Balance Training With a Vibrotactile Biofeedback System Affects the Dynamical Structure of the Center of Pressure Trajectories in Chronic Stroke Patients
Balance Training With a Vibrotactile Biofeedback System Affects the Dynamical Structure of the Center of Pressure Trajectories in Chronic Stroke Patients
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DOI：
10.3389/fnhum.2019.00084
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发表时间：
2019-03-12
影响因子：
2.9
通讯作者：
Iwata, Hiroyasu
中科院分区：
文献类型：
--
作者：
Kodama, Kentaro;Yasuda, Kazuhiro;Iwata, Hiroyasu
基于触觉的振动触觉生物反馈（BF）是一种很有前途的技术，以改善脑卒中患者的平衡康复。然而，BF训练改变压力中心（CoP）轨迹的时间结构的程度仍然未知。本研究旨在探讨振动触觉BF训练对慢性脑卒中患者安静站立时CoP时间结构的影响。9名慢性卒中患者（年龄;卒中后81.56 +/- 44个月）接受了使用振动触觉BF系统的平衡训练方案，每周两次，持续4周。使用Wii平衡板记录50 Hz下训练前和训练后的5次30 s安静站立试验。DFA显示存在两个线性标度区域的CoP表示存在的快速和缓慢的规模波动。所有试验的平均值显示，快尺度波动显示持续动力学（ML的α = 1.05 +/- 0.08，AP的α = 0.99 +/- 0.17），慢尺度波动是反持续的（ML的α = 0.35 +/- 0.05，AP的α = 0.32 +/- 0.05）。从训练前到BF训练后，卒中患者ML CoP的慢尺度动力学降低（α = 0.40 +/- 0.13 vs. 0.31 +/- 0.09）。这些结果表明，振动触觉BF训练影响姿势控制策略使用的慢性脑卒中患者在ML方向。DFA的结果进行了进一步讨论的背景下，使用振动触觉BF的平衡训练和解释的角度间歇控制直立的立场。
Haptic-based vibrotactile biofeedback (BF) is a promising technique to improve rehabilitation of balance in stroke patients. However, the extent to which BF training changes temporal structure of the center of pressure (CoP) trajectories remains unknown. This study aimed to investigate the effect of vibrotactile BF training on the temporal structure of CoP during quiet stance in chronic stroke patients using detrended fluctuation analysis (DFA). Nine chronic stroke patients (age; 81.56 +/- 44 months post-stroke) received a balance training regimen using a vibrotactile BF system twice a week over 4 weeks. A Wii Balance board was used to record five 30 s trials of quiet stance pre- and post-training at 50 Hz. DFA revealed presence of two linear scaling regions in CoP indicating presence of fast- and slow-scale fluctuations. Averaged across all trials, fast-scale fluctuations showed persistent dynamics (alpha = 1.05 +/- 0.08 for ML and alpha = 0.99 +/- 0.17 for AP) and slow-scale fluctuations were anti-persistent (alpha = 0.35 +/- 0.05 for ML and alpha = 0.32 +/- 0.05 for AP). The slow-scale dynamics of ML CoP in stroke patients decreased from pre-training to post-BF training (alpha = 0.40 +/- 0.13 vs. 0.31 +/- 0.09). These results suggest that the vibrotactile BF training affects postural control strategy used by chronic stroke patients in the ML direction. Results of the DFA are further discussed in the context of balance training using vibrotactile BF and interpreted from the perspective of intermittent control of upright stance.