Dept of Neurology, University of Basel Hospital, Basel, Switzerland; Dept of ORL, University of Basel Hospital, Basel, Switzerland.
Dept of Neurology, University of Basel Hospital, Basel, Switzerland; Dept of ORL, University of Basel Hospital, Basel, Switzerland.
J Neurol Sci. 2021 Jun 15;425:117432. doi: 10.1016/j.jns.2021.117432. Epub 2021 Apr 1.
Previously, we determined that training with vibrotactile feedback (VTfb) of trunk sway improves MS patients' balance impairment. Here, we posed 5 questions: 1) How many weeks of VTfb training are required to obtain the best short-term carry over effect (CoE) with VTfb? 2) How long does the CoE last once VTfb training terminates? 3) Is the benefit similar for stance and gait? 4) Is position or velocity based VTfb more effective in reducing trunk sway? 5) Do patients' subjective assessments of balance control improve?
Balance control of 16 MS patients was measured with gyroscopes at the lower trunk. The gyroscopes drove directionally active VTfb in a head-band. Patients trained twice per week with VTfb for 4 weeks to determine when balance control with and without VTfb stopped improving. Thereafter, weekly assessments without VTfb over 4 weeks and at 6 months determined when CoEs ended.
A 20% improvement in balance to normal levels occurred with VTfb. Short term CoEs improved from 15 to 20% (p ≤ 0.001). Medium term (1-4 weeks) CoEs were constant at 19% (p ≤ 0.001). At 6 months improvement was not significant, 9%. Most improvement was for lateral sway. Equal improvement occurred when angle position or velocity drove VTfb. Subjectively, balance improvements peaked after 3 weeks of training (32%, p ≤ 0.05).
3-4 weeks VTfb training yields clinically relevant sway reductions and subjective improvements for MS patients during stance and gait. The CoEs lasted at least 1 month. Velocity-based VTfb was equally effective as position-based VTfb.
此前，我们发现通过躯干摆动的振动触觉反馈（VTfb）进行训练可以改善 MS 患者的平衡障碍。在此，我们提出了 5 个问题：1）需要多少周的 VTfb 训练才能获得最佳的短期延续效应（CoE）？2）VTfb 训练停止后，CoE 持续多长时间？3）对站位和步态的效果是否相同？4）基于位置或速度的 VTfb 对减少躯干摆动更有效吗？5）患者对平衡控制的主观评估是否有所改善？
通过在下肢躯干上的陀螺仪来测量 16 名 MS 患者的平衡控制。陀螺仪通过头带驱动方向活性 VTfb。患者每周进行两次训练，持续 4 周，以确定平衡控制在有无 VTfb 的情况下何时停止改善。此后，每周在没有 VTfb 的情况下进行 4 周评估，然后在 6 个月时进行评估，以确定 CoE 何时结束。
VTfb 使平衡提高到正常水平的 20%。短期 CoE 从 15%提高到 20%（p≤0.001）。中期（1-4 周）CoE 保持在 19%（p≤0.001）。6 个月时，改善不显著，为 9%。最大的改善是横向摆动。当角度位置或速度驱动 VTfb 时，会出现同等的改善。主观上，平衡改善在 3 周的训练后达到峰值（32%，p≤0.05）。
3-4 周的 VTfb 训练可使 MS 患者在站位和步态期间获得具有临床意义的摆动减少和主观改善。CoE 至少持续 1 个月。基于速度的 VTfb 与基于位置的 VTfb 同样有效。
