A randomized, double-blind study to assess if vitamin D treatment affects the outcomes of rehabilitation and balance in hemiplegic patients.
Aylin Sari, Bekir Durmus, Cigdem Arifoglu Karaman and 2 others
PMID 29950783WHAT IT FOUND
In hemiplegic stroke patients with low vitamin D, a vitamin D injection added to 3 months of rehabilitation showed better balance and daily-life scores than saline.
Walking and motor recovery were not clearly improved.
Key findings
01At the 3rd month, among patients who also received rehabilitation, the vitamin D injection group had higher Berg Balance Scale scores than the saline injection group (38.72 vs 24.75; p=0.000).
02At the 3rd month, among patients who also received rehabilitation, the vitamin D injection group had higher Modified Barthel Index scores than the saline injection group (59.18 vs 41.87; p=0.002).
03Among patients who also received rehabilitation, walking and motor recovery were unclear: the results text says Functional Ambulation Scale and Brunnstrom Recovery Staging did not significantly differ, while Table 2 gives 3rd-month Functional Ambulation Scale p=0.018 and BRS lower extremity p=0.028.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The analysis included only 32 patients in each group in Table 1, and the authors say the small number limits generalization. Follow-up was only 3 months, so longer-term rehabilitation effects are not shown. The paper does not name a single primary outcome, and the results text and Table 2 disagree about Functional Ambulation Scale and Brunnstrom Recovery Staging. All patients received rehabilitation, so the effect of the vitamin D injection alone cannot be separated. Only patients with low vitamin D levels were studied, so the results may not apply to patients with normal vitamin D levels. The study tested only one intramuscular 300,000 IU vitamin D injection, so it does not show what other vitamin D treatments would do.
Declared interests
The authors declared no conflict of interest. The supplied text does not state a funding source.
The easy way to misread this
Do not conclude that vitamin D injection alone improves rehabilitation. Both groups received 3 months of rehabilitation, and the paper reports inconsistent results for walking and motor recovery.