De Angelis Sara, Princi Alessandro Antonio, Dal Farra Fulvio, Morone Giovanni, Caltagirone Carlo, Tramontano Marco
Fondazione Santa Lucia IRCCS, 00179 Rome, Italy.
SOMA-Istituto Osteopatia Milano, 20126 Milan, Italy.
Brain Sci. 2021 Apr 19;11(4):518. doi: 10.3390/brainsci11040518.
Postural instability and fear of falling represent two major causes of decreased mobility and quality of life in cerebrovascular and neurologic diseases. In recent years, rehabilitation strategies were carried out considering a combined sensorimotor intervention and an active involvement of the patients during the rehabilitation sessions. Accordingly, new technological devices and paradigms have been developed to increase the effectiveness of rehabilitation by integrating multisensory information and augmented feedback promoting the involvement of the cognitive paradigm in neurorehabilitation. In this context, the vibrotactile feedback (VF) could represent a peripheral therapeutic input, in order to provide spatial proprioceptive information to guide the patient during task-oriented exercises. The present systematic review and metanalysis aimed to explore the effectiveness of the VF on balance and gait rehabilitation in patients with neurological and cerebrovascular diseases. A total of 18 studies met the inclusion criteria and were included. Due to the lack of high-quality studies and heterogeneity of treatments protocols, clinical practice recommendations on the efficacy of VF cannot be made. Results show that VF-based intervention could be a safe complementary sensory-motor approach for balance and gait rehabilitation in patients with neurological and cerebrovascular diseases. More high-quality randomized controlled trials are needed.
姿势不稳和跌倒恐惧是脑血管疾病和神经疾病患者活动能力下降及生活质量降低的两大主要原因。近年来,康复策略的实施考虑了感觉运动联合干预以及患者在康复训练期间的积极参与。因此,已开发出新的技术设备和模式,通过整合多感官信息和增强反馈来提高康复效果,促进认知模式在神经康复中的应用。在此背景下,振动触觉反馈(VF)可作为一种外周治疗输入,以便在以任务为导向的训练中提供空间本体感觉信息来引导患者。本系统评价和荟萃分析旨在探讨VF对神经和脑血管疾病患者平衡和步态康复的有效性。共有18项研究符合纳入标准并被纳入。由于缺乏高质量研究且治疗方案存在异质性,无法就VF的疗效给出临床实践建议。结果表明,基于VF的干预可能是神经和脑血管疾病患者平衡和步态康复的一种安全的补充性感觉运动方法。需要更多高质量的随机对照试验。