van der Logt R P, Findling O, Rust H, Yaldizli O, Allum J H J
Division of Audiology and Neurootology, Department of ORL, University Hospital Basel, CH-4031 Basel, Switzerland.
Department of Neurology, University Hospital Basel, Switzerland; Department of Neurology, Cantonal Hospital Aarau, Switzerland.
Mult Scler Relat Disord. 2016 Jul;8:58-63. doi: 10.1016/j.msard.2016.05.003. Epub 2016 May 2.
Patients with multiple sclerosis (MS) suffer from diminished balance control due to slowed sensory conduction and possibly delayed central processing. Vibrotactile biofeedback of trunk sway has been shown to improve balance control in patients with peripheral and central vestibular disorders. Here, the effects of vibrotactile feedback training on trunk sway and a possible carry-over effect was measured in MS patients during stance and gait.
Ten MS patients (mean age 46.8±7.7 years, 40% male) participated in a crossover study in which 7 different stance and gait tasks were trained with and without angle feedback for stance and angular velocity feedback for gait. An assessment sequence of 12 tasks was performed once before and twice after the training sequence. Trunk sway was measured with body-worn gyroscopes. Head mounted vibrotactile biofeedback of trunk sway was provided during one crossover training arm and the following second assessment sequence.
Biofeedback generally leads to a decrease in sway but an increase in sway angular velocities during some stance tasks compared to training without biofeedback. Biofeedback while walking eyes open resulted in a decreased sway angular velocity. The greatest changes were found in the pitch direction of trunk sway. Effects diminished after biofeedback was removed.
This study showed that vibrotactile biofeedback of trunk sway beneficially effects stance and provides significant improvement in gait compared to training without biofeedback in MS patients.
由于感觉传导减慢以及可能存在的中枢处理延迟,多发性硬化症(MS)患者的平衡控制能力下降。躯干摆动的振动触觉生物反馈已被证明可改善外周和中枢前庭障碍患者的平衡控制。在此,我们测量了MS患者在站立和行走过程中,振动触觉反馈训练对躯干摆动的影响以及可能的延续效应。
10名MS患者(平均年龄46.8±7.7岁,40%为男性)参与了一项交叉研究,其中7种不同的站立和行走任务在有和没有站立角度反馈及行走角速度反馈的情况下进行训练。在训练序列之前进行一次12项任务的评估序列,训练序列之后进行两次。使用佩戴在身体上的陀螺仪测量躯干摆动。在一个交叉训练组和随后的第二次评估序列中提供头戴式躯干摆动振动触觉生物反馈。
与无生物反馈训练相比,生物反馈通常会导致摆动减少,但在一些站立任务中摆动角速度增加。睁眼行走时的生物反馈导致摆动角速度降低。在躯干摆动的俯仰方向上发现了最大的变化。去除生物反馈后效果减弱。
本研究表明,与MS患者无生物反馈训练相比,躯干摆动的振动触觉生物反馈对站立有有益影响,并能显著改善步态。