Neck muscle vibration and prism adaptation fail to improve balance disturbances after stroke: A multicentre randomised controlled study - 07/11/24
, Etienne Allart e, Lucie Chochina d, Dominic Pérennou f, Gilles Rode g, François Constant Boyer h, Jean Paysant i, Alain Yelnik j, Karim Jamal c, Quentin Duché b, Jean-François Morcet c, Bruno Laviolle c, k, Benoit Combès b, Elise Bannier b, l, Isabelle Bonan a, b, cHighlights |
• | Cumulative sessions of neck muscle vibration do not improve postural balance. |
• | Cumulative sessions of prism adaptation do not improve postural balance. |
• | Combining vibration and prisms does not produce a synergistic effect. |
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
Le texte complet de cet article est disponible en PDF.Keywords : Prism adaptation, Neck vibration, Stroke, Rehabilitation, Postural balance
Abbreviations : AP, BBS, CT, CoP, FLAIR, GLMM, ML, MNI, MRI, NMV, PA, PASS, SCP, SLB, SSA, TUG, WBA
Plan
Vol 67 - N° 7
Article 101871- octobre 2024 Retour au numéro
Article précédent
- Recommendations from the French Societies of Rheumatology and Physical Medicine and Rehabilitation on the non-pharmacological management of knee osteoarthritis
- Yves-Marie Pers, Christelle Nguyen, Constance Borie, Camille Daste, Quentin Kirren, Cyril Lopez, Gaëlle Ouvrard, Romane Ruscher, Jean-Noël Argenson, Sylvie Bardoux, Laurence Baumann, Francis Berenbaum, Aymeric Binard, Emmanuel Coudeyre, Sébastien Czernichow, Arnaud Dupeyron, Marie-Christine Fabre, Nathan Foulquier, Caroline Gérard, Vivien Hausberg, Yves Henrotin, Claude Jeandel, François-Xavier Lesage, Brigitte Liesse, Didier Mainard, Fabrice Michel, Grégory Ninot, Paul Ornetti, Agnès Oude-Engberink, Anne-Christine Rat, Pascal Richette, Alexandra Roren, Philippe Thoumie, Stéphane Walrand, François Rannou, Jérémie Sellam, Société Française de Rhumatologie and Société Française de Médecine Physique et de Réadaptation
- Short- medium- and long-term effects of botulinum toxin on upper limb spasticity in children with cerebral palsy: A meta-analysis of randomized controlled trials
- Tingting Chen, Yin Wu, Mengru Zhong, Kaishou Xu
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?