Early Rehabilitation Program and Vitamin D Supplementation Improves Sensitivity of Balance and the Postural Control in Patients after Posterior Lumbar Interbody Fusion: A Randomized Trial
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design
2.2. Participants, Therapists, Centers
2.3. Intervention
2.4. Outcome Measures
2.4.1. Limits of Stability Test (LOS)
2.4.2. Postural Stability Test (PST)
2.4.3. Risk of Fall Test (RFT)
2.4.4. Rehabilitation Protocol
2.5. Data Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Abbreviations
PLIF | Posterior Lumbar Interbody Fusion |
CRP | C-Reactive Protein |
IL-6 | Interleukin 6 |
BBS | The Biodex Balance System |
PST | Postural Stability Test |
LOS | Limits of Stability Test |
RFT | Risk of Fall Test |
MRI | magnetic resonance imaging |
References
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Week | Intervention |
---|---|
I | Instruction on ergonomic behavior during daily activities; instruction about deep trunk stabilization; and movements of the upper and lower limbs were performed while maintaining a neutral posture. |
II–III | The same exercise as above but with increased challenge. Previous exercises were difficult; continuing deep stabilization with dissociated exercises; patients performed exercises in a closed chain at the wall in a standing position, which prepared them to plank, and balance exercises. |
IV | Balance exercises with sensorimotor discs. |
V | Additional isometric contractions of stabilizing muscles, changes in sequence and duration of movements. |
Vit D Supplemented (EG) | Control Group (CG) | rANOVA | ||||||
---|---|---|---|---|---|---|---|---|
Baseline (n = 15) | After 5 weeks of supplementation (n = 15) | Baseline (n = 18) | After 5 weeks of supplementation (n = 18) | Time | ηp2 | Group x time interaction | ηp2 | |
General | 0.35 (0.15) | 0.27 * (0.08) | 0.34 (0.20) | 0.32 (0.18) | p = 0.01 | 0.19 | p = 0.47 | 0.02 |
AP | 0.21 (0.07) | 0.19 (0.08) | 0.32 (0.16) | 0.25 * (0.15) | p = 0.00 | 0.25 | p = 0.04 | 0.13 |
ML | 0.12 (0.09) | 0.11 (0.08) | 0.16 (0.09) | 0.14 (0.07) | p = 0.45 | 0.02 | p = 0.88 | 0.00 |
RFT | 1.03 (0.50) | 0.91 (0.38) | 1.16 (0.69) | 1.01 (0.39) | p = 0.20 | 0.06 | p = 0.81 | 0.00 |
25-0HD [nmol • L−1] | 48.37 (9.51) | 75.10 * (10.25) | 51.35 (18.05) | 49.46 (11.84) | p = 0.00 | 0.52 | p = 0.00 | 0.59 |
Vit D Supplemented (EG) | Control Group (CG) | rANOVA | ||||||
---|---|---|---|---|---|---|---|---|
After operation (n = 15) | After 5 weeks of rehabilitation (n = 15) | After operation (n = 18) | After 5 weeks of rehabilitation (n = 18) | Time | ηp2 | Group x time interaction | ηp2 | |
General | 0.31 (0.08) | 0.23 * (0.08) | 0.33 (0.18) | 0.29 (0.11) | p = 0.02 | 0.17 | p = 0.46 | 0.02 |
AP | 0.26 (0.18) | 0.19 * (0.08) | 0.24 (0.08) | 0.22 (0.09) | p = 0.03 | 0.15 | p = 0.19 | 0.05 |
ML | 0.13 (0.07) | 0.07 * (0.04) | 0.13 (0.08) | 0.13 (0.07) | p = 0.05 | 0.14 | p = 0.04 | 0.14 |
Risk | 0.91 (0.38) | 1.03 (0.38) | 1.01 (0.39) | 1.08 (0.63) | p = 0.12 | 0.08 | p = 0.74 | 0.00 |
25-0H-D [nmol • L−1] | 75.10 (10.25) | 67.11 (11.45) | 49.46 (11.84) | 43.62 (11.92) | p = 0.00 | 0.34 | p = 0.57 | 0.01 |
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Skrobot, W.; Liedtke, E.; Krasowska, K.; Dzik, K.P.; Flis, D.J.; Samoraj-Dereszkiewicz, A.; Libionka, W.; Kortas, J.; Kloc, W.; Antosiewicz, J.; et al. Early Rehabilitation Program and Vitamin D Supplementation Improves Sensitivity of Balance and the Postural Control in Patients after Posterior Lumbar Interbody Fusion: A Randomized Trial. Nutrients 2019, 11, 2202. https://doi.org/10.3390/nu11092202
Skrobot W, Liedtke E, Krasowska K, Dzik KP, Flis DJ, Samoraj-Dereszkiewicz A, Libionka W, Kortas J, Kloc W, Antosiewicz J, et al. Early Rehabilitation Program and Vitamin D Supplementation Improves Sensitivity of Balance and the Postural Control in Patients after Posterior Lumbar Interbody Fusion: A Randomized Trial. Nutrients. 2019; 11(9):2202. https://doi.org/10.3390/nu11092202
Chicago/Turabian StyleSkrobot, Wojciech, Ewelina Liedtke, Katarzyna Krasowska, Katarzyna P. Dzik, Damian J. Flis, Anna Samoraj-Dereszkiewicz, Witold Libionka, Jakub Kortas, Wojciech Kloc, Jedrzej Antosiewicz, and et al. 2019. "Early Rehabilitation Program and Vitamin D Supplementation Improves Sensitivity of Balance and the Postural Control in Patients after Posterior Lumbar Interbody Fusion: A Randomized Trial" Nutrients 11, no. 9: 2202. https://doi.org/10.3390/nu11092202