Muñoz-Hellín Elena, Cano-de-la-Cuerda Roberto, Miangolarra-Page Juan Carlos
Departamento de Fisioterapia, Terapia Ocupacional, Medicina Física y Rehabilitación, Laboratorio de Análisis del Movimiento, Biomecánica, Ergonomía y Control Motor, Facultad de Ciencias de Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, España.
Rev Esp Geriatr Gerontol. 2013 Jul-Aug;48(4):190-7. doi: 10.1016/j.regg.2013.03.002. Epub 2013 Jun 2.
Sensory stimuli or sensory cues are being used as a therapeutic tool for improving gait disorders in Parkinson's disease patients, but most studies seem to focus on auditory stimuli. The aim of this study was to conduct a systematic review regarding the use of visual cues over gait disorders, dual tasks during gait, freezing and the incidence of falls in patients with Parkinson to obtain therapeutic implications. We conducted a systematic review in main databases such as Cochrane Database of Systematic Reviews, TripDataBase, PubMed, Ovid MEDLINE, Ovid EMBASE and Physiotherapy Evidence Database, during 2005 to 2012, according to the recommendations of the Consolidated Standards of Reporting Trials, evaluating the quality of the papers included with the Downs & Black Quality Index. 21 articles were finally included in this systematic review (with a total of 892 participants) with variable methodological quality, achieving an average of 17.27 points in the Downs and Black Quality Index (range: 11-21). Visual cues produce improvements over temporal-spatial parameters in gait, turning execution, reducing the appearance of freezing and falls in Parkinson's disease patients. Visual cues appear to benefit dual tasks during gait, reducing the interference of the second task. Further studies are needed to determine the preferred type of stimuli for each stage of the disease.
感觉刺激或感觉线索正被用作改善帕金森病患者步态障碍的一种治疗工具,但大多数研究似乎都集中在听觉刺激上。本研究的目的是针对帕金森病患者在步态障碍、步态中的双重任务、冻结现象和跌倒发生率方面视觉线索的应用进行系统综述,以获得治疗启示。根据《报告试验的统一标准》的建议,我们于2005年至2012年期间在主要数据库(如Cochrane系统评价数据库、Trip数据库、PubMed、Ovid MEDLINE、Ovid EMBASE和物理治疗证据数据库)中进行了系统综述,使用唐斯和布莱克质量指数评估纳入论文的质量。本系统综述最终纳入了21篇文章(共892名参与者),方法学质量各不相同,在唐斯和布莱克质量指数中平均得分为17.27分(范围:11 - 21分)。视觉线索可改善帕金森病患者步态的时空参数、转弯执行情况,减少冻结现象和跌倒的发生。视觉线索似乎有利于步态中的双重任务,减少第二项任务的干扰。需要进一步研究以确定疾病各阶段的首选刺激类型。