Effects of varying dose of balance training with sensory manipulation for patients with mild traumatic brain injury
|Keywords:||輕度創傷性腦傷;頭暈;平衡;感覺操弄;劑量效應;mild traumatic brain injury;dizziness;balance;sensory manipulation;dose-response relationship||Issue Date:||2007||Abstract:||
Background and purpose: Mild traumatic brain injury (mTBI) patients occupies up to 90% of all TBI patients and their dizziness and unsteadiness symptoms and signs can last more than several months to years, hence limiting the function and welfare of the patients. Even though these symptoms are well documented, but exercise intervention trials attempting to reduce such symptoms have not been found. The purpose of this study was to investigate the immediate and long term effects of varying doses of balance training with sensory manipulation for patients with mTBI. Methods: Fifteen subjects were recruited and randomized into a low-dose exercise group (30 minutes/session, 2 sessions/week, 2 weeks), a high-dose exercise group (60 minutes/session, 2 sessions/week, 2weeks), or a control group (no training). All subjects were assessed three times (pre-treatment evaluation, post-treatment evaluation, and follow-up evaluation) with physical examination (range of motion, muscle strength, sensation), Smart Balance Master balance evaluation including sensory organization test (SOT), limits of stability (LOS), rhythmic weight shifting (RWS), dynamic gait index (DGI), and dizziness handicap inventory (DHI). Two way repeated measures analysis of variance (ANOVA) was performed to identify the effect of time and intervention on differences of dependent variables. If there was any significant result, post hoc analysis was performed. Results: There was no group effect among pre-treatment evaluation, post-treatment evaluation, and follow-up evaluation. It meant no training effect in this study. However, there were effective trends toward SOT (eyes open, sway referenced support condition; eyes closed, sway referenced support condition; eyes open, sway referenced surround and support; composite equilibrium scores), DGI, and DHI. In addition, statistical analysis showed significant time effect. It meant three groups improved significantly as time passed. There were significant improvements between follow-up and post-treatment evaluation, follow-up and pre-treatment evaluation on SOT (eyes open, sway referenced support condition; eyes closed, sway referenced support condition; eyes open, sway referenced surround and support), and LOS (backward movement velocity). There were significant improvements among pre-treatment, post-treatment, and follow-up evaluation on SOT (composite equilibrium scores) and DGI. There were significant improvements between follow-up and pre-treatment evaluation on LOS (right forward direction reaction time). There were significant improvements between follow-up and post-treatment evaluation, follow-up and pre-treatment evaluation on DHI. Conclusion: Patients with mTBI, dizziness and unsteadiness did not improve their postural equilibrium, gait adjustment ability, and subjective symptoms of dizziness by a two-hour or four-hour balance training with sensory manipulation. However, there were effective trends toward SOT (eyes open, sway referenced support condition; eyes closed, sway referenced support condition; eyes open, sway referenced surround and support; composite equilibrium scores), DGI, and DHI. It is proposed we can recruit chronic patients with mTBI in the future to rule out factors in natural recovery and variations among subjects. In this way, the research questions can be answered more clearly.
|Appears in Collections:||物理治療學系所|
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