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

IF 3.9 3区医学 Q1 REHABILITATION Annals of Physical and Rehabilitation Medicine Pub Date : 2024-08-21 DOI:10.1016/j.rehab.2024.101871

Stephanie Leplaideur , Etienne Allart , Lucie Chochina , Dominic Pérennou , Gilles Rode , François Constant Boyer , Jean Paysant , Alain Yelnik , Karim Jamal , Quentin Duché , Jean-François Morcet , Bruno Laviolle , Benoit Combès , Elise Bannier , Isabelle Bonan

{"title":"Neck muscle vibration and prism adaptation fail to improve balance disturbances after stroke: A multicentre randomised controlled study","authors":"Stephanie Leplaideur , Etienne Allart , Lucie Chochina , Dominic Pérennou , Gilles Rode , François Constant Boyer , Jean Paysant , Alain Yelnik , Karim Jamal , Quentin Duché , Jean-François Morcet , Bruno Laviolle , Benoit Combès , Elise Bannier , Isabelle Bonan","doi":"10.1016/j.rehab.2024.101871","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Pilot studies suggest potential effects of neck muscle vibration (NMV) and prism adaptation (PA) on postural balance disturbances related to spatial cognition.</p></div><div><h3>Objectives</h3><p>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.</p></div><div><h3>Methods</h3><p>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).</p></div><div><h3>Primary outcome</h3><p>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.</p></div><div><h3>Results</h3><p>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 (<em>P</em> = .001, omega-squared = 0.08) was found, with no significant between-group differences in ML deviation (<em>P</em> = .12) or in secondary outcomes (<em>P</em> = .08). Between-group differences were found on Day 1 (<em>P</em> = .03), Day 90 (<em>P</em> = .001) and Day 180 (<em>P</em> < .0001) regardless of age and stroke-related data. On Day 1, ML deviation improved in both the PA and NMV groups (<em>P</em> = .03 and <em>P</em> = .01). In contrast, ML deviation deteriorated in the NMV+PA group on Day 90 and Day 180 (<em>P</em> = .01 and <em>P</em> = .01).</p></div><div><h3>Conclusions</h3><p>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.</p></div><div><h3>Trial registration</h3><p>ClinicalTrials.gov identifier NCT01677091</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 7","pages":"Article 101871"},"PeriodicalIF":3.9000,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Physical and Rehabilitation Medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1877065724000551","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}

引用次数: 0

Abstract

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

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

颈部肌肉振动和棱镜适应无法改善中风后的平衡障碍：一项多中心随机对照研究。

背景：试点研究表明，颈部肌肉振动（NMV）和棱镜适应（PA）对与空间认知相关的姿势平衡障碍有潜在影响：目的：评估 10 次颈部肌肉振动和/或棱镜适应训练对 ML 偏差的影响。我们将内外侧压力中心位置（ML 偏差）作为空间认知干扰的生物标记，假设 PA 和 NMV 可改善 ML 偏差，同时使用时可能会产生协同影响：我们进行了一项多中心、单盲、随机对照研究。方法：我们进行了一项多中心单盲随机对照研究，将右半球脑室上中风后 9 个月内且站立时支撑瘫痪侧体重不足 40% 的参与者随机分为 4 组（PA、NMV、PA+NMV 或对照组）：次要结果：首次训练后（第 1 天）、第 90 天和第 180 天测量的力量平台数据、平衡能力、自主性和 ML 偏差。采用广义线性混合模型（GLMM）评估了干预对这些结果的影响，调整了初始 ML 偏差并纳入了其他相关因素：89 名参与者接受了随机治疗，分析了 80 名参与者的数据，他们的平均年龄（SD）为 59.2（10.2）岁，平均中风时间为 94（61）天。在第 14 天，发现时间与组间存在微弱的交互作用（P = .001，ω-平方 = 0.08），组间在 ML 偏差（P = .12）或次要结果（P = .08）方面无显著差异。在第 1 天（P = .03）、第 90 天（P = .001 ）和第 180 天（P < .0001）发现了组间差异，与年龄和中风相关数据无关。第 1 天，PA 组和 NMV 组的 ML 偏差均有所改善（P = .03 和 P = .01）。相比之下，NMV+PA 组的 ML 偏差在第 90 天和第 180 天有所恶化（P = .01 和 P = .01）：结论：该研究没有发现任何证据表明重复单模式或联合 NMV 和/或 PA 治疗对中风后的 ML 偏差有任何有益影响：试验注册：ClinicalTrials.gov 标识符 NCT01677091。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Annals of Physical and Rehabilitation Medicine Medicine-Rehabilitation

CiteScore

7.80

自引率

4.30%

发文量

136

审稿时长

34 days

期刊介绍： Annals of Physical and Rehabilitation Medicine covers all areas of Rehabilitation and Physical Medicine; such as: methods of evaluation of motor, sensory, cognitive and visceral impairments; acute and chronic musculoskeletal disorders and pain; disabilities in adult and children ; processes of rehabilitation in orthopaedic, rhumatological, neurological, cardiovascular, pulmonary and urological diseases.