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帕金森病患者的部分体重支持跑步机训练:对步态和临床表现的影响

Partial Body Weight-Supported Treadmill Training in Patients With Parkinson Disease: Impact on Gait and Clinical Manifestation.

作者信息

Ganesan Mohan, Sathyaprabha Talakad N, Pal Pramod Kumar, Gupta Anupam

机构信息

Department of Neurophysiology, National Institute of Mental Health and Neurosciences, Bangalore, India; Department of Physical Therapy, College of Applied Health sciences, University of Illinois, Chicago, IL.

Department of Neurophysiology, National Institute of Mental Health and Neurosciences, Bangalore, India.

出版信息

Arch Phys Med Rehabil. 2015 Sep;96(9):1557-65. doi: 10.1016/j.apmr.2015.05.007. Epub 2015 May 23.

Abstract

OBJECTIVE

To evaluate the effect of conventional gait training (CGT) and partial weight-supported treadmill training (PWSTT) on gait and clinical manifestation.

DESIGN

Prospective experimental research design.

SETTING

Hospital.

PARTICIPANTS

Patients with idiopathic Parkinson disease (PD) (N=60; mean age, 58.15±8.7y) on stable dosage of dopaminomimetic drugs were randomly assigned into the 3 following groups (20 patients in each group): (1) nonexercising PD group, (2) CGT group, and (3) PWSTT group.

INTERVENTIONS

The interventions included in the study were CGT and PWSTT. The sessions of the CGT and PWSTT groups were given in patient's self-reported best on status after regular medications. The interventions were given for 30min/d, 4d/wk, for 4 weeks (16 sessions).

MAIN OUTCOME MEASURES

Clinical severity was measured by the Unified Parkinson Disease Rating Scale (UPDRS) and its subscores. Gait was measured by 2 minutes of treadmill walking and the 10-m walk test. Outcome measures were evaluated in their best on status at baseline and after the second and fourth weeks.

RESULTS

Four weeks of CGT and PWSTT gait training showed significant improvements of UPDRS scores, its subscores, and gait performance measures. Moreover, the effects of PWSTT were significantly better than CGT on most measures.

CONCLUSIONS

PWSTT is a promising intervention tool to improve the clinical and gait outcome measures in patients with PD.

摘要

目的

评估传统步态训练(CGT)和部分体重支撑跑步机训练(PWSTT)对步态及临床表现的影响。

设计

前瞻性实验研究设计。

地点

医院。

参与者

正在服用稳定剂量多巴胺模拟药物的特发性帕金森病(PD)患者(N = 60;平均年龄,58.15±8.7岁)被随机分为以下3组(每组20例患者):(1)非运动性PD组,(2)CGT组,(3)PWSTT组。

干预措施

本研究中的干预措施包括CGT和PWSTT。CGT组和PWSTT组的训练课程在患者自述常规服药后状态最佳时进行。干预措施为每天30分钟,每周4天,共4周(16节课程)。

主要观察指标

采用统一帕金森病评定量表(UPDRS)及其子评分来衡量临床严重程度。通过跑步机行走2分钟和10米步行测试来测量步态。在基线时以及第二周和第四周后,在患者状态最佳时评估观察指标。

结果

四周的CGT和PWSTT步态训练显示UPDRS评分、其子评分以及步态表现指标有显著改善。此外,在大多数指标上,PWSTT的效果明显优于CGT。

结论

PWSTT是一种有前景的干预工具,可改善PD患者的临床和步态观察指标。

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