Multimodal Stimulation in Impaired Gait and Balance Correction in Post-Stroke Patients

Aim: To assess the effect of multimodal virtual reality stimulation on gait and balance restoration in patients in acute and early recovery ischemic stroke.

Design: Comparative randomised clinical study.

Materials and methods. This study enrolled 67 patients with primary ischemic stroke which occurred during past 6 months, complicated with hemiparesis or lower limb monoparesis. Patients included 47 men and 20 women aged 44 to 75 years old. Patients were divided into two groups: in the study group (n = 36), the primary rehabilitation was supplemented with multimodal stimulation exercises on a training virtual reality set; controls (n = 31) had only primary therapy.

Rehabilitation efficiency was assessed using the Montreal Cognitive Assessment, Hospital Anxiety and Depression Scale, National Institutes of Health Stroke Scale (NIHSS), Medical Research Council Scale (MRCS), Tinetti Test, Rivermead Mobility Index.

Results. In the study group, a course of rehabilitation resulted in marked improvement in motor functions and functional independence. NIHSS symptoms intensity decreased from 5.5 [4.0; 7.0] to 4.0 [3.0; 5.0] points in the study group and from 6.0 [5.0; 7.0] to 5.0 [4.5; 6.0] points in the control group (p = 0.019). Rivermead Mobility Index increased from 7.0 [6.0; 10.0] to 10.0 [8.0; 12.0] points in the study group and from 7.0 [5.0; 7.5] to 8.0 [6.5; 10.5] points in the control group (p = 0.049). When multimodal stimulation was added, also a more prominent increase in the MRCS muscle strength of the lower limb was observed: an increase was 0.7 [0.3; 0.9] points in the study group and 0.4 [0.2; 0.7] points in controls (p = 0.046).

Conclusion. Multimodal stimulation is an efficient adjuvant approach to rehabilitation of patients shortly after an ischemic stroke.

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