Mehrholz Jan, Friis Robert, Kugler Joachim, Twork Sabine, Storch Alexander, Pohl Marcus
Wissenschaftliches Institut, Private Europäische Medizinische Akademie der Klinik Bavaria in Kreischa GmbH, An der Wolfsschlucht 1-2, Kreischa, Germany, 01731.
Cochrane Database Syst Rev. 2010 Jan 20(1):CD007830. doi: 10.1002/14651858.CD007830.pub2.
Treadmill training is used in rehabilitation and is described as improving gait parameters of patients with Parkinson's disease.
To assess the effectiveness of treadmill training in improving the gait function of patients with Parkinson's disease and the acceptability and safety of this type of therapy.
We searched the Cochrane Movement Disorders Group Specialised Register (see Review Group details for more information) (last searched March 2009), Cochrane Central Register of Controlled Trials (The Cochrane Library 2009, Issue 2), MEDLINE (1950 to March 2009), and EMBASE (1980 to March 2009).We also handsearched relevant conference proceedings, searched trials and research registers, and checked reference lists (last searched March 2009). We contacted trialists, experts and researchers in the field and manufacturers of commercial devices.
We included randomised controlled trials comparing treadmill training with no treadmill training in patients with Parkinson's disease.
Two review authors independently selected trials for inclusion, assessed trial quality and extracted data. We contacted the trialists for additional information. We analysed the results as standardised mean differences (SMDs) and mean differences (MDs) for continuous variables and relative risk differences (RD) for dichotomous variables.
We included eight trials (203 participants) in this review. Treadmill training improved gait speed (SMD 0.50; 95% confidence interval (CI) 0.17 to 0.84; P = 0.003; I(2) = 0%) (fixed-effect model), stride length (SMD 0.42; 95% CI 0.00 to 0.84; P = 0.05; I(2) = 0%), walking distance (MD = 358 metres; 95% CI 289 to 426; P < 0.0001; I(2) = 30%), but cadence did not improve (MD 1.06; 95% CI -4.32 to 6.44; P = 0.70; I(2) = 0%) at the end of study. Treadmill training did not increase the risk of patients dropping out (RD -0.07; 95% CI -0.18 to 0.05; P = 0.26; I(2) = 51%) (random-effects model). Adverse events were not reported.
AUTHORS' CONCLUSIONS: Patients with Parkinson's disease who receive treadmill training are more likely to improve their impaired gait hypokinesia. However, the results must be interpreted with caution because there were variations between the trials in patient characteristics, the duration and amount of training, and types of treatment. Additionally, it is not known how long these improvements may last.
跑步机训练用于康复治疗，据称可改善帕金森病患者的步态参数。
评估跑步机训练对改善帕金森病患者步态功能的有效性以及此类治疗的可接受性和安全性。
我们检索了Cochrane运动障碍小组专业注册库（更多信息见综述小组详情）（最后检索时间为2009年3月）、Cochrane对照试验中心注册库（《Cochrane图书馆》2009年第2期）、MEDLINE（1950年至2009年3月）和EMBASE（1980年至2009年3月）。我们还手工检索了相关会议论文集，检索了试验和研究注册库，并检查了参考文献列表（最后检索时间为2009年3月）。我们联系了该领域的试验者、专家、研究人员以及商用设备制造商。
我们纳入了比较帕金森病患者跑步机训练与无跑步机训练的随机对照试验。
两位综述作者独立选择纳入试验，评估试验质量并提取数据。我们联系试验者获取更多信息。对于连续变量，我们将结果分析为标准化均数差（SMD）和均数差（MD），对于二分变量，分析为相对危险度差（RD）。
本综述纳入了八项试验（203名参与者）。跑步机训练改善了步速（SMD 0.50；95%置信区间（CI）0.17至0.84；P = 0.003；I² = 0%）（固定效应模型）、步长（SMD 0.42；95% CI 0.00至0.84；P = 0.05；I² = 0%）、行走距离（MD = 358米；95% CI 289至426；P < 0.0001；I² = 30%），但在研究结束时步频未改善（MD 1.06；95% CI -4.32至6.44；P = 0.70；I² = 0%）。跑步机训练未增加患者退出风险（RD -0.07；95% CI -0.18至0.05；P = 0.26；I² = 51%）（随机效应模型）。未报告不良事件。
接受跑步机训练的帕金森病患者更有可能改善其受损的步态运动徐缓。然而，由于试验在患者特征、训练持续时间和量以及治疗类型方面存在差异，结果必须谨慎解释。此外，尚不清楚这些改善可能持续多长时间。
