{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:59:46Z","timestamp":1787029186392,"version":"build-2736575974"},"reference-count":37,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2020,12,18]],"date-time":"2020-12-18T00:00:00Z","timestamp":1608249600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004281","name":"Narodowe Centrum Nauki","doi-asserted-by":"publisher","award":["NCN UMO-2012\/05\/B\/NZ7\/02493"],"award-info":[{"award-number":["NCN UMO-2012\/05\/B\/NZ7\/02493"]}],"id":[{"id":"10.13039\/501100004281","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Study Design: A double-blinded, randomized controlled trial. Background: Surgery is effective in reducing pain intensity in patients with cervical disc disease. However, functional measurements demonstrated that the results have been not satisfactory enough. Thus, rehabilitation programs combined with the supplementation of vitamin D could play an essential role. Methods. The study recruited 30 patients, aged 20 to 70 years, selected for anterior cervical interbody fusion (ACIF). The patients were randomly divided into the placebo (Pl) and vitamin D (3200 IU D3\/day) supplemented groups. The functional tests limits of stability (LOS), risk of falls (RFT), postural stability (PST), Romberg test, and foot pressure distribution were performed before supplementation (BS\u2014week 0), five weeks after supplementation (AS\u2014week 5), four weeks after surgery (BSVR\u2014week 9), and 10 weeks after supervising rehabilitation (ASVR\u2014week 19). Results. The concentration of 25(OH)D3 in the serum, after five weeks of supplementation, was significantly increased, while the Pl group maintained the same. The RFT was significantly reduced after five weeks of vitamin D supplementation. Moreover, a further significant decrease was observed following rehabilitation. In the Pl group, no changes in the RFT were observed. The overall postural stability index (OSI), LOS, and the outcomes of the Romberg test significantly improved in both groups; however, the effects on the OSI were more pronounced in the D3 group at the end of the rehabilitation program. Conclusions. Our data suggest that vitamin D supplementation positively affected the rehabilitation program in patients implemented four weeks after ACIF by reducing the risk of falls and improving postural stability.<\/jats:p>","DOI":"10.3390\/nu12123874","type":"journal-article","created":{"date-parts":[[2020,12,18]],"date-time":"2020-12-18T11:42:09Z","timestamp":1608291729000},"page":"3874","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Vitamin D Supplementation Improves the Effects of the Rehabilitation Program on Balance and Pressure Distribution in Patients after Anterior Cervical Interbody Fusion-Randomized Control Trial"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7133-5970","authenticated-orcid":false,"given":"Wojciech","family":"Skrobot","sequence":"first","affiliation":[{"name":"Department of Functional Diagnostics and Kinesiology, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7698-5166","authenticated-orcid":false,"given":"Ewelina","family":"Perzanowska","sequence":"additional","affiliation":[{"name":"Department of Functional Diagnostics and Kinesiology, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Krasowska","sequence":"additional","affiliation":[{"name":"Department of Functional Diagnostics and Kinesiology, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6176-4536","authenticated-orcid":false,"given":"Damian J.","family":"Flis","sequence":"additional","affiliation":[{"name":"Department of Physiology and Biochemistry, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5414-7479","authenticated-orcid":false,"given":"Katarzyna P.","family":"Dzik","sequence":"additional","affiliation":[{"name":"Department of Physiology and Biochemistry, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wojciech","family":"Kloc","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Copernicus Hospital, 80-803 Gdansk, Poland"},{"name":"Department of Neurology and Neurosurgery, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6370-2160","authenticated-orcid":false,"given":"Jan Jacek","family":"Kaczor","sequence":"additional","affiliation":[{"name":"Department of Physiology and Biochemistry, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7871-6469","authenticated-orcid":false,"given":"J\u0119drzej","family":"Antosiewicz","sequence":"additional","affiliation":[{"name":"Department of Bioenergetics and Physiology of Exercise, Medical University of Gdansk, 80-211 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,12,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1016\/j.ncl.2007.01.006","article-title":"Neck and back pain: Musculoskeletal disorders","volume":"25","author":"Meleger","year":"2007","journal-title":"Neurol. