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Authors: Вязгина Е.М., Борисов А.В., Иванова
Institutions: Multidisciplinary rehabilitation center “Sputnik in Komarovo”. Saint-Petersburg, Russia.
Year: 2019
Publication: IV International Scientific and Practical Conference on Neurorehabilitation in Neurosurgery “Opportunities for cognitive rehabilitation in neurosurgical pathology of the brain and spinal cord”, 19-20 September 2019, CBD, Russia (N.E. Ivanova).

Congress with international participation XXI ” Davydenkovskie Readings” “Dynamics of cognitive impairment after brain injury”, September 26-27, 2019, St. Petersburg (N.E. Ivanova).

Abstract:
The problem of falling remains one of the most acute among older people. Regular exercise can reduce the risk of falling, including if the patient exercises at home. The use of the complex in the conditions of the clinic with the subsequent transition to independent exercise makes it possible to maintain the results of rehabilitation and continue it outpatiently. Application of biofeedback in patients with cognitive deficit allows improving cognitive functions. At present, the degree of cognitive impairment that limits the ability to perform this cognitive stimulation remains unexplored.

The purpose of the study:
Evaluate the effectiveness of the virtual stability platform with biofeedback (H.MotionLab) for patients with focal and cognitive impairment. Objectives of the study: to develop an algorithm for assessing balance and gait disturbances in elderly patients (using the H.MotionLab module of the Habilect system) and an algorithm of physical exercises to improve balance and gait (using the H.MotionLab module of the Habilect system).

Materials and methods:
A total of 10 patients with severe cognitive impairment due to mild to moderate dementia participated in the study. 4 patients with dementia of degenerative genesis, 4 patients with dementia of mixed (degenerative and vascular) genesis, 2 patients with dementia of vascular genesis. The average age is 77±6.3 years. MMSE <26 points, FAB < 11 points. High risk of falling from one or more tests (4,5,6): Test “stand up and walk” (TUG) >20 s, balance scale by Berg (BBS) < 43 points, dynamic gait index (DGI) < 19 points. Exclusion criteria: late stage of any type of dementia, noncorrecting vision disorders. In the course of comprehensive rehabilitation with the Habilect system, 10 patients were able to walk independently on flat surfaces and only needed help or support when climbing stairs and walking on uneven surfaces. 3 patients needed only visual or verbal control, 2 patients were able to move independently on any surface. Decrease in the angle of center of gravity deviation in the Romberg position (with open eyes) after a course of trans-lingual stimulation according to the virtual stability platform Habilect. Improvement of the stabilogram indicators was confirmed by reliable improvement of BBS and DGI indicators.

Results and discussions:
The use of the Habilect system in patients with coordinating disorders can improve gait and balance, including in the presence of severe cognitive impairment.