Department of Neurology and Psychiatry, General Hospital of the City of Linz, Linz, Austria.
J Neural Transm (Vienna). 2011 May;118(5):773-81. doi: 10.1007/s00702-011-0622-9. Epub 2011 Apr 3.
Former studies on the effects of physical exercise, physical and occupational therapy (PT, OT) and speech and swallowing therapy (ST, SwT) in Parkinson's disease (PD) have demonstrated little or uncertain effects. New pathophysiological concepts have been developed. Recent controlled high-level studies demonstrate improvement of mobility and balance after training of muscular strength and endurance, trunk control, and amplitude and rhythmicity of movements (treadmill). Attentional and cognitive strategies were found to enforce body awareness and improve movement sequences. Dance, sensory (auditory, visual, tactile) and cognitive cueing are effective for problems of gait and balance. Whether PT and OT reduce the risk of falls remains uncertain. ST including Lee Silverman Voice Treatment has been shown to relieve speech problems. SwT and OT are frequently applied, however, further studies are necessary. Therapeutic interventions need to be evaluated with regard to consistency, intensity, frequency, duration, side effects, home versus institution based and standardized versus individualized training, quality standards, practicability in real life, and cost-effectiveness. Parkinson patients should resume or continue physical exercise as long as possible. There is hope that regular sport may modify PD risk and progression.
以往关于体育锻炼、物理治疗（PT、OT）和言语及吞咽治疗（ST、SwT）对帕金森病（PD）影响的研究显示效果甚微或不确定。新的病理生理学概念已经发展起来。最近的对照高级别研究表明，在进行肌肉力量和耐力、躯干控制以及运动幅度和节奏（跑步机）训练后，移动性和平衡能力得到改善。注意力和认知策略被发现可以增强身体意识并改善运动序列。舞蹈、感觉（听觉、视觉、触觉）和认知提示对于步态和平衡问题很有效。PT 和 OT 是否能降低跌倒风险仍不确定。ST 包括 Lee Silverman 语音治疗已被证明可以缓解言语问题。SwT 和 OT 经常应用，但仍需要进一步研究。治疗干预措施需要根据一致性、强度、频率、持续时间、副作用、家庭与机构、标准化与个体化训练、质量标准、实际生活中的实用性以及成本效益进行评估。帕金森病患者应尽可能恢复或继续进行体育锻炼。人们希望有规律的运动可能会改变 PD 的风险和进展。
