Impairments in Postural Control and Re-test Reliability of Dynamic Posturographic Measures after Lung Transplantation

Objective To classify impairments in postural control using computerized posturography in lung transplant recipients (LuTXr) undergoing subacute rehabilitation, and to examine the re-test reliability of these measures. Methods In a prospective repeated-measures study, 50 LuTXr underwent clinical and quantitative posturographic testing (SMART EquiTest), which included the Sensory Organisation Test (SOT), Motor Control Test (MCT) and Limits of Stability Test (LOS). Testing was repeated after 1-to-2 days and upon completion of rehabilitation, two months later. Main outcome measures were: SOT-composite score, MCT-latency and amplitude scaling, LOS-movement velocity (LOS-MV) and end-point-excursion (LOS-EPE)/maximum-excursion (LOS-MXE). Results At the beginning of rehabilitation, the mean SOT-CS and LOS, but not the MCT scores were below normative reference values, and did not return to normal after rehabilitation. Intra-class correlation coefficients (ICC2,1) yielded excellent relative reliability for all posturographic tests. The smallest detectable differences observed for the SOT and LOS exceeded the mean changes observed upon completion of rehabilitation. Conclusion Impairments in sensory and anticipatory postural control was insufficiently restored after subacute LuTX rehabilitation. The little sensitivity of the SOT-CS or LOS scores to detect a minimal change in performance due to rehabilitation limits the clinical applicability of these tests as objective outcome measures in LuTX rehabilitation. Part of this work was supported by the Slovak Research and Development Agency under the contract No. SK-AT-2015-0031. Corresponding author: Gerold Ebenbichler, MD, Department of Physical Medicine, Rehabilitation & Occupational Medicine, Vienna Medical University, General Hospital of Vienna, Wahringer Gurtel 18-20, 1090 Vienna, Austria, Gerold.ebenbichler@meduniwien.ac.at, +43 1 40400 23080 Financial disclosure statement: No party having a direct interest in the results of this research has or will confer a benefit on us or on any organization with which we are associated. Acknowledgement: This study was the master thesis of Stephan Doblhammer, MD and Melanie Pachner, MD who both published major findings of this research as master theses. We would like to thank Grace Achim, MD and Jennifer Gibley, MD for their generous help with data collection, Oliver Braumann for his help with data processing, and Haley Milko for editing the manuscript. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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