Dipasquale Savina, Meroni Roberto, Sasanelli Francesco, Messineo Ivan, Piscitelli Daniele, Perin Cecilia, Cornaggia Cesare Maria, Cerri Cesare G
School of Medicine and Surgery, University of Milano Bicocca, Monza, Italy.
Department of Neurology, AO Melegnano, Italy.
J Parkinsons Dis. 2017;7(1):203-210. doi: 10.3233/JPD-161015.
Several studies suggest that general exercise (GE) and physical therapy programmes (PT) improve the outcomes of Parkinson's disease (PD) patients; however, the available data do not allow a determination of which treatment is more effective. Our study aims to compare the effects of physiotherapy and general exercise in Parkinson's disease.
Design and setting: Randomized controlled trial -general hospital outpatient clinic. The participants were patients with Hoehn Yahr stage II PD. Two randomized groups: one receiving PT and one receiving GE. The outcome measures were the FIM, Hamilton Rating Scale, TUG test, and UPDRS.
FIM median scores improved by 3 points in the PT group after treatment, and the improvements were maintained at follow-up. The GE FIM median scores were unchanged after treatment and were reduced by 1 point at follow-up (p < 0.05). The TUG test time was reduced in the PT group but increased in the GE group with a 3-second difference between groups at follow-up, suggesting improved functional mobility after specific physiotherapy (p < 0.05). The UPDRS median score change from baseline was significantly different between the two groups at the end of treatment (6.5 points) and at follow-up (11 points), with a benefit for the physiotherapy group.
Physiotherapy seems to be more effective than a generic exercise programme in patients with Hoehn Yahr stage II PD.
多项研究表明，全身运动（GE）和物理治疗方案（PT）可改善帕金森病（PD）患者的治疗效果；然而，现有数据无法确定哪种治疗方法更有效。我们的研究旨在比较物理治疗和全身运动对帕金森病的影响。
设计与设置：随机对照试验——综合医院门诊。参与者为Hoehn Yahr II期PD患者。两个随机分组：一组接受PT，另一组接受GE。结局指标为功能独立性测量（FIM）、汉密尔顿评定量表、定时起立步行试验（TUG）和统一帕金森病评定量表（UPDRS）。
治疗后，PT组FIM中位数得分提高了3分，且在随访时保持改善。GE组FIM中位数得分在治疗后未改变，随访时降低了1分（p<0.05）。PT组的TUG试验时间缩短，而GE组延长，随访时两组相差3秒，表明特定物理治疗后功能移动性有所改善（p<0.05）。治疗结束时（6.5分）和随访时（11分），两组UPDRS中位数得分与基线相比的变化有显著差异，物理治疗组更具优势。
对于Hoehn Yahr II期PD患者，物理治疗似乎比一般运动方案更有效。
