Practical aspects of balance and vestibular rehabilitation after stroke
https://doi.org/10.21518/2079-701X-2018-12-36-38
Abstract
Balance and vestibular disorders are often detected in patients who have suffered a stroke. Instability may be caused by various reasons. In some cases, impairment of gait is caused by spastic paresis, in others by proprioceptive sensitivity and cerebellar disorders. Management of patients with balance disorders in the post-stroke period is composed of a detailed assessment of functional capabilities, the risk of falls and the cause of instability, as well as the adjustment of physical rehabilitation and drug therapy. The effective methods of physical rehabilitation include general exercises to strengthen stability and physical endurance, and special simulators with biological feedback. The drug therapy includes basic pharmacotherapy for the secondary prevention of stroke and symptomatic agents that can manage various disorders due to pathogenetic mechanisms of cerebral stroke (botulinum therapy, Vasobral).
About the Authors
M. V. ZamergradRussian Federation
S. E. Khatkova
Russian Federation
References
1. Whitney SL, Marchetti GF, Schade A, Wrisley DM. The sensitivity and specificity of the Timed «Up and Go» and the Dynamic Gait Index for self-reported falls in persons with vestibular disorders. J Vestib Res, 2004, 14(5): 397-409.
2. Goldberg A, Casby A, Wasielewski M. Minimum detectable change for single-leg-stance-time in older adults. Gait Posture, 2011, 33(4): 737-9.
3. Bohannon RW. Comfortable and maximum walking speed of adults aged 20–79 years: reference values and determinants. Age Ageing, 1997, 26(1): 15-9.
4. Duncan PW, Weiner DK, Chandler J, Studenski S. Functional reach: a new clinical measure of balance. J Gerontol, 1990, 45(6): 192-7.
5. Maciaszek J, Borawska S, Wojcikiewicz J. Influence of posturographic platform biofeedback training on the dynamic balance of adult stroke patients. J Stroke Cerebrovasc Dis, 2014, 23(6): 1269-74. doi: 10.1016/j.jstrokecerebrovasdis.2013.10.029.
6. Omiyale O, Crowell CR, Madhavan S. Effect of Wii-based balance training on corticomotor excitability post stroke. J Mot Behav, 2015, 47(3): 190-200. doi: 10.1080/00222895.2014.971699.
7. Maciaszek J. Effects of Posturographic Platform Biofeedback Training on the Static and Dynamic Balance of Older Stroke Patients. J Stroke Cerebrovasc Dis, 2018, pii: S1052-3057(18)30117-4. doi: 10.1016/j.jstrokecerebrovasdis.2018.02.055.
8. Baier B, Janzen J, Müller-Forell W, Fechir M, Müller N, Dieterich M. Pusher syndrome: its cortical correlate. J Neurol, 2012, 259(2): 277-283. doi: 10.1007/s00415-011-6173-z.
9. Abe H, Kondo T, Oouchida Y, Suzukamo Y, Fujiwara S, Izumi S. Prevalence and length of recovery of pusher syndrome based on cerebral hemispheric lesion side in patients with acute stroke. Stroke, 2012, 43(6): 1654-6. doi: 10.1161/STROKEAHA.111.638379.
10. Karnath HO, Broetz D. Understanding and treating «pusher syndrome». Phys Ther, 2003, 83(12): 1119-25.
11. Uchiyama Y, Koyama T, Wada Y, Katsutani M, Kodama N, Domen K. Botulinum Toxin Type A Treatment Combined with Intensive Rehabilitation for Gait Poststroke: A Preliminary Study. J Stroke Cerebrovasc Dis, 2018. pii: S1052-3057(18)30116-2. doi: 10.1016/j.jstrokecerebrovasdis.2018.02.054.
12. Gupta AD, Chu WH, Howell S, Chakraborty S, Koblar S, Visvanathan R, Cameron I, Wilson D. A systematic review: efficacy of botulinum toxin in walking and quality of life in post-stroke lower limb spasticity. Syst Rev, 2018, 7(1): 1. doi: 10.1186/s13643-017-0670-9.
Review
For citations:
Zamergrad MV, Khatkova SE. Practical aspects of balance and vestibular rehabilitation after stroke. Meditsinskiy sovet = Medical Council. 2018;(12):36-38. (In Russ.) https://doi.org/10.21518/2079-701X-2018-12-36-38