Rehabilitation of balance after stroke with multisensorial training: a single-blind randomized controlled study.
OBJECTIVE
To compare 2 rehabilitation strategies to improve balance after stroke: (1) a multisensorial approach based on higher intensity of balance tasks and exercise during visual deprivation and (2) a conventional neurodevelopmentaltheory-based treatment (NDT) that used a general approach for sensorimotor rehabilitation.


METHODS
This prospective, multicenter, randomized, parallel-group study measured outcomes with blinded assessors. Sixty-eight patients able to walk without human assistance were entered from 3 to 15 months (mean, 7 months) after a first hemispheric stroke. They received 20 sessions in 4 weeks of NDT or multisensorial rehabilitation. On day 0, day 30, and day 90, assessment included the Berg Balance Scale (BBS), posturography, gait (velocity, double stance phase, climbing 10 steps, amount of walking per day), the Functional Independence Measure, and the Nottingham Health Profile.


RESULTS
All subjects improved significantly in balance and walking parameters. Regarding the main dependent variable (BBS on day 30), no difference between groups was found. Analysis of secondary outcomes suggested small differences in favor of the experimental group, but the differences are not likely to be clinically relevant.


CONCLUSIONS
No evidence was found for the superiority of a multisensorial rehabilitation program in ambulatory patients with impairments beyond the time of inpatient therapy. Additional studies are recommended.
Yelnik
Alain P
AP
Physical Medicine and Rehabilitation Department, G.H. Lariboisière-F. Widal, Paris, France. alain.yelnik@lrb.aphp.fr
Le Breton
Frederique
F
Colle
Florence M
FM
Bonan
Isabelle V
IV
Hugeron
Caroline
C
Egal
Véronique
V
Lebomin
Elizabeth
E
Regnaux
Jean-Philippe
JP
Pérennou
Dominic
D
Vicaut
Eric
E
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D015444:Exercise; D056228:Feedback, Sensory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D004856:Postural Balance / Q000502:physiology*; D011597:Psychomotor Performance; D020127:Recovery of Function; D012678:Sensation Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D016037:Single-Blind Method; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*