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抗阻运动对无动僵直期帕金森病患者的影响:一项随机对照试验。

Effects of progressive resistance exercise in akinetic-rigid Parkinson's disease patients: a randomized controlled trial.

机构信息

University School of Sports Medicine, University of Oviedo, Oviedo, Spain -

Performance and Health Group, Department of Physical Education and Sport, Faculty of Sports Sciences and Physical Education, University of A Coruña, A Coruña, Spain -

出版信息

Eur J Phys Rehabil Med. 2017 Oct;53(5):651-663. doi: 10.23736/S1973-9087.17.04572-5. Epub 2017 Mar 13.

Abstract

BACKGROUND

Progressive resistance exercise (PRE) can have a positive effect in individuals with Parkinson's disease (PD). However, the effect of PRE may vary with the clinical subtype of PD. To date, no study has assessed the effects of PRE in the different subtypes of PD.

AIM

The aim of the present study was to assess the effects of PRE in PD patients with akinesia and rigidity (AR-subtype).

DESIGN

A randomized controlled trial was conducted.

SETTING

Outpatients clinics of the Bierzo Parkinson Association (Ponferrada, Spain) and the Asturias Parkinson Association (Oviedo, Spain).

POPULATION

Twenty-eight patients with AR-subtype PD were randomized into an Experimental Group (EG, N.=13) and Control Group (CG, N.=15).

METHODS

Static posturography (Centre of Pressure -CoP- parameters), gait (the Ten-Meter Walk Test [TMWT]), freezing of gait (the Freezing of Gait Questionnaire [FOG-Q]), the motor portion of the Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and patient-perceived quality of life (the 39-item Parkinson's disease Questionnaire [PDQ39]), were assessed at pre-test, post-test, and re-test. Ratings of perceived exertion (RPE) (Borg >6-20 Scale) were recorded at the end of each PRE training session.

RESULTS

The EG displayed significant ameliorations in Length (CoP parameters) from pre- to post-test (P=0.048), in speed of fast rhythm walking (TMWT) from pre- to post-test (P=0.000), and from pre- to re-test (P=0.027), and in the PDQ39 Score from pre- to post-test (P=0.024). No significant differences were detected in Area or Speed (CoP parameters), speed of preferred rhythm walking (TMWT), FOG-Q scores, or the motor portion of the MDS-UPDRS scores. The EG reported a mean RPE of 9.95 (between "very light" and "fairly light") for the whole training program.

CONCLUSIONS

These findings provide support for the use of PRE training in the rehabilitation of individuals with AR-subtype PD, as it can improve static posturography, gait, and quality of life. Furthermore, RPE scores showed that individuals with AR-subtype PD consider that PRE training require only light efforts.

CLINICAL REHABILITATION IMPACT

The PRE training can be a helpful and fruitful rehabilitation tool for AR-subtype PD patients.

摘要

背景

渐进式抗阻运动(PRE)对帕金森病(PD)患者可能有积极影响。然而,PRE 的效果可能因 PD 的临床亚型而异。迄今为止,尚无研究评估 PRE 在 PD 不同亚型中的作用。

目的

本研究旨在评估 PRE 对帕金森病伴运动不能和僵硬(AR 亚型)患者的影响。

设计

随机对照试验。

地点

比耶佐帕金森协会(西班牙蓬费拉达)和阿斯图里亚斯帕金森协会(西班牙奥维耶多)的门诊诊所。

人群

28 名 AR 亚型 PD 患者被随机分为实验组(EG,n=13)和对照组(CG,n=15)。

方法

静态姿势描记术(压力中心 -CoP- 参数)、步态(十米步行测试 [TMWT])、步态冻结(步态冻结问卷 [FOG-Q])、运动障碍协会统一帕金森病评定量表的运动部分(MDS-UPDRS)和患者感知的生活质量(帕金森病问卷 39 项 [PDQ39]),在预测试、后测试和再测试时进行评估。在每次 PRE 训练结束时,记录感知用力程度(RPE)(Borg >6-20 量表)。

结果

EG 在从预测试到后测试的 CoP 参数的长度(P=0.048)、从预测试到后测试的快速节奏行走速度(TMWT)(P=0.000)和从预测试到再测试的速度(P=0.027)以及 PDQ39 评分从预测试到后测试(P=0.024)都有显著改善。CoP 参数的面积或速度、首选节奏行走速度(TMWT)、FOG-Q 评分或 MDS-UPDRS 运动部分评分均无显著差异。EG 报告整个训练计划的平均 RPE 为 9.95(介于“非常轻”和“相当轻”之间)。

结论

这些发现为在 AR 亚型 PD 患者的康复中使用 PRE 训练提供了支持,因为它可以改善静态姿势描记术、步态和生活质量。此外,RPE 评分表明 AR 亚型 PD 患者认为 PRE 训练只需要轻微的努力。

临床康复影响

PRE 训练可以成为 AR 亚型 PD 患者有益且富有成效的康复工具。

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