Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Italy
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy.
Mult Scler. 2015 Jul;21(8):1055-63. doi: 10.1177/1352458514557985. Epub 2014 Nov 12.
BACKGROUND: Altered integration of signals from visual (VIS), somatosensory (PROP) and vestibular system (VEST) lead to balance control impairments affecting the daily living activities of patients with multiple sclerosis (PwMS). As a consequence, tailored interventions could be crucial in improving efficacy of balance rehabilitation treatments. OBJECTIVE: The objective of this paper is to assess the efficacy of tailored rehabilitation treatments for balance disorders based on visual, somatosensory and vestibular deficits versus traditional rehabilitation exercises. METHODS: Thirty-two PwMS were assessed with the Berg Balance Scale (BBS), the composite score (CS) obtained by computerized dynamic posturography (CDP) test and the Modified Fatigue Impact Scale (MFIS). Based on CDP analysis, prevalent VIS, PROP or VEST deficits were identified and patients randomly allocated to a personalized (PRG) or traditional (TRG) rehabilitation group. RESULTS: BBS score showed a significant difference between pre- and post-treatment scores of 6.3 and 2.0 points respectively for PRG and TRG. CS showed a significant difference between pre- and post-treatment scores of 16.6 and 7.6 points respectively for PRG and TRG. No interaction effect was found for MFIS score. CONCLUSIONS: BBS and CS showed changes in the PRG group that met clinical relevant difference, underlining that tailored rehabilitation interventions based on patient-specific sensory system impairment could improve balance and postural control in PwMS.
背景:视觉(VIS)、躯体感觉(PROP)和前庭系统(VEST)信号整合的改变导致平衡控制受损,影响多发性硬化症(PwMS)患者的日常生活活动。因此,量身定制的干预措施可能对改善平衡康复治疗的效果至关重要。
目的:本文旨在评估基于视觉、躯体感觉和前庭缺陷的个性化康复治疗对平衡障碍的疗效,与传统康复运动相比。
方法:32 名 PwMS 患者接受 Berg 平衡量表(BBS)、计算机动态姿势图(CDP)测试的综合评分(CS)和改良疲劳影响量表(MFIS)评估。基于 CDP 分析,确定常见的 VIS、PROP 或 VEST 缺陷,并将患者随机分配到个性化(PRG)或传统(TRG)康复组。
结果:BBS 评分在 PRG 和 TRG 组中,治疗前后的差异分别为 6.3 分和 2.0 分。CS 在 PRG 和 TRG 组中,治疗前后的差异分别为 16.6 分和 7.6 分。MFIS 评分无交互作用。
结论:BBS 和 CS 在 PRG 组中发生了变化,达到了临床相关的差异,这表明基于患者特定感觉系统损伤的个性化康复干预措施可以改善 PwMS 的平衡和姿势控制。
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