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14 pages, 1877 KiB  
Article
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
by Wojciech Skrobot, Ewelina Perzanowska, Katarzyna Krasowska, Damian J. Flis, Katarzyna P. Dzik, Wojciech Kloc, Jan Jacek Kaczor and Jędrzej Antosiewicz
Nutrients 2020, 12(12), 3874; https://doi.org/10.3390/nu12123874 - 18 Dec 2020
Cited by 4 | Viewed by 2935
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Vitamin D, Diet and Musculoskeletal Health)
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Figure 1

Figure 1
<p>Participants flow diagram.</p>
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<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> &lt; 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>
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<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> &lt; 0.05, significantly different compared with BS and b, <span class="html-italic">p</span> &lt; 0.05, significantly different compared with Pl-ASVR.</p>
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<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> &lt; 0.05, significantly different compared with the before supplementation (BS) control; b, <span class="html-italic">p</span> &lt; 0.05, significantly different compared with the D3-BSVR group by one-way ANOVA; and c, <span class="html-italic">p</span> &lt; 0.05, significantly different compared with the Pl-BSVR group.</p>
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<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> &lt; 0.05, significantly different compared with the D3-BS; b, <span class="html-italic">p</span> &lt; 0.05, significantly different compared with the Pl-BS; and c, <span class="html-italic">p</span> &lt; 0.05, significantly different compared with and the Pl-after supplementation (AS) group, respectively by one-way ANOVA.</p>
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<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> &lt; 0.05, significantly different compared with D3-BS and b, <span class="html-italic">p</span> &lt; 0.05, significantly different compared with Pl-BS by one-way ANOVA.</p>
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<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> &lt; 0.05, significantly different compared with ASVR D3 by one-way ANOVA.</p>
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<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> &lt; 0.05, significantly different compared with ASVR D3 by one-way ANOVA.</p>
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