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帕金森病的有氧运动:随机对照试验的系统评价和荟萃分析

Aerobic exercise for Parkinson's disease: a systematic review and meta-analysis of randomized controlled trials.

作者信息

Shu Hai-Feng, Yang Tao, Yu Si-Xun, Huang Hai-Dong, Jiang Ling-Li, Gu Jian-Wen, Kuang Yong-Qin

机构信息

Department of Neurosurgery, General Hospital of the People's Liberation Army Chengdu Military Region, Chengdu, Sichuan, China.

出版信息

PLoS One. 2014 Jul 1;9(7):e100503. doi: 10.1371/journal.pone.0100503. eCollection 2014.

Abstract

BACKGROUND

Although some trials assessed the effectiveness of aerobic exercise for Parkinson's disease (PD), the role of aerobic exercise in the management of PD remained controversial.

OBJECTIVE

The purpose of this systematic review is to evaluate the evidence about whether aerobic exercise is effective for PD.

METHODS

Seven electronic databases, up to December 2013, were searched to identify relevant studies. Two reviewers independently extracted data and assessed methodological quality based on PEDro scale. Standardised mean difference (SMD) and 95% confidence intervals (CI) of random-effects model were calculated. And heterogeneity was assessed based on the I2 statistic.

RESULTS

18 randomized controlled trials (RCTs) with 901 patients were eligible. The aggregated results suggested that aerobic exercise should show superior effects in improving motor actions (SMD, -0.57; 95% CI -0.94 to -0.19; p = 0.003), balance (SMD, 2.02; 95% CI 0.45 to 3.59; p = 0.01), and gait (SMD, 0.33; 95% CI 0.17 to 0.49; p<0.0001) in patients with PD, but not in quality of life (SMD, 0.11; 95% CI -0.23 to 0.46; p = 0.52). And there was no valid evidence on follow-up effects of aerobic exercise for PD.

CONCLUSION

Aerobic exercise showed immediate beneficial effects in improving motor action, balance, and gait in patients with PD. However, given no evidence on follow-up effects, large-scale RCTs with long follow-up are warrant to confirm the current findings.

摘要

背景

尽管一些试验评估了有氧运动对帕金森病(PD)的有效性,但有氧运动在PD管理中的作用仍存在争议。

目的

本系统评价的目的是评估关于有氧运动对PD是否有效的证据。

方法

检索了截至2013年12月的七个电子数据库以识别相关研究。两名评价者独立提取数据并根据PEDro量表评估方法学质量。计算随机效应模型的标准化均数差(SMD)和95%置信区间(CI)。并基于I²统计量评估异质性。

结果

18项随机对照试验(RCT)共901例患者符合纳入标准。汇总结果表明,有氧运动在改善PD患者的运动功能(SMD,-0.57;95%CI -0.94至-0.19;p = 0.003)、平衡能力(SMD,2.02;95%CI 0.45至3.59;p = 0.01)和步态(SMD,0.33;95%CI 0.17至0.49;p<0.0001)方面显示出更好的效果,但对生活质量无影响(SMD,0.11;95%CI -0.23至0.46;p = 0.52)。并且没有关于有氧运动对PD随访效果的有效证据。

结论

有氧运动对改善PD患者的运动功能、平衡能力和步态有即时有益效果。然而,鉴于缺乏随访效果的证据,需要进行大规模、长期随访的RCT来证实目前的研究结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9f1/4077570/32f121b01e0e/pone.0100503.g001.jpg

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