Ataksili Hastalarda Tüm Vücut Vibrasyonun Postüral Kontrol Üzerine Etkileri

Abstract

This study was planned to evaluate the effects of an individual exercise programs supported by WBV on postural control components, ‘Biomechanical constraints’, ‘Movement strategies’, ‘Control of dynamics’, ‘Cognitive processing’, ‘Sensory strategies’, ‘Orientation in space’ and on the level of satisfaction with how well patients' expectations and goals. 20 cerebellar ataxic individuals whose mean age was 34.00 ± 9.15 were included in the study. In the study designed as cross-over, cases were separated into 2 groups and treated for 3 days in a week, 1 hour in each day for a total of 16 weeks (8 weeks × 2). In the first protocol, the whole body vibration and exercise program were applied together for 8 weeks and after the 1-week wash-out period, only the exercise program was applied for 8 weeks. In the second protocol, only the exercise program was applied for the first 8 weeks and after the 1-week wash-out period, the whole body vibration and the exercise program were applied together for 8 weeks. Stabilization, balance and functional exercises, which were created by considering the individual needs of the patients, were applied in the exercise program. The assessments were administered by a blind physiotherapist for four times, before and after both treatment programs. After recording demographic informations, pain and fatigue severity (Visual Analogue Scale 0-10) of individuals, postural control components were assessed by Computerized Dynamic Posturography, Sensory Organization Test (SOT), Adaptation Test (ADT), and Stability Limits Test (SLT). Also in the study disease severity (International Classification Ataxia Ratio Scale), trunk control (Trunk Impairment Scale), functional mobility skills (Timed Up and Go Test), stability limits (Functional Reach Test), walking performance (10-meter Walking Test), performance-based balance (Berg Balance Scale), daily living activities (Barthel Index), quality of life (Nottingham Health Profile), satisfaction with the patients' expectations and goals (Goal Attainment Scale) were assessed. Stability limits, adaptive reactions, three different versions of functional mobility skills, walking performance, pain and fatigue severity, and quality of life were improved only after exercise program with WBV (p<0,05). Disease severity, combined balance score of sensory organization test, trunk control, performance based balance, level of attainment of treatment goal and participation in daily life activities were improved after both exercise programs (p<0,05) but it was found that after exercise program with WBV, more improvement was observed (p <0.05). As a result; exercise programs supported by WBV has been shown to play an important role in the improvement of postural control of cerebellar ataxic patients and increasing levels of activity and participation.