Kaut Oliver, Brenig Daniel, Marek Milena, Allert Niels, Wüllner Ullrich
Department of Neurology, University of Bonn, 53105 Bonn, Germany.
Neurological Rehabilitation Center, Godeshoehe, 53117 Bonn, Germany.
Parkinsons Dis. 2016;2016:7948721. doi: 10.1155/2016/7948721. Epub 2016 Jan 26.
Background. Postural instability in Parkinson's disease (PD) increases the risk of falls and is not improved by pharmacological therapy. Objective. We performed a double-blind, randomized sham-controlled study to test the effects of stochastic resonance (whole body vibration) therapy on postural stability in PD. Methods. Fifty-six PD participants were allocated to either experimental or sham groups. The experimental group received four series of vibration over eight days, with each series consisting of six stimulus trains of 60-second duration using a randomized whole body vibration. Participants allocated to the control group received a sham treatment. Results. Within-group analysis revealed that postural stability in the experimental group improved by 17.5% (p = 0.005) comparing experimental and sham groups. The between-group analysis of change after treatment comparing both groups also showed a significant improvement of postural stability (p = 0.03). Only in the within-group analysis several items were improved after Bonferroni correction, too, rigor 41.6% (p = 0.001), bradykinesia 23.7% (p = 0.001), tremor 30.8% (p = 0.006), and UPDRSIII sum score 23.9% (p = 0.000), but did not reach the level of significance in the between-group analysis. Conclusions. Stochastic resonance therapy significantly enhanced postural stability even in individuals with increased risk of falling. Thus it offers a potential supplementation to canonical treatments of PD.
背景。帕金森病(PD)中的姿势不稳会增加跌倒风险,且药物治疗无法改善。目的。我们进行了一项双盲、随机假对照研究,以测试随机共振(全身振动)疗法对PD患者姿势稳定性的影响。方法。56名PD参与者被分配到实验组或假对照组。实验组在八天内接受四组振动,每组由六次持续60秒的刺激序列组成,采用随机全身振动。分配到对照组的参与者接受假治疗。结果。组内分析显示,实验组的姿势稳定性提高了17.5%(p = 0.005),比较实验组和假对照组。两组治疗后变化的组间分析也显示姿势稳定性有显著改善(p = 0.03)。仅在组内分析中,经Bonferroni校正后,几个项目也有所改善,僵直改善41.6%(p = 0.001),运动迟缓改善23.7%(p = 0.001),震颤改善30.8%(p = 0.006),统一帕金森病评定量表III总分改善23.9%(p = 0.000),但在组间分析中未达到显著水平。结论。随机共振疗法即使在跌倒风险增加的个体中也能显著增强姿势稳定性。因此,它为PD的传统治疗提供了一种潜在的补充。