Comparative effectiveness of various methods of physical rehabilitation in the complex treatment of patients with dyscirculatory encephalopathy with vestibulo-atactic syndrome

Abstract

To compare the effectiveness of a special complex of therapeutic (vestibular) gymnastics and training with biofeedback (BFB) on a stabiloplatform in the rehabilitation of patients with dyscirculatory encephalopathy with vestibulo-atactic syndrome. A cohort prospective single-center randomized comparative study of the clinical effectiveness of the author's complex of therapeutic exercises and stabilometric training with BFB in the complex treatment of patients with dyscirculatory encephalopathy with vestibulo-atactic syndrome was carried out. The study involved 40 patients aged 65-89 years who were randomized into 2 equal groups. Patients of the 1st group, against the background of drug therapy and physiotherapy, were trained on a stabiloplatform with BFB (a training game according to the manufacturer's instructions). Patients of the 2nd group performed a complex of therapeutic (vestibular) gymnastics specially designed for this study. The effectiveness of physical rehabilitation was assessed by the dynamics of (1) subjective symptoms (complaints of patients), (2) indicators of stabilometry (symmetry index, the sum of the coordination indices for the right and left legs, fluctuation) and (3) the results of functional testing using the Get up and go test, the Berg balance scale and the Tinetti mobility scale. In the group of patients who performed vestibular gymnastics, in contrast to patients who participated in training using a multifunctional stabiloplatform with BFB, a statistically significant improvement was revealed when assessed by the Get up and go test and the Berg balance scale. In none of the groups, a distinct dynamics of stabilometry indicators was registered. No correlation was found between the main indicators of stabilometry and the data of functional tests. Thus, vestibular gymnastics has demonstrated greater effectiveness in the rehabilitation of patients with dyscirculatory encephalopathy and vestibulo-atactic syndrome in comparison with stabilometric training with biofeedback. The discrepancy between stabilometry indicators and the results of functional testing in patients requires a targeted study.