Vallabhajosula Srikant, McMillion Amy K, Freund Jane E
a Department of Physical Therapy Education, School of Health Sciences , Elon University , Elon , NC , USA.
Physiother Theory Pract. 2017 Dec;33(12):920-931. doi: 10.1080/09593985.2017.1359867. Epub 2017 Aug 16.
Parkinson's disease (PD) commonly impairs posture, gait, and cognition. Exercise in the form of aerobic activity as well as exergaming may improve motor ability and cognition in persons with PD. Exergaming and treadmill training can be a practical form of exercise within the home; however, there is minimal research on this combined multimodal intervention for persons with PD.
We investigated the effects of this combined intervention on cognition, balance, and gait in a person with PD through supervised lab sessions augmented by home-based sessions.
This case study utilized an ABA single subject experimental design with 4 weeks of pre-intervention, followed by 8 weeks of intervention, and 4 weeks of post-intervention. The intervention consisted of treadmill walking and Xbox Kinect exergaming, 30 minutes each, performed unsupervised at home and at supervised lab sessions. The two standard deviation band method was used to determine significance.
MiniBEST test, 2-minute walk distance, sway area, endurance test, and a few parameters of gait initiation and gait improved significantly throughout the intervention period. Only a few measures sustained the improvement 4 weeks after completion of intervention.
Eight weeks of treadmill and exergaming intervention with a person with PD improved static and dynamic postural control measures, but not gait, cognition, endurance, and clinical measures of balance. Longer and more intense multimodal intervention may be warranted.
帕金森病（PD）通常会损害姿势、步态和认知能力。有氧运动以及运动游戏形式的锻炼可能会改善帕金森病患者的运动能力和认知能力。运动游戏和跑步机训练可以成为在家中进行锻炼的一种实用形式；然而，针对帕金森病患者的这种联合多模式干预的研究极少。
我们通过以家庭训练为辅的监督性实验室训练课程，研究了这种联合干预对一名帕金森病患者的认知、平衡和步态的影响。
本案例研究采用ABA单受试者实验设计，包括4周的干预前阶段，随后是8周的干预阶段，以及4周的干预后阶段。干预包括跑步机行走和Xbox Kinect运动游戏，各30分钟，在家中无监督进行以及在监督性实验室训练课程中进行。采用双标准差带法来确定显著性。
在整个干预期内，MiniBEST测试、2分钟步行距离、摆动面积、耐力测试以及一些步态起始和步态参数均有显著改善。干预结束4周后，只有少数指标维持了改善效果。
对一名帕金森病患者进行为期8周的跑步机和运动游戏干预，改善了静态和动态姿势控制指标，但未改善步态、认知、耐力和平衡的临床指标。可能需要更长时间和更强化的多模式干预。
