Cugusi Lucia, Solla Paolo, Zedda Francesca, Loi Martina, Serpe Roberto, Cannas Antonino, Marrosu Francesco, Mercuro Giuseppe
Department of Medical Sciences "M. Aresu", University of Cagliari, Cagliari, Italy Adapted Physical Activity Master Degree Course, University of Cagliari, Cagliari, Italy.
Movement Disorders Center, Institute of Neurology, University of Cagliari, Cagliari, Italy Adapted Physical Activity Master Degree Course, University of Cagliari, Cagliari, Italy.
NeuroRehabilitation. 2014;35(4):789-94. doi: 10.3233/NRE-141162.
Several studies have clearly shown that strategies of health promotion, such as fitness and general exercise programs, may improve quality of life (QoL), motor and non-motor functions in Parkinson's disease (PD) patients. However, little is known about the effects of specific Adapted Physical Activity (APA) programs on PD patients.
To determine the effects of an APA program on motor and non-motor symptoms, functional performances and QoL in PD patients.
Nine consecutive PD patients (5 men, 4 women, 64.4 ± 6.8 years) able to ambulate independently (Hoehn and Yahr: from stage 1 to 3) and not demented, were enrolled. Patients performed an APA program, 3 sessions/week, for 9 weeks. Exercises focused on balance, walking, strength and functional activities. Functional effects were assessed by Six Minute Walking Test (6MWT), Five Time Sit to Stand Test (FTSST), Berg Balance Scale (BBS), Sit and Reach Test (SRT), and Timed Up and Go test (TUG). Motor impairment and disability were assessed using the Unified Parkinson's Disease Rating Scale - part III (UPDRS-III) and the Hoehn and Yahr Scale, respectively. Non-motor symptoms were evaluated by PD Fatigue Scale (PFS), Beck Depression Inventory II (BDI-II) and PD Quality of life scale, 8 items (PDQ-8).
A significant decrease in resting HR (67.55 ± 10.85 vs 70.22 ± 12.34 bpm, p < 0.05) and a significant increase in walked distance (p < 0.0005) were observed. A significant impairment of the muscles strength was noted (FTSST, p < 0.05). BBS showed a significant increase in balance abilities (p < 0.0005) and safety with mobility (TUG, p < 0.005) was enhanced. Finally, a significant improvement in motor and non-motor symptoms was detected: UPDRS-III (p < 0.00005), PFS (p < 0.005), BDI-II (p < 0.05) and PDQ-8 (p < 0.05).
A tailored exercise program in PD patients could be effective as an adjunct to conventional therapy on improving daily activities, motor and non-motor symptoms, with better QoL.
多项研究已明确表明，健康促进策略，如健身和常规运动计划，可能改善帕金森病（PD）患者的生活质量（QoL）、运动和非运动功能。然而，关于特定的适应性身体活动（APA）计划对PD患者的影响知之甚少。
确定一项APA计划对PD患者运动和非运动症状、功能表现及生活质量的影响。
连续纳入9例能够独立行走（Hoehn和Yahr分期：1至3期）且无痴呆的PD患者（5例男性，4例女性，64.4±6.8岁）。患者每周进行3次APA计划，共9周。运动重点为平衡、行走、力量和功能活动。通过六分钟步行试验（6MWT）、五次坐立试验（FTSST）、伯格平衡量表（BBS）、坐位体前屈试验（SRT）和计时起立行走试验（TUG）评估功能效果。分别使用统一帕金森病评定量表第三部分（UPDRS-III）和Hoehn和Yahr量表评估运动障碍和残疾情况。通过PD疲劳量表（PFS）、贝克抑郁量表第二版（BDI-II）和8项PD生活质量量表（PDQ-8）评估非运动症状。
观察到静息心率显著降低（67.55±10.85对70.22±12.34次/分钟，p<0.05），步行距离显著增加（p<0.0005）。注意到肌肉力量有显著损害（FTSST，p<0.05）。BBS显示平衡能力显著提高（p<0.0005），移动安全性（TUG，p<0.005）增强。最后，检测到运动和非运动症状有显著改善：UPDRS-III（p<0.00005）、PFS（p<0.005）、BDI-II（p<0.05）和PDQ-8（p<0.05）。
针对PD患者量身定制的运动计划作为传统治疗的辅助手段，在改善日常活动、运动和非运动症状以及提高生活质量方面可能是有效的。
