Department of Physical Medicine & Rehabilitation, S, Raffaele Arcangelo Fatebenefratelli Hospital, Cannaregio, Venice, 3458, Italy.
BMC Geriatr. 2013 Jun 4;13:54. doi: 10.1186/1471-2318-13-54.
People with idiopathic Parkinson's disease (PD) frequently have low activity levels, poor mobility and reduced quality of life. Although increased physical activity may improve mobility, balance and wellbeing, adherence to exercises and activity programs over the longer term can be challenging, particularly for older people with progressive neurological conditions such as PD. Physical activities that are engaging and enjoyable, such as dancing, might enhance adherence over the long term. The objective of this study was to evaluate the feasibility of a randomized controlled trial of Irish set dancing compared with routine physiotherapy for people with mild to moderately severe PD.
Twenty-four people with idiopathic PD referred for movement rehabilitation were randomized to receive standard physiotherapy exercises or Irish set dancing classes once per week plus a weekly home program for 6 months (12 in each group). The feasibility and safety of the proposed RCT protocol was the main focus of this evaluation. The primary outcome was motor disability measured by the motor component of the UPDRS, which was assessed prior to and after therapy by trained assessors blinded to group assignment. The Timed Up and Go, the Berg Balance Scale and the modified Freezing of Gait Questionnaire were secondary measures. Quality of life of the people with PD was evaluated using the PDQ-39.
Both the Irish set dancing and physiotherapy exercise program were shown to be feasible and safe. There were no differences between groups in the rate of adverse events such as falls, serious injuries, death or rates of admission to hospital. The physiotherapists who provided usual care remained blind to group allocation, with no change in their standard clinical practice. Compliance and adherence to both the exercise and dance programs were very high and attrition rates were low over the 6 months of therapy. Although improvements were made in both groups, the dance group showed superior results to standard physiotherapy in relation to freezing of gait, balance and motor disability.
Irish dancing and physiotherapy were both safe and feasible in this sample from Venice, with good adherence over a comparatively long time period of 6 months. A larger multi-centre trial is now warranted to establish whether Irish set dancing is more effective than routine physiotherapy for enhancing mobility, balance and quality of life in people living with idiopathic PD.
EudraCT number 2012-005769-11.
特发性帕金森病(PD)患者通常活动水平较低、移动能力差且生活质量下降。虽然增加身体活动可能会改善移动性、平衡和整体健康状况,但对于患有进展性神经疾病(如 PD)的老年人来说,长期坚持锻炼和活动计划可能具有挑战性。有趣且令人愉悦的身体活动,如跳舞,可能会在长期内提高依从性。本研究的目的是评估与常规物理治疗相比,爱尔兰集舞(Irish set dancing)对轻度至中度 PD 患者的随机对照试验的可行性。
24 名特发性 PD 患者被转诊接受运动康复治疗,随机分为接受标准物理治疗运动或每周一次爱尔兰集舞课程加每周家庭计划(每组 12 人),为期 6 个月。本评估的主要重点是拟议 RCT 方案的可行性和安全性。主要结局是通过训练有素的评估者在治疗前后对 UPDRS 的运动成分进行评估,以评估运动障碍,评估者对分组情况不知情。计时起立行走测试(Timed Up and Go)、伯格平衡量表(Berg Balance Scale)和改良冻结步态问卷(modified Freezing of Gait Questionnaire)是次要测量指标。PD 患者的生活质量使用 PDQ-39 进行评估。
爱尔兰集舞和物理治疗运动方案均被证明是可行且安全的。两组之间在跌倒、严重受伤、死亡或住院率等不良事件的发生率方面没有差异。提供常规护理的物理治疗师仍然对分组情况不知情,他们的标准临床实践没有改变。在 6 个月的治疗过程中,对运动和舞蹈计划的依从性和坚持率都非常高,且脱落率很低。虽然两组都有所改善,但与标准物理治疗相比,舞蹈组在冻结步态、平衡和运动障碍方面的效果更好。
在威尼斯的这个样本中,爱尔兰舞和物理治疗都是安全且可行的,在相对较长的 6 个月时间内,坚持率较高。现在需要进行更大的多中心试验,以确定爱尔兰集舞是否比常规物理治疗更能提高特发性 PD 患者的移动性、平衡和生活质量。
EudraCT 编号 2012-005769-11。