Abstract：
BACKGROUND: Persons with Parkinson\'s disease (PwPD) suffer from motor and non-motor symptoms which significantly affect their quality of life (QoL), and the QoL of their care partners (CP). Tandem cycling reduces PwPD motor symptoms; however, no studies have examined other benefits or included PwPD CP. We conducted an 8-week community virtual reality (VR) tandem cycling intervention to assess the feasibility and efficacy for PwPD and their CP (i.e., PD dyads). We hypothesized that dyadic tandem cycling would improve (1) PwPD motor and non-motor symptoms and (2) dimensions of PD dyads\' QoL and physiologic health.
METHODS: Ten PD dyads were recruited to complete 8 weeks of progressive intensity, bi-weekly tandem cycling. At pre- and post-testing, PwPD were assessed using the Movement Disorder Society-Unified Parkinson\'s Disease Rating Scale-III (MDS-UPDRS-III), functional gait assessment (FGA), and 10-m gait speed test. PD dyads also completed emotional and cognitive status questionnaires [e.g., Geriatric Depression Scale-Short Form (GDS-SF)], and wore BodyGuard 2 heart rate (HR) monitors for 48 h to assess surrogate measures of heart rate variability. Statistical analyses were conducted using Student\'s t tests with significance set at p ≤ 0.05.
RESULTS: Eight PD dyads and one PwPD completed the intervention. Retention of PwPD (90%) and CP (80%) was adequate, and PD dyad adherence ranged from 91.67 to 97.91%. PwPD demonstrated significant clinical improvements in MDS-UPDRS-III scores (- 7.38, p < 0.01), FGA scores (+ 3.50, p < 0.01), and 10-m gait speed times (+ 0.27 m/s, p < 0.01), in addition to significant self-reported improvements in mobility (- 13.61, p = 0.02), fatigue (- 5.99, p = 0.02), and social participation (+ 4.69, p < 0.01). CP depressive symptoms significantly decreased (- 0.88, p = 0.02), and PD dyads shared a significant increase in root mean square of the successive differences (RMSSD; p = 0.04).
CONCLUSIONS: Our pilot study demonstrated feasibility and multiple areas of efficacy supporting further investigation of community VR tandem cycling as a therapeutic intervention for PD dyads.
METHODS: Ten PD dyads were recruited to complete 8 weeks of progressive intensity, bi-weekly tandem cycling. At pre- and post-testing, PwPD were assessed using the Movement Disorder Society-Unified Parkinson\'s Disease Rating Scale-III (MDS-UPDRS-III), functional gait assessment (FGA), and 10-m gait speed test. PD dyads also completed emotional and cognitive status questionnaires [e.g., Geriatric Depression Scale-Short Form (GDS-SF)], and wore BodyGuard 2 heart rate (HR) monitors for 48 h to assess surrogate measures of heart rate variability. Statistical analyses were conducted using Student\'s t tests with significance set at p ≤ 0.05.
RESULTS: Eight PD dyads and one PwPD completed the intervention. Retention of PwPD (90%) and CP (80%) was adequate, and PD dyad adherence ranged from 91.67 to 97.91%. PwPD demonstrated significant clinical improvements in MDS-UPDRS-III scores (- 7.38, p < 0.01), FGA scores (+ 3.50, p < 0.01), and 10-m gait speed times (+ 0.27 m/s, p < 0.01), in addition to significant self-reported improvements in mobility (- 13.61, p = 0.02), fatigue (- 5.99, p = 0.02), and social participation (+ 4.69, p < 0.01). CP depressive symptoms significantly decreased (- 0.88, p = 0.02), and PD dyads shared a significant increase in root mean square of the successive differences (RMSSD; p = 0.04).
CONCLUSIONS: Our pilot study demonstrated feasibility and multiple areas of efficacy supporting further investigation of community VR tandem cycling as a therapeutic intervention for PD dyads.
摘要：
背景：患有帕金森病（PwPD）的人患有运动和非运动症状，这些症状显着影响其生活质量（QoL），和他们的护理伙伴的QoL(CP)。串联循环可减少PwPD运动症状；然而，没有研究检查其他获益或包括PwPDCP.我们进行了为期8周的社区虚拟现实（VR）串联自行车干预，以评估PwPD及其CP的可行性和有效性（即，PD二元）。我们假设二进串联循环可以改善（1）PwPD运动和非运动症状，以及（2）PD二联QoL和生理健康的维度。
方法：招募10个PDdyads以完成8周的进行性强度，每两周一次的串联自行车运动。在测试前和测试后，PwPD使用运动障碍协会-统一帕金森病评定量表-III（MDS-UPDRS-III）进行评估，功能步态评估（FGA），和10米的步态速度测试。PDdyads还完成了情感和认知状态问卷[例如，老年抑郁量表-简表（GDS-SF）]，并佩戴BodyGuard2心率（HR）监测器48小时，以评估心率变异性的替代措施。使用Studentt检验进行统计学分析,显著性设定为p≤0.05。
结果：8个PDdyads和1个PwPD完成了干预。PwPD（90％）和CP（80％）的保留是足够的，PD二元组的依从性为91.67％至97.91％。PwPD在MDS-UPDRS-III评分方面表现出显着的临床改善（-7.38，p<0.01），FGA评分（+3.50，p<0.01），和10米步态速度时间(+0.27米/秒，p<0.01),除了自我报告的流动性显着改善（-13.61，p=0.02），疲劳（-5.99，p=0.02），和社会参与(+4.69，p<0.01)。CP抑郁症状显著降低（-0.88，p=0.02），PD二元组的连续差异均方根显着增加（RMSSD；p=0.04）。
结论：我们的初步研究证明了社区VR串联循环作为PDdyads治疗干预的可行性和多个功效领域的进一步研究。
方法：招募10个PDdyads以完成8周的进行性强度，每两周一次的串联自行车运动。在测试前和测试后，PwPD使用运动障碍协会-统一帕金森病评定量表-III（MDS-UPDRS-III）进行评估，功能步态评估（FGA），和10米的步态速度测试。PDdyads还完成了情感和认知状态问卷[例如，老年抑郁量表-简表（GDS-SF）]，并佩戴BodyGuard2心率（HR）监测器48小时，以评估心率变异性的替代措施。使用Studentt检验进行统计学分析,显著性设定为p≤0.05。
结果：8个PDdyads和1个PwPD完成了干预。PwPD（90％）和CP（80％）的保留是足够的，PD二元组的依从性为91.67％至97.91％。PwPD在MDS-UPDRS-III评分方面表现出显着的临床改善（-7.38，p<0.01），FGA评分（+3.50，p<0.01），和10米步态速度时间(+0.27米/秒，p<0.01),除了自我报告的流动性显着改善（-13.61，p=0.02），疲劳（-5.99，p=0.02），和社会参与(+4.69，p<0.01)。CP抑郁症状显著降低（-0.88，p=0.02），PD二元组的连续差异均方根显着增加（RMSSD；p=0.04）。
结论：我们的初步研究证明了社区VR串联循环作为PDdyads治疗干预的可行性和多个功效领域的进一步研究。
