Dreneva Anna A, Skvortsov Dmitry V
Faculty of Psychology, Lomonosov Moscow State University, Mokhovaya st. 11/9, 125009 Moscow, Russia.
Clinical Rehabilitation Research Center, Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology, Samory Mashela str. 1, 117997 Moscow, Russia.
Clin Biomech (Bristol). 2020 Jan;71:53-58. doi: 10.1016/j.clinbiomech.2019.10.025. Epub 2019 Oct 31.
The rehabilitation after pediatric brain tumors is a pressing issue in current neuro-oncology. The purpose of this study was to reveal the peculiarities of postural stability in pediatric posterior fossa tumor survivors as compared to the healthy controls. Additionally, we aimed to determine the feasibility of the balance biofeedback training for these patients.
We measured 6 postural stability parameters with the eyes opened and closed in 35 patients and 25 healthy controls aged 7-17. Further, the patients were divided into two groups: the intervention and waitlist. The intervention group was the first to undergo a 2-week biofeedback training designed to enhance balance control, while the waitlist group performed only the usual exercises. Then the groups were interchanged. Pre- and post-stability scores were measured in each condition.
The current results suggest the pronounced deficiency of stability in the patients. Their results in both opened and closed eyes conditions were similar. The post-training measurements revealed that some stability parameters were improved: ellipse square and mean root square oscillations in the frontal and sagittal planes.
The patients predictably demonstrated the significantly worse stability measurements as compared to the healthy controls. Moreover, they were shown not to use visual information to correct postural balance thus prompting us to assume severe deficits of the eye movements control due to the cerebellar pathology. This specificity, as well as the post-training significant improvement, emphasizes the clinical necessity to consider them when designing the rehabilitation protocols for posterior fossa tumor survivors.
小儿脑肿瘤后的康复是当前神经肿瘤学中的一个紧迫问题。本研究的目的是揭示小儿后颅窝肿瘤幸存者与健康对照相比姿势稳定性的特点。此外，我们旨在确定对这些患者进行平衡生物反馈训练的可行性。
我们在35例7至17岁的患者和25名健康对照中测量了睁眼和闭眼时的6个姿势稳定性参数。此外，将患者分为两组：干预组和候补组。干预组首先接受为期2周的旨在增强平衡控制的生物反馈训练，而候补组仅进行常规锻炼。然后两组互换。在每种情况下测量训练前后的稳定性得分。
目前的结果表明患者存在明显的稳定性不足。他们在睁眼和闭眼条件下的结果相似。训练后的测量结果显示，一些稳定性参数得到了改善：额面和矢状面的椭圆面积和均方根振荡。
与健康对照相比，患者的稳定性测量结果明显更差。此外，他们没有利用视觉信息来纠正姿势平衡，这促使我们推测由于小脑病变导致眼球运动控制存在严重缺陷。这种特殊性以及训练后的显著改善，强调了在为后颅窝肿瘤幸存者设计康复方案时考虑这些因素的临床必要性。
