Tatiana Rocha Silva, Ludimila Labanca, Júlia Fonseca de Morais Caporali, Mauricio Campelo Tavares, Nathália de Castro Botini Rausse, Maria Júlia Amaral Abranches de Almeida, Maxmilliam de Souza Martins, Laura Fernandes Amorim, Léo Dantas Sitibaldi, Denise Utsch Gonçalves
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引用次数: 0
Abstract
Introduction: Galvanic vestibular stimulation (GVS) is a simple, safe, and noninvasive method of neurostimulation that can be used to improve body balance. Several central nervous system diseases cause alterations in body balance, including HTLV-1-associated myelopathy (HAM).
Objective: To test GVS as a balance rehabilitation strategy for HAM.
Methods: This study is a quasi-experimental clinical trial in which postural balance was compared before and after a GVS rehabilitation protocol applied to 20 patients with HAM, 12 women and 8 men, average age of 78 and 79 years, respectively. They were followed for nine months after the end of the GVS protocol, which consisted of one GVS session per week for 12 consecutive weeks. The GVS current intensity was progressively increased from 1.0 milliamperes (mA) to 3.5 mA until the third session and maintained at 3.5 mA until the 12th session. The electrical stimulation time progressively increased from 9 min in the first session to 18 min in the second session and maintained at 30 min from the third session onwards. Postural balance was assessed by Time up and go test (TUG), Berg balance scale (BBS) and posturography that were performed before the beginning of the intervention, during the intervention (6th week), at the end of the intervention (12th week) and after 9 months of follow-up without electrical stimulation.
Results: In a blind comparison, in the 12th week of stimulation, improvement was observed in all the tests. In TUG, time in seconds changed from 28 before to 18 after GVS (p < 0,001). In BBS, the score changed from 29.00 before to 41.00 points after GVS. In posturography, the stability limit improved after the intervention (p < 0.05). However, after nine months without stimulation, the gain was lost for TUG, for BBS and for stability limit.
Conclusion: GVS was an effective method to improve postural instability of patients with HAM in the short term, but the gain in postural stability was not maintained in the long term. A device for home use may be an option for long-term use.
导语：前庭电刺激（GVS）是一种简单、安全、无创的神经刺激方法，可用于改善身体平衡。几种中枢神经系统疾病引起身体平衡的改变，包括htlv -1相关脊髓病（HAM）。目的：验证GVS作为HAM平衡康复策略的可行性。方法：本研究是一项准实验临床试验，比较了20例HAM患者（女性12例，男性8例，平均年龄分别为78岁和79 岁）采用GVS康复方案前后的姿势平衡。在GVS方案结束后，他们被跟踪了9个月，其中包括每周一次连续12周的GVS会议。GVS电流强度从1.0毫安（mA）逐渐增加到3.5 mA，直到第三次，并保持在3.5 mA，直到第12次。电刺激时间从第一组的9 min逐渐增加到第二组的18 min，从第三组开始保持在30 min。姿势平衡通过干预开始前、干预期间（第6周）、干预结束时（第12周）和无电刺激随访9个 月后的Time up and go test （TUG）、Berg平衡量表（BBS）和姿势照相进行评估。结果：在盲法比较中，在刺激第12周，所有测试均有改善。在TUG组中，从GVS前的28秒变为GVS后的18秒（p p ）。结论：GVS在短期内可以有效改善HAM患者的姿势不稳定性，但在长期内不能维持姿势稳定性的提高。家庭使用的设备可能是长期使用的选择。
期刊介绍：
Frontiers in Human Neuroscience is a first-tier electronic journal devoted to understanding the brain mechanisms supporting cognitive and social behavior in humans, and how these mechanisms might be altered in disease states. The last 25 years have seen an explosive growth in both the methods and the theoretical constructs available to study the human brain. Advances in electrophysiological, neuroimaging, neuropsychological, psychophysical, neuropharmacological and computational approaches have provided key insights into the mechanisms of a broad range of human behaviors in both health and disease. Work in human neuroscience ranges from the cognitive domain, including areas such as memory, attention, language and perception to the social domain, with this last subject addressing topics, such as interpersonal interactions, social discourse and emotional regulation. How these processes unfold during development, mature in adulthood and often decline in aging, and how they are altered in a host of developmental, neurological and psychiatric disorders, has become increasingly amenable to human neuroscience research approaches. Work in human neuroscience has influenced many areas of inquiry ranging from social and cognitive psychology to economics, law and public policy. Accordingly, our journal will provide a forum for human research spanning all areas of human cognitive, social, developmental and translational neuroscience using any research approach.
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