The Integrating Role of Restoration of Voluntary Postural Control in the Rehabilitation of Patients with Craniocerebral Trauma

Abstract

We present here results from complex clinical, stabilographic, and electroencephalographic (EEG) studies of 20 patients (aged 28 ± 6.9 years) with severe craniocerebral trauma. Studies were performed in the early post-trauma period before and after rehabilitation using stabilographic training with visual feedback, with comparison with a group of 18 healthy subjects (aged 26 ± 5.8 years). Stabilographic training regimes consisted of 8–15 sessions over 4–6 weeks. Before stabilographic training regimes, patients showed defects in all spheres of activity, most severely in the motor domain. This was associated with impairment of the temporospatial organization of the EEG, as a maximum decrease in alpha-range power and coherence and increases in the slow components of the delta range. Rehabilitation with stabilographic training was found to be not only effective in terms of recovery of voluntary postural control, but also in terms of decreases in defects in other spheres. EEG data showed that this corresponded to maximal increases in alpha-rhythm power in the occipital-parietal leads, with a tendency to normalization of specific regional EEG characteristics. EEG coherence analysis in all patients showed maximum increases in interhemisphere coherence in different EEG ranges, particularly the alpha range, in the central and parietal areas. Overall, these EEG changes may serve as a marker for the integrating role of postural control and may be an important stage in the recovery of brain integrative activity in patients, accompanied by improvements in impaired functions at early time points after severe craniocerebral trauma.