School of Medicine, Griffith University , Gold Coast, QLD , Australia.
School of Medicine, Griffith University, Gold Coast, QLD, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia.
Front Med (Lausanne). 2016 Aug 17;3:35. doi: 10.3389/fmed.2016.00035. eCollection 2016.
Parkinson's disease (PD) is a neurological disorder that is associated with both motor and non-motor symptoms (NMS). The management of PD is primarily via pharmaceutical treatment; however, non-pharmaceutical interventions have become increasingly recognized in the management of motor and NMS. In this review, the efficacy of physical activity, including physiotherapy and occupational therapy, as an intervention in NMS will be assessed. The papers were extracted between the 20th and 22nd of June 2016 from PubMed, Web of Science, Medline, Ovid, SportsDiscuss, and Scopus using the MeSH search terms "Parkinson's," "Parkinson," and "Parkinsonism" in conjunction with "exercise," "physical activity," "physiotherapy," "occupational therapy," "physical therapy," "rehabilitation," "dance," and "martial arts." Twenty studies matched inclusion criteria of having 10 or more participants with diagnosed idiopathic PD participating in the intervention as well as having to evaluate the effects of physical activity on NMS in PD as controlled, randomized intervention studies. The outcomes of interest were NMS, including depression, cognition, fatigue, apathy, anxiety, and sleep. Risk of bias in the studies was evaluated using the Cochrane Collaboration's tool for assessing risk of bias. Comparability of the various intervention methods, however, was challenging due to demographic variability and methodological differences. Nevertheless, physical activity can positively impact the global NMS burden including depression, apathy, fatigue, day time sleepiness, sleep, and cognition, thus supporting its therapeutic potential in neurodegenerative conditions such as PD. It is recommended that further adequately powered studies are conducted to assess the therapeutic role of physical activity on both motor and non-motor aspects of PD. These studies should be optimally designed to assess non-motor elements of disease using instruments validated in PD.
帕金森病（PD）是一种与运动和非运动症状（NMS）都有关的神经障碍。PD 的治疗主要通过药物治疗；然而，非药物干预在运动和 NMS 的治疗中已得到越来越多的认可。在这篇综述中，将评估体育活动（包括物理治疗和职业治疗）作为 NMS 干预措施的效果。这些论文是在 2016 年 6 月 20 日至 22 日期间，从 PubMed、Web of Science、Medline、Ovid、SportsDiscuss 和 Scopus 中提取的，使用了 MeSH 搜索词“Parkinson's”、“Parkinson”和“Parkinsonism”，并与“exercise”、“physical activity”、“physiotherapy”、“occupational therapy”、“physical therapy”、“rehabilitation”、“dance”和“martial arts”相结合。有 20 项研究符合纳入标准，即有 10 名或更多被诊断为特发性 PD 的参与者参加干预，并将评估体育活动对 PD 中 NMS 的影响作为对照、随机干预研究。感兴趣的结果是 NMS，包括抑郁、认知、疲劳、淡漠、焦虑和睡眠。研究的偏倚风险使用 Cochrane 协作组评估偏倚风险的工具进行评估。然而，由于人口统计学的变异性和方法学的差异，各种干预方法的可比性具有挑战性。尽管如此，体育活动可以积极影响包括抑郁、淡漠、疲劳、白天嗜睡、睡眠和认知在内的整体 NMS 负担，从而支持其在 PD 等神经退行性疾病中的治疗潜力。建议进行进一步的充分-powered 研究，以评估体育活动对 PD 的运动和非运动方面的治疗作用。这些研究应优化设计，使用在 PD 中验证过的仪器评估疾病的非运动元素。
