关键词: Exercise Therapy Parkinson disease Physical Therapy Modalities Postural balance Rehabilitation

来  源:   DOI:10.1016/j.apmr.2024.05.031

Abstract:
OBJECTIVE: To investigate the effects of balance exercise and brisk walking on nonmotor and motor symptoms, balance and gait functions, walking capacity, and balance confidence in Parkinson disease (PD) at posttraining and 6-month follow-up.
METHODS: Two-arm, assessor-blinded randomized controlled trial SETTING: University research laboratory and the community PARTICIPANTS: Ninety-nine eligible individuals with mild-to-moderate PD INTERVENTIONS: Participants were randomized to balance and brisk walking group (B&B, n=49) or active control group (n=50). B&B received ten 90-minute sessions of balance exercises and brisk walking supervised by physical therapists for 6 months (week 1-6: weekly, week 7-26: monthly), whereas control practiced whole-body flexibility and upper limb strength exercise at same dosage (180 min/wk). Both groups performed unsupervised home exercises 2-3 times/wk during intervention and continued at follow-up.
METHODS: Primary outcomes were Movement Disorder Society Unified Parkinson Disease Rating Scale nonmotor (MDS-UPDRS-I) and motor (MDS-UPRDS-III) scores. Secondary outcomes were mini-Balance Evaluation Systems Test (mini-BEST) score, comfortable gait speed (CGS), 6-minute walk test (6MWT), dual-task timed-Up-and-Go (DTUG) time, and Activities-Specific Balance Confidence Scale score.
RESULTS: Eighty-three individuals completed the 6-month intervention with no severe adverse effects. The mean between-group (95% CI) difference for the MDS-UPDRS nonmotor score was 1.50 (0.19-2.81) at 6 months and 1.09 (-0.66 to 2.85) at 12 months. The mean between-group (95% CI) difference for the MDS-UPDRS motor score was 3.75 (0.69-6.80) at 6 months and 4.57 (1.05-8.01) at 12 months. At 6 and 12 months, there were significant between-group improvements of the B&B group in mini-BEST score, CGS, 6MWT, and DTUG time.
CONCLUSIONS: This combined balance and brisk walking exercise program alleviates nonmotor and motor symptoms and improves walking capacity, balance, and gait functions posttraining, with positive carryover effects for all except nonmotor outcomes, at 6-month follow-up in mild-to-moderate PD.
摘要:
目的:研究平衡运动和快走对非运动和运动症状的影响,平衡和步态功能,步行能力,并在训练后和6个月随访时平衡对帕金森病(PD)的信心。
方法:双臂,评估者盲法随机对照试验地点:大学研究实验室和社区参与者:99名符合条件的轻度至中度PD干预者:参与者被随机分为平衡和快走组(B&B,n=49)或主动对照组(CON,n=50)。B&B在物理治疗师的监督下接受了10次90分钟的平衡练习和快走,为期6个月(第1-6周:每周,第7-26周:每月),而CON则以相同的剂量(180分钟/周)进行全身柔韧性和上肢力量锻炼。两组在干预期间每周进行2-3次无监督的家庭锻炼,并继续随访。
方法:主要结果是运动障碍协会帕金森病统一评分量表非运动(MDS-UPDRS-I)和运动(MDS-UPRDS-III)评分。次要结果是迷你平衡评估系统测试(Mini-BEST)评分,舒适的步态速度(CGS),六分钟步行距离(6MWD)双任务定时和执行(DTUG)时间,和特定活动平衡信心量表(ABC)得分。
结果:83名个体完成了为期6个月的干预,没有严重的不良反应。MDS-UPDRS非运动评分的平均组间差异(95%CI)在6个月时为1.50(0.19-2.81),在12个月时为1.09(-0.66-2.85)。MDS-UPDRS运动评分的平均组间差异(95%CI)在6个月时为3.75(0.69-6.80),在12个月时为4.57(1.05-8.01)。在6个月和12个月时,B&B组的Mini-BEST评分在组间有显著改善,CGS,6MWD和DTUG时光。
结论:这种结合平衡和快走运动的运动计划可以减轻非运动和运动症状,并提高步行能力,balance,训练后的步态功能,除了非运动结果之外,对所有人都有积极的结转效应,在轻度至中度PD的6个月随访中。
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