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Peolsson, A., Oberg, B., Wibault, J., Dedering, A., Zsigmond, P., Bernfort, L., Kammerlind, A.S., Persson, L.C.G., and Lofgren, H. (2014). Outcome of physiotherapy after surgery for cervical disc disease: A prospective randomised multi-centre trial. BMC Musculoskel. Dis., 15.","DOI":"10.1186\/1471-2474-15-34"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1097\/BRS.0b013e31826d2cbb","article-title":"Physical Function Outcome in Cervical Radiculopathy Patients After Physiotherapy Alone Compared with Anterior Surgery Followed by Physiotherapy A Prospective Randomized Study With a 2-Year Follow-up","volume":"38","author":"Peolsson","year":"2013","journal-title":"Spine"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1097\/BRS.0000000000003239","article-title":"Early Self-directed Home Exercise Program after Anterior Cervical Discectomy and Fusion A Pilot Study","volume":"45","author":"Coronado","year":"2020","journal-title":"Spine"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"589587","DOI":"10.1155\/2014\/589587","article-title":"Vitamin d status in central europe","volume":"2014","author":"Pludowski","year":"2014","journal-title":"Int. J. Endocrinol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2685","DOI":"10.1210\/me.2005-0106","article-title":"Large-scale in silico and microarray-based identification of direct 1,25-dihydroxyvitamin D3 target genes","volume":"19","author":"Wang","year":"2005","journal-title":"Mol. Endocrinol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1023\/A:1017535728844","article-title":"In situ detection of 1,25-dihydroxyvitamin D-3 receptor in human skeletal muscle tissue","volume":"33","author":"Bischoff","year":"2001","journal-title":"Histochem. J."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Mieszkowski, J., Niespodzinski, B., Kochanowicz, A., Gmiat, A., Prusik, K., Prusik, K., Kortas, J., Ziemann, E., and Antosiewicz, J. (2018). The Effect of Nordic Walking Training Combined with Vitamin D Supplementation on Postural Control and Muscle Strength in Elderly PeopleA Randomized Controlled Trial. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15091951"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1186\/s13075-016-1099-6","article-title":"Vitamin D attenuates inflammation, fatty infiltration, and cartilage loss in the knee of hyperlipidemic microswine","volume":"18","author":"Rai","year":"2016","journal-title":"Arthritis Res. Ther."},{"key":"ref_10","first-page":"530","article-title":"Vitamin D status in Poland","volume":"126","author":"Pludowski","year":"2016","journal-title":"Polskie Archiwum Medycyny Wewn\u0229trznej"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1055\/s-0033-1354252","article-title":"Hypovitaminosis D and Cervical Disk Herniation among Adults Undergoing Spine Surgery","volume":"3","author":"Stoker","year":"2013","journal-title":"Glob. Spine J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1007\/s00402-015-2376-6","article-title":"Perioperative vitamin D levels correlate with clinical outcomes after ankle fracture fixation","volume":"136","author":"Warner","year":"2016","journal-title":"Arch. Orthop. Trauma Surg."},{"key":"ref_13","first-page":"323","article-title":"Examination of Balance Measures Produced by the Biodex Stability System","volume":"33","author":"Arnold","year":"1998","journal-title":"J. Athl. Train."},{"key":"ref_14","first-page":"1655","article-title":"Training on Biodex balance system improves balance and mobility in the elderly","volume":"68","author":"Siddiqi","year":"2018","journal-title":"J. Pak. Med. Assoc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1016\/j.gaitpost.2015.01.002","article-title":"Gait and balance in adults with Friedreich\u2019s ataxia","volume":"41","author":"Stephenson","year":"2015","journal-title":"Gait Posture"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/S0196-0709(82)80002-1","article-title":"Normal subject postural sway during the Romberg test","volume":"3","author":"Black","year":"1982","journal-title":"Am. J. Otolaryngol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.gaitpost.2014.12.007","article-title":"Romberg ratio in quiet stance posturography--Test to retest reliability","volume":"42","author":"Tjernstrom","year":"2015","journal-title":"Gait Posture"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/j.gaitpost.2012.07.009","article-title":"Clinical stabilometry standardization: Basic definitions--acquisition interval--sampling frequency","volume":"37","author":"Scoppa","year":"2013","journal-title":"Gait Posture"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.gaitpost.2017.03.016","article-title":"The Romberg ratio in people with multiple sclerosis","volume":"54","author":"Kalron","year":"2017","journal-title":"Gait Posture"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.jns.2013.09.029","article-title":"Postural control, falls and fear of falling in people with multiple sclerosis without mobility aids","volume":"335","author":"Kalron","year":"2013","journal-title":"J. Neurol. Sci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1007\/s00264-014-2519-3","article-title":"Vitamin D insufficiency in the elderly orthopaedic patient: An epidemic phenomenon","volume":"39","author":"Maier","year":"2015","journal-title":"Int. Orthop."