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
<p>Participants flow diagram.</p> "> Figure 2
<p>The concentration of 25(OH)D3 in the serum, after five weeks of supplementation, was significantly increased. Columns, mean; bars SD; and a, <span class="html-italic">p</span> < 0.05, significantly different compared with BS. BS—before supplementation, AS—5 weeks after supplementation, BSVR—4 weeks after surgery, and ASVR—10 weeks after supervised rehabilitation.</p> "> Figure 3
<p>Vitamin D supplementation reduced the risk of falls of patients before anterior cervical interbody fusion (ACIF) surgery. The data are presented as the means and standard deviations (SDs). a, <span class="html-italic">p</span> < 0.05, significantly different compared with BS and b, <span class="html-italic">p</span> < 0.05, significantly different compared with Pl-ASVR.</p> "> Figure 4
<p>Vitamin D supplementation improves the effects of rehabilitation on the overall postural stability of patients after an anterior cervical interbody fusion surgery. Columns, mean and bars, standard deviations (SDs). a, <span class="html-italic">p</span> < 0.05, significantly different compared with the before supplementation (BS) control; b, <span class="html-italic">p</span> < 0.05, significantly different compared with the D3-BSVR group by one-way ANOVA; and c, <span class="html-italic">p</span> < 0.05, significantly different compared with the Pl-BSVR group.</p> "> Figure 5
<p>Vitamin D supplementation had no effects on the rehabilitation-induced improvement on the limits of stability of patients after anterior cervical interbody fusion surgery. Columns, mean and bars, standard deviations (SDs). a, <span class="html-italic">p</span> < 0.05, significantly different compared with the D3-BS; b, <span class="html-italic">p</span> < 0.05, significantly different compared with the Pl-BS; and c, <span class="html-italic">p</span> < 0.05, significantly different compared with and the Pl-after supplementation (AS) group, respectively by one-way ANOVA.</p> "> Figure 6
<p>Vitamin D supplementation had no effects on the rehabilitation-induced improvement on the ellipse sway area (mm<sup>2</sup>) of patients after anterior cervical interbody fusion surgery. Columns, mean and bars, standard deviations (SDs). a, <span class="html-italic">p</span> < 0.05, significantly different compared with D3-BS and b, <span class="html-italic">p</span> < 0.05, significantly different compared with Pl-BS by one-way ANOVA.</p> "> Figure 7
<p>Vitamin D supplementation decrease sway rate (mm/s) in patients after anterior cervical interbody fusion surgery. Columns, mean and bars, standard deviations (SDs). a, <span class="html-italic">p</span> < 0.05, significantly different compared with ASVR D3 by one-way ANOVA.</p> "> Figure 8
<p>Vitamin D supplementation decreased the center of pressure (CoP) path length (mm) in patients after anterior cervical interbody fusion surgery. Columns, mean and bars, standard deviations (SDs). a, <span class="html-italic">p</span> < 0.05, significantly different compared with ASVR D3 by one-way ANOVA.</p> ">
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants, Therapists, and Centers
2.1.1. Including Criteria
2.1.2. Excluding Criteria
2.2. Functional Tests
2.3. Sample Collection
2.4. Postural Stability Test
2.5. Risk of Falls Test
2.6. Limits of Stability Test
2.7. Romberg Test
- (1)
- the ellipse sway area (mm2), defined as a 95% confidence ellipse area for the mean movements of the center of pressure (CoP) anterior, posterior, medial, and lateral coordinates.
- (2)
- the sway rate (mm/s), defined as the mean speed of movement of the CoP throughout the testing period.
- (3)
- the CoP path length (mm), defined as the absolute length of the CoP path movements throughout the testing period.
- (4)
- the average pressure distribution of the left and right feet expressed in body weight (%). Additionally, the bilateral pressure distribution asymmetry score was calculated as the absolute difference in pressure distribution between the legs. In a perfect symmetrical stance, this variable is zero [20].
2.8. Data Analysis
2.9. Rehabilitation Protocol
3. Results
3.1. Vitamin D
3.2. Risk of Falls
3.3. Postural Stability
3.4. Limits of Stability
3.5. Ellipse Sway Area
3.6. Sway Rate Center of Pressure (COP AV)
3.7. CoP Path Length
4. Discussion
Limitation of the Study
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Abbreviations
ACIF | Anterior cervical interbody fusion |
OSI | Overall postural stability index |
Pl | Placebo |
LOS | Limits of stability |
RFT | Risk of falls |
PST | Postural stability |
BS | Before supplementation |
AS | After supplementation |
BSVR | After surgery—Before supervising rehabilitation |
ASVR | After supervising rehabilitation |
25(OH)D3 | 25-hydroxy cholecalciferol |
1,25(OH)2D3 | 1,25-dihydroxycholecalciferol |
VDR | Vitamin D receptor |
MRI | Magnetic resonance imaging |
BBS | Biodex Balance System |
CVs | Coefficients of variability |
APSI | Anterior-Posterior Stability Index |
MLSI | Medial-Lateral Stability Index |
EC | Eyes closed |
CoP | Center of pressure |
SDs | Standard deviations |
CNS | Central Nervous System |
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Week | Intervention |
---|---|
I | Instruction about ergonomics behavior during daily activities; instruction about keeping right position with correction of a head, shoulder, and pelvic girdle; and, also, deep trunk stabilization was led. Maintaining a neutral posture movement of the upper and lower limbs was performed. |
II–III | The same exercise as above, but more difficulty was conducted. Exercises with a head’s laser for control movement of the head was applied. Shoulder’s girdle stabilization, with additional control of the key parts of the body, was carried out. Proprioception exercises were led with opened and closed eyes. Exercises in the closed chain on the wall in a standing position were performed, which were prepared with plank and balance exercises. |
IV | Balancing exercises with sensorimotor discs with the control of body swaying were conducted. Learning tensions of the deep cervical flexors was managed. |
V | Increasing the number of isometric contractions of stabilizing muscles exercises and changes in the sequence and time performed of the movement were applied. |
VI–VII | At the beginning of the sixth week, independent head movements in the range to the threshold of pain in the cervical spines of patients were performed. In the next weeks, an increased intensity and difficulty of the exercises were applied. |
VIII–X | From the eighth week, patients started plank exercises. After ten weeks of supervised rehabilitation, patients were encouraged to continue their activities at home. |
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Skrobot, W.; Perzanowska, E.; Krasowska, K.; Flis, D.J.; Dzik, K.P.; Kloc, W.; Kaczor, J.J.; Antosiewicz, J. 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. Nutrients 2020, 12, 3874. https://doi.org/10.3390/nu12123874
Skrobot W, Perzanowska E, Krasowska K, Flis DJ, Dzik KP, Kloc W, Kaczor JJ, Antosiewicz J. 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. Nutrients. 2020; 12(12):3874. https://doi.org/10.3390/nu12123874
Chicago/Turabian StyleSkrobot, Wojciech, Ewelina Perzanowska, Katarzyna Krasowska, Damian J. Flis, Katarzyna P. Dzik, Wojciech Kloc, Jan Jacek Kaczor, and Jędrzej Antosiewicz. 2020. "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" Nutrients 12, no. 12: 3874. https://doi.org/10.3390/nu12123874