Vitamin D Supplementation Improves the Effects of the Rehabilitation Program on Balance and Pressure Distribution in Patients after Anterior Cervical Interbody Fusion-Randomized Control Trial.

Wojciech Skrobot,Katarzyna P Dzik,Ewelina Perzanowska,Wojciech Kloc,Jędrzej Antosiewicz,Jan Jacek Kaczor,Katarzyna Krasowska,Damian J Flis

doi:10.3390/nu12123874

Abstract

Study Design: A double-blinded, randomized controlled trial. Background: Surgery is effective in reducing pain intensity in patients with cervical disc disease. However, functional measurements demonstrated that the results have been not satisfactory enough. Thus, rehabilitation programs combined with the supplementation of vitamin D could play an essential role. Methods. The study recruited 30 patients, aged 20 to 70 years, selected for anterior cervical interbody fusion (ACIF). The patients were randomly divided into the placebo (Pl) and vitamin D (3200 IU D3/day) supplemented groups. The functional tests limits of stability (LOS), risk of falls (RFT), postural stability (PST), Romberg test, and foot pressure distribution were performed before supplementation (BS—week 0), five weeks after supplementation (AS—week 5), four weeks after surgery (BSVR—week 9), and 10 weeks after supervising rehabilitation (ASVR—week 19). Results. The concentration of 25(OH)D3 in the serum, after five weeks of supplementation, was significantly increased, while the Pl group maintained the same. The RFT was significantly reduced after five weeks of vitamin D supplementation. Moreover, a further significant decrease was observed following rehabilitation. In the Pl group, no changes in the RFT were observed. The overall postural stability index (OSI), LOS, and the outcomes of the Romberg test significantly improved in both groups; however, the effects on the OSI were more pronounced in the D3 group at the end of the rehabilitation program. Conclusions. Our data suggest that vitamin D supplementation positively affected the rehabilitation program in patients implemented four weeks after ACIF by reducing the risk of falls and improving postural stability.

Highlights

Patients with cervical disc disease often present with symptoms that include pain, sensory loss, motor loss, and reflex impairment
The concentration of the serum 25(OH)D3 did not differ between the groups at the beginning of the study
We demonstrated that the vitamin D supplementation significantly improved the outcome of supervising rehabilitation in the D3 group who underwent anterior cervical interbody fusion (ACIF) surgery

Summary

Introduction

Patients with cervical disc disease often present with symptoms that include pain, sensory loss, motor loss, and reflex impairment. The consequence of these is a physical disability and a significant drop in quality of life [1]. Anterior cervical interbody fusion (ACIF) is a standard procedure for such problems; the outcome is strongly dependent on postsurgery rehabilitation [2]. Postoperative rehabilitation to increase the effects of cervical spine surgery by encouraging safe physical activities, improving function and reducing the fear of pain. A rehabilitation program applied after surgery is crucial and usually focused on the improvement of cervical muscle endurance, strength, and postural control [3]

Methods

Results

Discussion

Conclusion