Division of Neurology, Ospedale Civile, Voghera, Pavia, Italy.
Mov Disord. 2010 Mar 15;25(4):421-5. doi: 10.1002/mds.22952.
Psychogenic movement disorders (PMD) are a diagnostic fascinating challenge in both neurologic and psychiatric setting. Many factors influence response to treatment, but few treatment strategies are available. Physical activity proves to be effective in the treatment of depression, anxiety, and other psychiatric disorders, but the effects of regular walking exercise on patients with PMD have never been investigated in a single-blind study. Sixteen outpatients [13 women; mean age 33.0 years (range 22-51)] with primarily mild-to-moderate PMD completed a thrice-weekly, 12-weeks mild walking program. Assessments included DSM-IV interview, the Psychogenic Movement Disorder Rating Scale (PMDRS), Beck Anxiety Inventory (BAI), Hamilton Depression Scale (HDS), V02 Max, and body mass index (BMI). Changes in total score on the PMDRS were the primary endpoint. A comparison of all measures taken at study onset and after completing the exercise program indicates statistically significant improvements. We observed a relevant improvement in 10 of 16 patients (62%). The mean difference for the primary outcome (PMDRS total) corresponded to about 70%. Compliance was good, and there were no adverse effects. This study provides preliminary evidence for regular low-medium intensity exercise as a safe, adequate, and pleasing intervention for PMD. Furthermore, well-designed studies appear justified to confirm these findings.
心因性运动障碍（PMD）在神经和精神科均是一个极具诊断挑战性的问题。许多因素影响着治疗反应，但目前可用的治疗策略却很少。身体活动已被证明对治疗抑郁、焦虑和其他精神障碍有效，但在单盲研究中，从未调查过规律步行运动对 PMD 患者的影响。16 名门诊患者（13 名女性；平均年龄 33.0 岁（范围 22-51））主要患有轻度至中度 PMD，完成了每周 3 次、为期 12 周的轻度步行计划。评估包括 DSM-IV 访谈、心因性运动障碍评定量表（PMDRS）、贝克焦虑量表（BAI）、汉密尔顿抑郁量表（HDS）、最大摄氧量（V02 Max）和体重指数（BMI）。PMDRS 总分的变化是主要终点。与研究开始时和完成运动计划后所有测量值的比较表明，有统计学意义的改善。我们观察到 16 名患者中有 10 名（62%）有明显改善。主要结局（PMDRS 总分）的平均差异约为 70%。依从性良好，无不良反应。这项研究为规律的低-中强度运动作为 PMD 的一种安全、充分和令人满意的干预措施提供了初步证据。此外，有必要进行精心设计的研究来证实这些发现。