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1302\/0301-620X.97B1.34558","article-title":"The prevalence of vitamin D deficiency in patients with vertebral fragility fractures","volume":"97","author":"Maier","year":"2015","journal-title":"Bone Joint J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1016\/j.jamda.2018.10.013","article-title":"Effect of 800 IU Versus 2000 IU Vitamin D3 With or Without a Simple Home Exercise Program on Functional Recovery After Hip Fracture: A Randomized Controlled Trial","volume":"20","author":"Stemmle","year":"2019","journal-title":"J. Am. Med. Dir. Assoc."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Skrobot, W., Liedtke, E., Krasowska, K., Dzik, K.P., Flis, D.J., Samoraj-Dereszkiewicz, A., Libionka, W., Kortas, J., Kloc, W., and Antosiewicz, J. (2019). Early Rehabilitation Program and Vitamin D Supplementation Improves Sensitivity of Balance and the Postural Control in Patients after Posterior Lumbar Interbody Fusion: A Randomized Trial. Nutrients, 11.","DOI":"10.3390\/nu11092202"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Krasowska, K., Skrobot, W., Liedtke, E., Sawicki, P., Flis, D.J., Dzik, K.P., Libionka, W., Kloc, W., and Kaczor, J.J. (2019). The Preoperative Supplementation With Vitamin D Attenuated Pain Intensity and Reduced the Level of Pro-inflammatory Markers in Patients After Posterior Lumbar Interbody Fusion. Front. Pharmacol., 10.","DOI":"10.3389\/fphar.2019.00527"},{"key":"ref_26","first-page":"518","article-title":"Effect of vitamin D on muscle strength and relevance in regard to osteoporosis prevention","volume":"62","author":"Conzelmann","year":"2003","journal-title":"Z. Rheumatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1359\/jbmr.2002.17.5.891","article-title":"Neuromuscular and psychomotor function in elderly subjects who fall and the relationship with vitamin D status","volume":"17","author":"Dhesi","year":"2002","journal-title":"J. Bone Miner. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"M438","DOI":"10.1093\/gerona\/56.7.M438","article-title":"Trunk sway measures of postural stability during clinical balance tests: Effects of age","volume":"56","author":"Gill","year":"2001","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.exger.2018.02.006","article-title":"Improvement of cognitive functions in response to a regular Nordic walking training in elderly women\u2014A change dependent on the training experience","volume":"104","author":"Gmiat","year":"2018","journal-title":"Exp. Gerontol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/j.math.2007.06.003","article-title":"Sensorimotor disturbances in neck disorders affecting postural stability, head and eye movement control","volume":"13","author":"Treleaven","year":"2008","journal-title":"Man. Ther."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.jsbmb.2009.01.020","article-title":"Vestibular dysfunction in vitamin D receptor mutant mice","volume":"114","author":"Minasyan","year":"2009","journal-title":"J. Steroid Biochem. Mol. Biol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.3390\/nu5041253","article-title":"Higher serum 25-hydroxyvitamin D concentrations associate with a faster recovery of skeletal muscle strength after muscular injury","volume":"5","author":"Barker","year":"2013","journal-title":"Nutrients"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.cyto.2013.03.018","article-title":"Vitamin D3 supplementation modulates inflammatory responses from the muscle damage induced by high-intensity exercise in SD rats","volume":"63","author":"Choi","year":"2013","journal-title":"Cytokine"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/s00586-006-0067-2","article-title":"Long-term randomised comparison between a carbon fibre cage and the Cloward procedure in the cervical spine","volume":"16","author":"Peolsson","year":"2007","journal-title":"Eur. Spine J."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Hassan-Smith, Z.K., Jenkinson, C., Smith, D.J., Hernandez, I., Morgan, S.A., Crabtree, N.J., Gittoes, N.J., Keevil, B.G., Stewart, P.M., and Hewison, M. (2017). 25-hydroxyvitamin D3 and 1,25-dihydroxyvitamin D3 exert distinct effects on human skeletal muscle function and gene expression. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0170665"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"3227","DOI":"10.1210\/en.2014-1016","article-title":"The vitamin D receptor (VDR) is expressed in skeletal muscle of male mice and modulates 25-hydroxyvitamin D (25OHD) uptake in myofibers","volume":"155","author":"Girgis","year":"2014","journal-title":"Endocrinology"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Mieszkowski, J., Stankiewicz, B., Kochanowicz, A., Niespodzi\u0144ski, B., Kowalik, T., \u017bmijewski, M., Kowalski, K., Rola, R., Bie\u0144kowski, T., and Antosiewicz, J. (2020). Ultra-Marathon-Induced Increase in Serum Levels of Vitamin D Metabolites: A Double-Blind Randomized Controlled Trial. Nutrients, 12.","DOI":"10.3390\/nu12123629"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/12\/12\/3874\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:46:48Z","timestamp":1760179608000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/12\/12\/3874"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,18]]},"references-count":37,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2020,12]]}},"alternative-id":["nu12123874"],"URL":"https:\/\/doi.org\/10.3390\/nu12123874","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,18]]}}}