The outcomes of two different balance rehabilitation in acute phase patients with cerebrovascular accident on posterior brain circulation system

Objective:To determine the effects of two different balance rehabilitation programmes on balance, gait, disability level, risk of falling and functional independency after cerebrovascular accident (CVA) which effects posterior circulation system of brain in acute phase patients with central vestibular function disorder.Method:Twenty-five patients who had brain stem and cerebellar infarctus were included in the study. After all patients were divided randomly into two groups as study and control group on inpatient stage, treatment groups were established by random card selection from the study group. Control group patients continued doing exercises which were taught in the hospital, for 6 weeks. Study group participated rehabilitation programmes including individual exercises for 6 weeks.One of the treatment methods was the rehabilitation programme which was performed in computerized balance system (NeuroCom System Version 8.1 Balance Master). In this system, exercises were preprogrammed individually and specially. Patients did their vestibular rehabilitation exercises at home by coming to control once a week in supervised home programme group. At the end of six weeks, assessments which were done before the treatment were repeated. In the assessment Berg Balance Scale, Scale for the Assessment and Rating of Ataxia, Dizziness Handicap Inventory, Activities Specific Balance Confidence Scale, Falls Efficacy Scale, Dynamic Gait Index, Timed up&go test, Instrumental Activities of Daily Living Scale and the statical and dynamical test parameters of Balance Master system were used for gait and balance abilities.Results:Balance scale results were improved significantly in all groups (p<0.05), but no significant difference was found between the groups in terms of post-treatment values (p>0.05). In Modified Clinical Test on Sensory Interaction on Balance, the sway velocity of center of gravity was improved significantly in all groups (p<0.05), but no significant difference was found between the groups in terms of post-treatment values (p>0.05). In Limits of Stability test, the outcomes which reflect dynamic balance abilities were improved in posturography training group significantly (p<0.05). According to Tandem Walk test, outcomes of home exercise group and according to walk across test, outcomes of control group patients were improved significantly (p<0.05).Conclusion:The outcomes of this study show that the balance functions were improved of three groups and there is no significant difference between three groups in terms of post-treatment improvement quantity. According to the results there is no additional effect of applied treatments in addition to routine programmes on improvements.Consequently it is interpreted that after acute phase attending to appropriate rehabilitation programmes in case of continuing balance disorders will lead more successful results.Key words: Central vestibulopathy, acute phase, rehabilitation, recovery