: Leplaideur S; CHU Rennes, Hopital Pontchaillou, service MPR adulte, Rennes, France; Univ Rennes, Inria, CNRS, Inserm, Irisa UMR 6074, EMPENN-ERL, U1228, Rennes, France; Inserm, CIC 1414, Rennes, France; CRRF Kerpape, Ploemeur, France. Electronic address: stephanie.leplaideur@chu-rennes.fr., Allart E; CHU de Lille, Service de Rééducation Neurologique Cérébrolésion, INSERM U1172 Lille Neuroscience et Cognition, Université de Lille, Lille, France., Chochina L; CRRF Kerpape, Ploemeur, France., Pérennou D; Univ. Grenoble Alpes, UMR CNRS 5105 Neuropsychology and NeuroCognition, CHU Grenoble Alpes, Dept of NeuroRehabilitation South Hospital, Cs 10217 - 38043 Grenoble cedex 9, France., Rode G; Hospices civils de Lyon, Hopital Henry-Gabrielle, Service de MPR, Saint-Genis-Laval, France., Boyer FC; CHRU Reims, Unités de Médecine Physique et de Réadaptation, Hôpital Sébastopol, Université Reims Champagne-Ardenne (URCA), EA3797, Reims, France., Paysant J; Institut Régional de Réadaptation, Nancy, France., Yelnik A; APHP Lariboisière, Université Paris Diderot,service MPR, GH Saint Louis - Lariboisière - F. Widal, Paris, France., Jamal K; Inserm, CIC 1414, Rennes, France., Duché Q; Univ Rennes, Inria, CNRS, Inserm, Irisa UMR 6074, EMPENN-ERL, U1228, Rennes, France., Morcet JF; Inserm, CIC 1414, Rennes, France., Laviolle B; Inserm, CIC 1414, Rennes, France; Univ Rennes, CHU Rennes, Inserm, CIC 1414, Rennes, France., Combès B; Univ Rennes, Inria, CNRS, Inserm, Irisa UMR 6074, EMPENN-ERL, U1228, Rennes, France., Bannier E; Univ Rennes, Inria, CNRS, Inserm, Irisa UMR 6074, EMPENN-ERL, U1228, Rennes, France; CHU Rennes, Department of Radiology, Rennes, France., Bonan I; CHU Rennes, Hopital Pontchaillou, service MPR adulte, Rennes, France; Univ Rennes, Inria, CNRS, Inserm, Irisa UMR 6074, EMPENN-ERL, U1228, Rennes, France; Inserm, CIC 1414, Rennes, France.
Jazyk: angličtina
Zdroj: Annals of physical and rehabilitation medicine [Ann Phys Rehabil Med] 2024 Aug 21; Vol. 67 (7), pp. 101871. Date of Electronic Publication: 2024 Aug 21.
DOI: 10.1016/j.rehab.2024.101871
Abstrakt: Background: Pilot studies suggest potential effects of neck muscle vibration (NMV) and prism adaptation (PA) on postural balance disturbances related to spatial cognition.
Objectives: To evaluate the effect of 10 sessions of NMV and/or PA on ML deviation. We used the mediolateral centre of pressure position (ML deviation) as a biomarker for spatial cognition perturbation, hypothesising that PA and NMV would improve ML deviation, with a potential synergistic impact when used together.
Methods: We conducted a multicentre, single-blind, randomised controlled study. Participants within 9 months of a right-hemisphere supratentorial stroke and with less than 40% body weight supported on the paretic side in standing were randomised into 4 groups (PA, NMV, PA+NMV, or control).
Primary Outcome: ML deviation at Day 14.
Secondary Outcomes: force platform data, balance abilities, autonomy, and ML deviation, measured just after the first session (Day 1), at Day 90, and Day 180. A generalised linear mixed model (GLMM) assessed intervention effects on these outcomes, adjusting for initial ML deviation and incorporating other relevant factors.
Results: 89 participants were randomised and data from 80 participants, mean (SD) age 59.2 (10.2) years, mean time since stroke 94 (61) days were analysed. At Day 14, a weak time x group interaction (P = .001, omega-squared = 0.08) was found, with no significant between-group differences in ML deviation (P = .12) or in secondary outcomes (P = .08). Between-group differences were found on Day 1 (P = .03), Day 90 (P = .001) and Day 180 (P < .0001) regardless of age and stroke-related data. On Day 1, ML deviation improved in both the PA and NMV groups (P = .03 and P = .01). In contrast, ML deviation deteriorated in the NMV+PA group on Day 90 and Day 180 (P = .01 and P = .01).
Conclusions: The study found no evidence of any beneficial effects of repeated unimodal or combined sessions of NMV and/or PA on ML deviation after stroke.
Trial Registration: ClinicalTrials.gov identifier NCT01677091.
Competing Interests: Declaration of competing interest The authors declare that they have no competing interests.
(Copyright © 2024. Published by Elsevier Masson SAS.)
Databáze: MEDLINE
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